Thread: For illegal immigrants: The doctor is out

http://www.gazette.com/display.php?id=1320685

August 20, 2006

For illegal immigrants: The doctor is out

Critics say new laws trade prevention for emergency care, and will punish some here legally

By PERRY SWANSON - THE GAZETTE

Colorado and federal lawmakers have launched an unprecedented effort to stop illegal immigrants from receiving tax-supported health care — everything from birth control to cancer screenings.

New laws have come in response to a widespread opinion that illegal immigrants take advantage of benefits they are not entitled to, benefits funded by U.S. taxpayers and benefits some fear are out of reach to themselves as medical costs soar.

But those new laws also raise questions about how far this movement might go:

- Could we deny all medical treatment to illegal immigrants?

- Should we?

- And


how would that affect everyone, legal and illegal alike?

No one knows how many illegal immigrants are here — estimates range up to 20 million —or how much tax-supported health care they receive.

But one thing is clear: No one is going to stop them from receiving emergency care any time soon.

“That would be inhumane, and it would be against the Hippocratic oath that physicians take,” said Chris Nevin-Woods, a doctor and director of the Pueblo City-County Health Department.

“It might be easy for politicians to tell health care workers that they can’t take care of immigrants and their families. That’s because they’re not standing in the emergency room door or the medical office door.”

Some activists have urged that even emergency care be denied to illegal immigrants to discourage them from coming to the United States. But federal law says hospitals must provide such treatment to anyone, re- gardless of immigration status.

“That really just reflects, I think, our basic sense of what it means to be a person, and the obligations we owe each other as human beings,” said Elizabeth Arenales, an attorney who studies the issue for the Colorado Center on Law and Policy.

“What are we going to do for people who face absolute emergencies? Are we going to let them die?”

Many illegal immigrants already avoid getting care from government offices because they fear being caught and deported, Nevin-Woods said. This month, Pueblo health workers struggled to locate a family that was thought to have been exposed to tuberculosis, a contagious disease that infected 14,517 people nationwide in 2004.

The law lets health agencies investigate disease outbreaks without verifying the immigration status of people that officials contact. But many illegal immigrants try to avoid any contact with the government.

“People will be frightened to check to see if they’re even eligible, because they feel once anyone in government finds out who they are, they’ll be deported,” Nevin-Woods said. “We’ll never know for sure, but we had a hard time finding the family. One wonders whether they’re just afraid to get back with us.”

Some worry that efforts to restrict medical care could have unintended consequences, such as encouraging the spread of disease and denying health care to U.S. citizens who lack the paperwork to prove citizenship. Experts also express concern that the efforts might not save much in tax money and could backfire in the form of higher long-term health costs.

In the United States, nearly 46 million people lacked health insurance in 2004. That was an increase of 12.4 million people since 1990.

The Center for Immigration Studies, a think tank that supports tighter immigration rules, said nearly threequarters of the increase was from legal and illegal immigrants, plus their U.S.-born children.

“The nation’s health insurance crisis is, to a large extent, being driven by its immigration policy,” said a study the center issued in December, written by Steven Camarota.

Those without insurance — U.S. citizens or not — find ways to cope. Sometimes, they do without medical care or seek it from hospital emergency rooms when a condition becomes too serious to ignore.

Millions of people, too, rely on taxsupported health programs such as Medicaid and locally run health agencies that provide services such as screening for cancer.

Two measures went into effect recently that aim to stop those services from reaching illegal immigrants: a state law on Aug. 1 and a federal law on July 1.

The centerpiece of several new laws at the state level is House Bill 1023, passed during a July special session of the state Legislature. It says that starting Aug. 1, anyone who receives government benefits must show proof they’re in Colorado legally.

The law says applicants can prove legal status by showing a Colorado driver’s license or ID card, a military ID or an American Indian tribal document. Applicants also must sign an affidavit swearing they are U.S. citizens or legally present in the country.

The rule has several exceptions. It doesn’t apply to children, for example, and it says health agencies must still provide health care required by federal law.

That leaves several health programs that will be denied to illegal immigrants. In El Paso County, the Department of Health and Environment said it will start checking the immigration status of clients in its Nurse Family Partnership program, which has nurses visiting low-income pregnant women at home. The program had 169 clients on Aug. 1, but it’s unknown how many were illegal immigrants.

A second affected program in El Paso County is the Colorado Women’s Cancer Control Initiative, which provides checks for breast and cervical cancer to low-income women. That program had 675 women enrolled as of June 29.

Another affected program administered by the state Health Department gives money for early detection of cancer, cardiovascular and pulmonary diseases.

Early identification of health problems, especially heart disease, might save money by preventing the need for emergency treatment later, said Colorado’s chief medical officer, Dr. Ned Calonge, during testimony to state lawmakers July 6.

