Thread: PA-Footing the bill for undocumented immigrants

Footing the bill for undocumented immigrants
By: JO CIAVAGLIA

Taxpayers footed a $25.3 million bill in 2007-08 to pay for emergency health care for non-citizens in Pennsylvania. Tax-funded subsidies of $2 million went to seven area hospitals.

While U.S. lawmakers seek to exclude illegal immigrant from proposed national health care reform plans, U.S. taxpayers already cover the medical bills for uninsured and undocumented immigrants.

Pennsylvania hospitals received $25.3 million in 2007-08 for the emergency care for nearly 4,700 noncitizens, including illegal residents, who otherwise would have qualified for government health benefits.

Collectively, seven local hospitals in Bucks and eastern Montgomery counties received nearly $2 million in emergency Medicaid reimbursements that fiscal year, according to the Pennsylvania Department of Welfare.

Abington Memorial Hospital alone received $1.4 million for treating 299 undocumented patients.

Medical treatment of illegal immigrants is among the most emotional issues surrounding the national health care reform debate. In opinion polls most Americans support requiring people prove they are a citizen to receive government health care benefits.

But public health and immigration experts worry excluding undocumented immigrants would put everyone at risk, hamper attempts to prevent the spread of disease and lead to an increase in health care spending.

The major House and Senate bills under consideration both bar undocumented U.S. residents from gaining access to government-paid subsidies designed to make insurance affordable, though only the Senate bill includes an eligibility screening mechanism.

The Senate Finance Committee bill would exclude illegal immigrants from buying insurance in the proposed national insurance exchange market for small businesses and individuals.

How large of a burden illegal immigrants are on the U.S. health care system is unclear since accurate statistics are unavailable and hospitals and clinics don't ask patients about their legal status.

New 2008 Census data estimates 9.5 million uninsured people were "not a citizen," but the number includes legal immigrant workers, visitors and foreign students.

A 2006 RAND study estimated about $1.1 billion in federal, state and local government funds are spent yearly on health services for undocumented adult immigrants under age 65. That is compared with $88 billion in government spending on health care for all nonelderly adults.

The Center for Immigration Studies estimates the cost of treating uninsured illegal immigrants to be $4.3 billion a year, primarily at emergency rooms and free clinics.

The Federation for American Immigration Reform, which opposes illegal immigration, says its research suggests the cost is closer to $11 billion a year, mostly for childbirth and pregnancy-related complications involving so called "anchor babies," the U.S.-born children of illegal immigrants.

Emergency care covered

Immigration activists, though, argue that opponents exaggerate the amount of public health services that illegal residents use. They contend immigrants either lack information about available services through hospitals or public health clinics or they avoid them for fear of being caught and deported.

"Nobody risks their life crossing the border or get in a raft to come here, so if they get sick they can go to the ER," said Leonardo Cuello, director of the Pennsylvania Health Law Project, which advocates for the poor, elderly, disabled and immigrants.

Currently legal immigrants are eligible for Medicaid benefits but only after living in the U.S. for five years, though states can waive the requirement to enroll children into the Children's Health Insurance Program.

But hospital emergency rooms are required to treat everyone regardless of their ability to pay or citizenship status, under a 1986 federal law. An emergency medical condition is considered one with immediate severe symptoms that, without immediate attention, seriously jeopardize a person's life, health or limbs.

Hospitals can be reimbursed for providing emergency treatment to noncitizens - which includes legal immigrants and foreign visitors - who are otherwise eligible for Medicaid, the government health program for the poor and disabled.

Federal Emergency Medicaid funding only covers hospital care until a patient's condition is stabilized. Also, to be reimbursed, hospitals must apply for the coverage on behalf of the patient.

Advertisement As part of the application process, hospitals must document a patient's immigration status, but they can't directly or require the patient show documentation. They can request information like a Social Security number, but the patient's name and address aren't submitted with the paperwork.

In Pennsylvania, health services for illegal immigrants represented less than half a percent of the overall $15 billion Medicaid budget in 2007-08, the most recent year statistics were available.

Most of the Emergency Medicaid money was spent on inpatient hospital care and 56 percent- nearly $14 million - for pregnancy, childbirth and OB-GYN-related services, according to the State Department of Welfare.

The state also receives $1.1 million in federal funding under a separate program within the 2003 Medicare Part D law called Section 1011. The program reimburses hospitals, certain doctors and ambulance services, some, or all, costs for providing emergency health services to illegal immigrants.

As of June, more than 24,000 providers across the United States are enrolled in the Section 1011 program, according to the Centers for Medicare & Medicaid Services. Among local hospitals, only Aria Health System participates, according to the state Department of Public Welfare.

The program authorizes $250 million a year for the payments with one-third of the money earmarked for six border states with the highest illegal immigrant populations; a bipartisan bill currently in Congress (H.R. 1386) calls for making the payments permanent.

Major health issue

The Bucks County Health Improvement Partnership doesn't request information about immigration status from patients treated at its three health clinics, Director Sally Fabian said. The clinics serve uninsured, low-income county residents.

"We sometimes learn about [a patient's] undocumented status incidentally, such as when they don't have a Social Security number," Fabian said. "There is no difference to us in providing care to those who are living here legally or those who are undocumented, since all the care is provided for free."

The Centers for Disease Control and Prevention recently announced it will include illegal immigrants in its national voluntary H1N1 vaccine program, which will get under way later this month.

From a public health standpoint, it would be "absolutely absurd" for public health officials to ignore illegal aliens, said David Barton Smith, a research professor in the Department of Health Management and Policy at the School of Public Health at Drexel University.

"I would be very surprised if many people would disagree. Infectious diseases don't check passports or citizenship papers," Smith said. "Do you want people who have these infectious conditions to hide? They are the people working the kitchens, taking care of children, cleaning houses doing all the things that bring them in close contact with law-abiding citizens."

Illegal immigrants are an integral component of the American economy, working in manufacturing, restaurants, construction and service industry, said Cuello, of the Pennsylvania Health Law Project.

"You have a whole group of people who don't have access to preventative care or care that will reasonably happen before emergency room," he said. "It obviously produces a major health issue for all of us and that is the thing most people ignore."

Not providing preventative health services to illegal aliens could end up costing more in the long-term, Cuello said.

"If a woman tomorrow gives birth to a baby in Pennsylvania, the child is a U.S. citizen," he said. "By not giving her prenatal care, we may have U.S. citizens born with health problems and we'll be liable as a health system."

He added that illegal immigrants exist in every first-world country, and anti-immigrant sentiment rises whenever there is an economic downturn.

"The argument they shouldn't have been here in the first place may be a comforting argument," Cuello added. "The argument they shouldn't be here in the first place, doesn't help you address the reality that we're in."

October 05, 2009 02:10 AM


http://www.phillyburbs.com/news/news_de ... rants.html

And what do the American tax payers get for their investment?

Since they let them stay, we have to pay!

Lack of enforcement of immigration laws has created a financial burden on the American taxpayers. Illegal aliens are here and they are costing us!

The solution is make them leave, and we can spend our money on something else.

Dixie

Originally Posted by ELE

And what do the American tax payers get for their investment?

The middle finger from groups like la raza and their ilk that demand even more rights and privileges for their illegal bretheren that have invaded this country.

That's what we get!

"The argument they shouldn't have been here in the first place may be a comforting argument," Cuello added. "The argument they shouldn't be here in the first place, doesn't help you address the reality that we're in."

Enforcement of existing Laws would!

Added to homepage
http://www.alipac.us/article4563.html