Thread: CA-Illegal imm health care costs state $1 billion annually

Illegal immigrant health care costs state $1 billion annually
By Karen de S

Posted: 09/11/2009 04:40:39 PM PDT


The latest dust-up over President Barack Obama's health care-for-all mission — Sen. Joe Wilson, R-S.C., angrily calling Obama a liar during a nationally televised speech — underscored conservatives' fears that illegal immigrants would benefit from efforts to expand coverage.

Obama insisted that the legislation would not give government subsidies to the nation's millions of undocumented residents. But if immigrant-rich California is any indication, considerable numbers of undocumented immigrants participate in taxpayer-supported health plans.

Although most federal benefit programs bar those who cannot prove their citizenship, California has been more generous than other states. Its taxpayers contribute more than $1 billion annually to cover the health care costs of illegal residents.

The state Department of Health Care Services estimates 768,400 undocumented immigrants will receive coverage this fiscal year through Medi-Cal, the health program funded by state and federal tax money. The cost: $1.2 billion.

Although people without documentation are ineligible for the comprehensive health care other low-income residents receive, the state pays the costs of those who seek emergency room care for life-threatening circumstances and childbirth, based on the presumption that the child will be a citizen.

Another state and federally funded program, Access for Infants and Mothers, serves pregnant women whose income is

slightly higher than Medi-Cal eligibility allows. That program enrolls 12,000 women statewide at a cost of $123 million, according to the Legislative Analyst's Office. Some participants are presumed to be undocumented, said Lisa Murawski, of the analyst's office, although no questions are asked.

According to the most recent estimates by the Public Policy Institute of California, 2.8 million illegal immigrants lived here in 2006 — one-fourth of the nation's total.

But in the context of the state's total population, many say the illegal immigrants constitute a negligible minority.

Actual numbers are difficult to tally. In California, some programs ask about citizenship, and some don't. Emergency rooms here and across the country guarantee care, because federal law bars hospitals from refusing service, regardless of immigration status or ability to pay.

County hospitals in the East Bay say they do not know how many illegal immigrants they serve in their emergency rooms.

In Santa Clara County, the most recent estimate found that about 250 to 300 illegal immigrants a year are admitted to Valley Medical Center after arriving at the emergency department. That would be about 3 percent of the hospital's 10,000 annual emergency room admissions.

"The undocumented cost is not as high as people might imagine," said spokeswoman Joy Alexiou. "The largest number of our folks who come through the emergency department are uninsured either because they lost their jobs or they lost their health insurance."

Several recent studies confirm this, revealing California's uninsured population to be overwhelmingly citizens and other legal residents.

The Henry J. Kaiser Family Foundation reports that "noncitizens are significantly less likely to use the emergency room than citizens" — about 13 percent of those surveyed, compared with 20 percent of citizens. Some stay away for fear of coming into contact with officials who might report them as undocumented.

In a report released last week by the UCLA Center for Health Policy Research, surveyors found that two-thirds of the state's uninsured are U.S. citizens; of 51,000 households surveyed, another 15 percent were permanent legal residents, and 19 percent were noncitizens without green cards.

"This is a population that is obviously not draining down public services, or even private services," said Shana Alex Lavarreda, director of the nonpartisan center's insurance studies. "They're just uninsured."

Contra Costa County this year eliminated basic health care coverage for an estimated 5,500 undocumented immigrants, but many of those clients have been referred to a dozen community clinics funded by a mix of sources, including the federal government.

"We are seeing really dramatic increases in the number of undocumented patients who are referred by the county and booking appointments in our clinics," said Soren Tjernell, a spokesman for the Community Clinic Consortium of Contra Costa.

The clinics turn away no one, said Tjernell, but federal law could — as some lawmakers propose— begin requiring them to check immigrant status. Tjernell said it's a distraction to focus on undocumented immigrants because when they are a relatively small portion of patients who need care.

"When you look at the percentage of the health system that goes to caring for the undocumented, the majority is to emergency care or pregnant women," he said. "It's minimal. ... Immigrants in general tend to be younger, healthier and less likely to go seek services than their counterparts. They're not the drain on the health care system that they're portrayed as being."

Immigrant-rights advocates and public health officials argue that providing basic medical care to all prevents more costly emergency services and stems the spread of infectious disease.

Before it cut the program this summer, Alameda County spent $75,000 over two years so that a nonprofit clinic, Axis Community Health, could treat mostly undocumented day laborers in the Tri-Valley cities of Pleasanton, Livermore and Dublin.

"They said, well, they'll never use that much in east county," said Sue Compton, director of the clinic. "Well, we did, and then some."

About 50 uninsured patients came in each month, said Compton. That's more than expected.

Most day laborers who visited the clinic had never been seen by American nurses or doctors before, even if they had lived here for years, she said.

Critics assert that having health benefits for illegal immigrants entices them into the country and squanders precious public dollars.

The president made clear in his address to Congress this week that he has no intention of making access for the undocumented any easier.

"There are those who claim our reform efforts would insure illegal immigrants — this, too, is false," Obama said, to which Rep. Wilson shouted: "You lie!"

Republican critics do not believe the president when he says his reforms would not apply to those who are here illegally. They note the legislation does not include enforcement mechanisms.

Wilson said Thursday that Democrats defeated GOP efforts to toughen the bill by requiring verification of citizenship.

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Immigrants in general tend to be younger, healthier and less likely to go seek services than their counterparts. They're not the drain on the health care system that they're portrayed as being."

Young, healthy and unable to pay bills, which has caused the closure of many hospitals due to non-payment of bills by those birthing anchor babies.

Exactly Vortex....and one way or another they are going to get medical, be it insurance or via the emergancy room....the only answer is to deport?

Problem is we have no one with the guts to enforce the laws of the land!