Thread: Georgia leads U.S. to immigration changes

http://msnbc.msn.com/id/13140025/

Georgia leads U.S. to immigration changes
By Erin Moriarty
Atlanta Business Chronicle


Updated: 5:00 p.m. PT June 4, 2006
Two Georgia congressmen are stirring things up in the national debate on illegal immigration with new federal legislation requiring patients to show proof of citizenship in order to receive Medicaid.

U.S. Reps. Charlie Norwood and Nathan Deal, both Georgia Republicans, drafted the new law, which takes effect July 1. It is part of the Deficit Reduction Act, which was signed into law by President George W. Bush in February.

Georgia is one of just a few states that requires immigrants to prove that they're here legally before they get Medicaid, the government program that provides health care to people who are poor, elderly or disabled.

Under the new law, health-care providers and health officials in every state will have to make sure each applicant has proof of citizenship.

"People have been signed up for Medicaid and not really checked to see whether they are citizens or not," Norwood said. "The taxpayers, in my district at least, are willing to help people in need, but they are not willing to spend money on people coming here illegally."

Forty-five of the 50 U.S. states do not verify citizenship on Medicaid applications, according to the congressmen, who spent several years working on the legislation. Georgia began requiring Medicaid applicants to prove their citizenship on Jan. 1.

"Although much of what has to be done on immigration is a federal issue, there are issues like this that states can take the initiative on," Deal said. "Unless we have the enforcement of the immigration law itself, then we are going to continue to allow these spinoff problems, such as this one with Medicaid, to be the thorn in our flesh."

Norwood says it's important to restrict illegal immigrants' access to Medicaid in order to make sure the already-burdened system is available to needy Americans.

"I have a lot of constituents on Medicaid and some of the benefits have been reduced over the years because of funding," Norwood said. "If this helps restore or protect some of those services for American citizens, then this is a very good thing."

Norwood's colleagues also believes the new law is needed to prevent health-care providers from making money illegally by caring for people who are not eligible for Medicaid. Currently, many states simply ask immigrants whether they are U.S. citizens before giving them Medicaid, rather than requiring any documents to prove it.

But the new law is causing a stir in the health-care community nationwide because many health-care providers worry that it will prevent some eligible citizens from getting Medicaid and force hospitals to pick up more of the tab for caring for immigrants. The American Hospital Association and seven other national health-care groups have sent letters to Mike Leavitt, secretary of the U.S. Department of Health and Human Services, pleading for the "maximum flexibility" in enforcing the new law.

"The impact is certainly going to vary depending on how financially healthy the hospital is," said Carla Luggiero, senior associate director for federal relations at the American Hospital Association. "Many of the rural hospitals are operating on the cusp or in the red, and this will exacerbate that."

Under a federal law known as EMTALA (the Emergency Medical Treatment & Labor Act), hospitals are legally required to treat and stabilize anyone who shows up in the emergency room and cannot pay -- regardless of whether the patient is a citizen or an illegal immigrant.

But hospital officials say the number of illegal immigrants showing up in emergency rooms continues to rise, putting a financial strain on hospitals. Hospitals also face the challenge of illegal immigrants arriving in emergency rooms with conditions that might not be medical emergencies.

Norwood acknowledges the rumblings from the medical community, and says he thinks it's time to consider revising EMTALA.

"I think the hospitals have a very legitimate complaint," he said. "It's one thing to take care of someone in an emergency situation, but it's another to have them come through the emergency rooms with chronic conditions."

Deal agrees.

"As long as hospitals are required to take people in their ER and as long as they have no protection for liability in diverting people to a non-emergency facility, then they really do have a problem," he said.

Meanwhile, another congressman, Arizona Republican Rick Renzi, is lobbying to weaken the new law.

Renzi argues the changes will harm Arizona's large population of Native Americans, who usually don't have birth certificates. He also points out the challenges of verifying eligibility for the elderly and those with Alzheimer's disease who haven't had a driver's license in years and don't know where their birth certificates are.

"We must avoid an environment where individuals may not seek needed care because they lack appropriate documents," Renzi wrote in a letter to Leavitt in May. "[That] could ultimately have a negative impact on our public health system."

But Norwood says the legislation is plenty lenient enough to take into account unusual circumstances. For example, an elderly person without a valid ID can use two blood relatives who are citizens to vouch for the person's citizenship.

"I think anyone asking us to pay for their health care in this country -- and very good health care it is -- should be asked to identify themselves," Norwood said.

Good for Georgia, more states should follow!!!

As for Rick Renzi, I doubt he's worried about the Native Americans, he's probably more concerned with the "so called rights" of illegal aliens.