Thread: CA: Hospitals may absorb $26 million annually in care for un

Hospitals may absorb $26 million annually in care for undocumented



By Tom Kisken

Posted July 3, 2011 at 5:14 p.m.
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Hospitals across California absorb roughly $1.25 billion a year in care for illegal immigrants, including about $26 million in Ventura County, according to a state hospital association supporting a national push for more federal funding for uncompensated care.

Eight general care hospitals in Ventura County charge a total of more than $260 million a year on care for uninsured or under-insured patients that isn't compensated, according to data provided by hospital officials. There are no specific numbers on the portion of uncompensated care spent on illegal immigrants, with hospitals saying they don't track the population. But California Hospital Association leaders estimate about 10 percent of a hospital's uncovered costs come from people without legal status in the United States.

"If they don't have Social Security or photo identification or a Mexican consulate card, if they don't have any of those, we estimate they are undocumented," said Jan Emerson-Shea, vice president of external affairs with the California Hospital Association.

She characterized the $1.25 billion calculation for 2010 as imperfect, offering certainty only on what direction the number is headed.

"It absolutely is growing," she said.

Leaders of the American Hospital Association are pressing the federal government to pay hospitals more for care of illegal immigrants. In a June letter to President Barack Obama, AHA President Richard Umbdenstock noted the federal Emergency Medical Treatment and Active Labor Act compels hospitals to provide emergency care for every patient.

"Yet federal support for hospitals providing these services to the undocumented population is virtually nonexistent," he said, suggesting the financial burden can compromise health care. "Many hospitals have had to curtail services, delay implementing services or close beds."

A 2003 law required the government to provide $250 million a year for four years to compensate hospitals for undocumented care. That funding expired in 2008. The national hospital group wants Obama's immigration reform plans to include what Umbdenstock called "adequate provisions."

"Hospitals should not have to bear the burden," he wrote.

Uncompensated care for illegal immigrants is a huge problem because hospitals are forced to pass on the costs, said U.S. Rep. Dana Rohrabacher, R-Huntington Beach.

"When you see $5 aspirin, it's not $5 aspirin, it's not corruption, it's the hospital trying to take care of the illegal alien who didn't have insurance," Rohrabacher said.

He contends the answer isn't in providing more money for hospitals, but rather in reducing the illegal immigrant population. Rohrabacher unsuccessfully sponsored legislation in 2004 that would have required hospitals receiving federal money to care for illegal immigrants to report those patients to immigration authorities. It's a caveat in which he still believes.

"As long as we're providing benefits, more and more of them will come to get the benefits. You can't blame them for that," he said, then assessing the financial impacts of illegal immigration. "It's bankrupting our country."

There's disagreement in the health care world about the legality of hospitals asking patients about immigration status. Leaders of the American Hospital Association and California Hospital Association said the law allows hospitals to ask patients about immigration status, but few, if any, choose to do so.

"Most hospitals feel it is their mission to take care of anyone coming through the door. They don't want to discourage anyone from care that is needed," said Carla Luggiero, senior associate director for federal relations at the American Hospital Association. "We do not feel it's our job to be pseudo border patrol agents."

In California, some government assistance is available for undocumented care for hospitals providing care that encompasses emergency rooms, prenatal needs and limited treatment related to breast and cervical cancer. Anthony Cava, a spokesman for the California Department of Health Care Services, said about $1.3 billion was spent in state and federal Medi-Cal money on care for the undocumented in California last year.

But the uncompensated care for illegal immigrants grew from $1.05 billion in 2007 to $1.25 billion last year, according to the California Hospital Association's calculations. It's not as big a financial drain as low government reimbursement rates for Medicare and Medi-Cal, but it contributes to hospital's financial burdens, said Emerson-Shea.

In Ventura County, hospitals say it's impossible to pinpoint costs of their care for illegal immigrants.

Dr. Robert Gonzalez, director of the Ventura County Health Care Agency, estimated total uncompensated care for the county hospital system at about $114 million in the 2009-10 fiscal year. He said the 10 percent calculation is far too low, noting a state-funding formula calculates the percentage at nearly 18 percent — or about $20 million of care for the undocumented.

County hospital leaders say providing care for people who have nowhere else to go, regardless of where they come from, is at the core of their mission — a reality around which they've built the financial support for their system. They argue that not providing care jeopardizes public health by increasing the risk of contagious disease like tuberculosis. Blocking access delays treatment until it's life or death and exponentially more expensive, said Gonzalez.

As a public hospital designed to serve the under-insured and uninsured, the county qualifies for some government compensation for care of the undocumented, but that doesn't nearly cover all the costs, Gonzalez said.

"It hurts us, too, but we've gotten used to the pain," he said.

Officials at St. John's Regional Medical Center in Oxnard and St. John's Pleasant Valley Hospital in Camarillo reported they absorbed about $58 million in total uncompensated care in the last 12 months. That translates into nearly $6 million for care of illegal immigrants, according to the California Hospital Association's calculations.

All of the uncompensated costs make it harder for hospitals to break even, said Laurie Eberst, St. John's CEO. The Oxnard hospital ended the fiscal year close to $1 million in the red, although the Camarillo hospital generated enough profit to push revenues into the black, Eberst said.

"Obviously I'm very much in favor of getting more financial support," she said, suggesting reimbursement that undercuts the cost of care is a huge problem. "We've got to turn it around so we have a health system that compensates at a reasonable cost."

Rohrabacher said the solution is fewer illegal immigrants.

U.S. Rep. Lois Capps, D-Santa Barbara, thinks the answer is coming up with an immigration reform solution that provides a pathway for undocumented people to become legal residents.

If the White House and Congress come up with a plan for more funding for hospitals, it means taxpayers will be hit, Capps said. But if there's not more funding, insurance premiums will rise as hospitals try to pass on their uncompensated costs.

"Taxpayers end up paying no matter what," she said.

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Illegals are BREAKING my state as we speak. 5 million of em and they all vote. Pissing me off to no end.

"Hospitals should not have to bear the burden," he wrote.

Neither should taxpayers.

Leaders of the American Hospital Association are pressing the federal government to pay hospitals more for care of illegal immigrants. In a June letter to President Barack Obama, AHA President Richard Umbdenstock noted the federal Emergency Medical Treatment and Active Labor Act compels hospitals to provide emergency care for every patient.

Pressing the federal government to pay hospitals MORE for illegal invader care! Where does this idiot think that "federal money" comes from? I do not want my federal tax dollars going to pay for providing health care to illegal invaders!

Instead of asking the federal government (aka taxpayers) for more money, how about we enforce our immigration laws! It's an absolute outrage that an illegal invader can walk into any hospital and receive treatment for free, while an American citizen would be required to present documentation, in order to secure payment from them - no matter how poor they might be!

Another example of illegal invaders receiving preferential treatment, while Americans go without!

This is exactly the reason we are broke. The media lies to help both parties tout the economy as the most important issue. Well, folks this is what happened to our economy. To fix the economy all we need to do is get rid of the illegals and our economy would improve greatly. But you will not hear that from the media, they are in bed with the political parties.

RELATED

As many as 220,000 uninsured children in California will be excluded from health care reform programs because of their or their parents’ immigration status, according to an analysis released Thursday. [CaliforniaWatch]

http://www.alipac.us/ftopict-242454.html