VITAL SIGNSrnI M M I G R A T I O NrnWelfareniks of thernWorld Uniternbv Don BarnettrnYuri Petrov (not his real name) immigratedrnto America from tlie SovietrnLhiion ten years ago. Now Yuri wants hisrnmother to move to America, but there isrnone problem. Ihs mother doesn’t wantrnto leae her life and the rest of her familyrnbehind in Russia. Tired of sending monevrnever’ month to Moscow for his mother’srnsupport, Yuri needs to promote thernidea that life would be better for hisrnmother here in the United States. Considerrnthe inducements he can offer hisrnnrother to immigrate. First, there is thern$440 monthly payment called a “pension”rnin the Russian-speaking immigrantrncommunity. This is better known asrnSupplemental Security hicome (SSI) forrnthe indigent elderly and the disabled.rnYuri’s mother would be eligible for SSIrn30 days after arrival. Between 1983 andrn1993, usage of SSI by elderly UnitedrnStates citizens actually declined b)- 25rnpercent while the number of noncitizcnrnimmigrants receiving SSI quadrupled.rnYuri’s mother could live with herrnson and keep this entitlement evenrnthough her son’s family income exceedsrn$100,000, or, as mother and son prefer,rnshe could set up housekeeping on herrnown in a public housing project wherernneady all the residents are recent arrivalsrnfrom the former Soviet Union. Therernshe could get Food Stamps and receivernsubsidized meals prepared under federalrnsenior nutrition programs. As one stafferrnat a federally funded agency to help thernnew arrivals explains, “We plead familyrnreunification in order to immigrate, butrnpromptly split up on arrival to increasernthe benefits stream.” Once establishedrnin America, mother can return for visitsrnwith her other children at the familyrndacha outside Moscow for six monthsrneach year without losing her entitlementrnto benefits in the United States.rnIf this isn’t enough, Yuri hopes thernpromise of practically free lifetime medicalrncare will clinch the deal. Medicaidrnalone carries an $8,000 annual value onrnaverage for the elderiy, and by some reportsrnthe usage of Medicaid is muchrnhigher than average among immigrantsrnfrom the former Soviet Union. Twornphysicians scandalized the immigrantrncommunity bv going public in the Russian-rnlanguage press about Medicaid andrnMedicare fraud in the community. Accordingrnto them, the United States governmentrnis paying for a lot of nonexistentrnhome oxgcn machines and wheelchairsrnin Brighton Beach, Brooklyn (a Soviet-rnAmerican colony). In a series of articlesrnentitled “How Our Immigrants RobrnMedicare and Medicaid,” the physiciansrnclaim that “tons” of medicine obtainedrnfraudulently through Medicaid andrnMedicare circulate on the black marketrnin Moscow. The physicians, who treatrnthe emigre community, report that theirrnaverage Medicaid/Nledicarc patient generatesrnnot the usual $4,000 to $8,000 inrncharges to the government, but morernthan $35,000 each year. Creative uses ofrnMedicaid services have given rise torncomical regulations. For instance, whenrnauditors realized Medicaid was payingrnfor shopping trips to Brighton Beach inrnambulettes, a decree went out forbiddingrnthe transport of clients with shoppingrnbags in the publicly supported vehicles.rnAn ambulette ride from Queens torna “clinic” in neighboring Brooklyn generatesrna bill to Medicaid of $47. Accordingrnto New York Cit’ documents cited by thernphysicians, former Soviets own aboutrnhalf of the ambulette services in Brooklyn.rnYuri’s mother, like most of the newrnarrivals, would not knoyvingly engage inrnoutright fraud, but abuse of the sstem isrnnot an isolated problem. As one of thernphysicians states: “Any pensioner inrnBrighton Beach would be glad to showrnhow to get all you could ever need usingrnyour Medicare or Medicaid card.”rnWere the House Republican welfarernreform bill to pass today, very little of thisrnbenefit analysis would change. For Yurirnis considered a refugee by United Statesrnlaw, and his mother would be joiningrnhim as a refugee. Refugees are exemptrnfrom the cuts proposed in welfare forrnother immigrants. That exemption remainsrnin effect for refugees for six yearsrnafter arrival, that is, until they becomerneligible for citizenship. Upon naturalization,rneligibility for benefits continues onrnthe same basis as it would for anv Americanrncitizen. None of the welfare programsrnnoted above are subject to a usagernlimit. Senior nutrition programs are notrneven means-tested and will remainrnthat way under the proposed changes.rn(When Donald Trump turns 65, he canrnget Meals on Wheels if he wishes.)rnA F D C , the program on which legislatorsrnare determined to show their resolve, isrnabout one-ninth the cost of the variousrnwelfare programs “i’uri’s mother will haverna lifetime entitlement to as soon as shernarrives. (SSI alone exceeds the total ofrnstate and federal costs for AFDC.)rnA recent Health and Human Ser icesrnstudy of refugees from the former SovietrnI’nion who arrived between 1988 andrn1993 (about 250,000) found 59.7 percentrnof the group to be receiving foodrnstamps and about half to be Medicaid recipients.rnTwenty-two percent of refugeernhouseholds in the five-year study grouprnlive in public housing, and an astonisliingrn28 percent of all households in the grouprnhave one or more members receivingrncash assistance through SSI. The Russian-rnlanguage press often criticizes “Wclfarechiks”rnwhom a reporter describes asrn”transported to the phantasmagoricrn’bright future’ of socialism . . . they live inrnlittle Odessas, Lcningrads, and Moscowsrndistinguished from the originals by thernfact that the stores are full and housing,rnfood and medical care really are free.”rnWhile much of the United Statesrnbudget is finally being examined by thernpublic, the cost of refugee support hasrnbeen ignored by the media and politiciansrnalike. Yet, if public assistancerncharges for ongoing refugee support atrnthe local, state, and federal levels arernadded to direct resettlement costs, it isrnlikely that the yearly cost of the refugeernprogram exceeds our entire 1994 foreignrnaid budget of $13.5 billion. That’s assumingrnaverage pcr-rceipient costs, notrnthe hypercosts of fraud. Most of this isrnMARCH 1996/4.3rnrnrn