But identifying the potential for long-term savings is less important now than complying with the new rules, said Rosemary Bakes-Martin, El Paso County’s public health administrator. Bakes-Martin said early treatment of medical problems for illegal immigrants might save more costly emergency care later, but “our approach is to follow the law.”

Many health providers are still sorting out how the law affects them, setting compliance policies and studying how the law might jibe with legal requirements at the federal level. Hospitals are among the biggest providers of health care to illegal immigrants, but no one knows how much money they spend on them.

The Government Accountability Office, the investigative arm of Congress, tried to measure how illegal immigrants contribute to the financial burden for hospitals that treat them without payment.

The office issued a May 2004 report saying researchers basically came up empty, because few hospitals track the immigration status of patients. Neither of the major hospitals in Colorado Springs, Penrose-St. Francis Health Services and Memorial Health System, tracks immigration status.

A spokesman for Memorial Health System, which is owned by the Colorado Springs government, said officials there were studying how new laws affect them.

The problem for some people seeking tax-supported health care will be producing documents to prove they’re eligible, said Arenales of the Colorado Center on Law and Policy.

The broadest range of health care for the poor is available from a combined federal and state program called Medicaid. Illegal immigrants have long been barred from enrolling in Medicaid. The federal Deficit Reduction Act of 2005, however, said that starting July 1, Medicaid applicants must produce documents proving citizenship.

Many people facing a health crisis, especially the poor, might not have documents such as a passport, birth certificate or other ID, Arenales said.

“Think about somebody with Alzheimer’s. Do we really want them to go down and get a driver’s license? I don’t think so. And how are they going to accomplish that?” she said.

The law will affect about 51.3 million people nationwide, including about 446,000 Colorado residents, according to the Center on Budget and Policy Priorities, a Washington think tank. The center said up to 2.26 million people nationwide might have problems documenting their citizenship, and as a result could be denied tax-supported health care.

Even if the law could be changed to target only illegal immigrants, Arenales said she worries about unforeseen consequences.

“I’m not sure that we’re doing a good enough job of standing back and looking at the big picture,” she said. “Just because you don’t provide a service today doesn’t mean you’re going to see the impact of that next month or 10 months down the road, but you might see the impact years later.”

CONTACT THE WRITER: 636-0187 or perry.swanson@gazette.com

BY THE NUMBERS

11.1 million

Illegal immigrants nationwide last year, as estimated by the Pew Hispanic Center.

225,000 to 275,000

Illegal immigrants in Colorado last year, as estimated by the Pew Hispanic Center.

3.1 million

Children nationally born into families in which at least one parent is an illegal immigrant, as estimated by the Pew Hispanic Center.

39.5%

Increase in noncitizens in El Paso County, including legal and illegal immigrants, from 2000 to 2005, according to the U.S. Census Bureau. That’s higher than the statewide increase (25.9 percent) or the national jump (11.6 percent) during the same period.

620,000

U.S.-born adults who might have problems documenting their citizenship under a new Medicaid ID rule, as projected by the Center for Budget and Policy Priorities.

1.64 million

U.S.-born children who might have problems documenting their citizenship under a new Medicaid ID rule, as projected by the Center for Budget and Policy Priorities.

Could we deny all medical treatment to illegal immigrants?

- Should we?

How about, yes and yes!!

Many people facing a health crisis, especially the poor, might not have documents such as a passport, birth certificate or other ID, Arenales said.

Most people can obtain a copy of their birth certificate if they have lost theirs. Most have their social security card.

“What are we going to do for people who face absolute emergencies? Are we going to let them die?”

Treat immediate need then deport them, charge medical bill to their homeland. If only it were that easy....

The nation’s health insurance crisis is, to a large extent, being driven by its immigration policy,” said a study the center issued in December, written by Steven Camarota.

woohoo....found one more thing to attempt to blame on our immigration policy. Well then, if the illegals weren't here, does that mean we wouldn't be having this insurance crisis? Another reason to tighten up immigration!

[quote]“That really just reflects, I think, our basic sense of what it means to be a person, and the obligations we owe each other as human beings,” said Elizabeth Arenales, an attorney who studies the issue for the Colorado Center on Law and Policy.

“What are we going to do for people who face absolute emergencies? Are we going to let them die?”

Many illegal immigrants already avoid getting care from government offices because they fear being caught
__________________________________________________ ___________


This is not true, if they fear being caught when going to emergency rooms, why do they go to have 3,4,5, and more "anchor babies"?

And the obligations we owe each other as human beings, but not to Americans? If an American owns a house and has no Health-care insurance, and has to go to an emergency room, has to pay, even if it is $20.00 a month, but has to pay. Those people have houses in their countries, and money under their mattress.

I almost duplicated this post.

Deport! Deport! Deport! Nothing for illegals except REAL emergency medical treatment. Childbirth doesn't count because they know in advance the baby is coming at some point plus they take advantage of anchor baby laws and Medicaid as a result. Illegal alien's home countries should be providing their medical care and welfare costs, not US taxpayers.