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Study: Illegal immigrants' care costs state $677 million
By JANET ELLIOTT Copyright 2008 Houston Chronicle Austin Bureau
Dec. 11, 2008, 11:40PM

AUSTIN — The state of Texas and local hospital districts spent an estimated $677 million to provide health care to illegal immigrants in a year, a new study says.

The survey, issued by the Texas Health and Human Services Commission, said that most of the money — $597 million — was spent by local hospital districts for the immigrants' care during the state's fiscal year that ended on Aug. 31, 2007.

Lawmakers from both parties said they were not surprised by the millions spent and expressed hope that the report, required by the 2007 Legislature, will help prompt Congress to pass comprehensive immigration reform legislation.

State Rep. Garnet Coleman, D-Houston, said the study only tells half of the story.
He noted that the immigrants contribute to government coffers by paying sales and property taxes.

The report said that in the fiscal year ending Aug. 31, 2008, the state spent $80 million under the Texas Emergency Medicaid program, which pays hospitals to provide life-saving care, including labor and delivery services, to patients living here illegally. The state also paid $1.2 million to provide services to undocumented immigrants in family violence shelters.

Federal law requires hospitals and ambulance services to provide care to anyone needing emergency treatment regardless of their citizenship, legal status or ability to pay.


Harris County's cost
The Harris County Hospital District provided $203.5 million in uncompensated care to illegal immigrants in 2007, the report said.

But county hospital district officials disputed the report's numbers, noting that they were calculated on the basis of charges instead of costs. They said charges are inflated, typically double the actual costs of services to taxpayers.

"The cost of health care to undocumented immigrants is something we worry about, something we monitor, but we don't want to overstate it," said David Lopez, president and CEO of the Harris County Hospital District. "It's not an overwhelming percentage of our budget."

Lopez said the actual cost is 10 to 14 percent of the hospital district's budget, or about $100 million to $120 million.

About 80 percent of the district's illegal immigrant patients were women and children, and most were pregnant women. Lopez said the hospital district was not consulted for the report.

In another sense, the report underestimated the cost of care to illegal immigrants because it did not include figures for the University of Texas Medical Branch at Galveston, which functioned like a hospital district by providing safety-net services. It spent $140 million annually on undocumented immigrant care, an official said Thursday.

Gov. Rick Perry is reviewing the report, but had no comment Thursday, a spokeswoman said. Likewise, Sen. Kay Bailey Hutchison, R-Texas, who is considering challenging Perry in 2010, declined comment until she studied the information.


Hoping to send a message
State Rep. Warren Chisum, R-Pampa, the House Appropriations Committee chairman, said the report puts a number on health care costs that the state cannot do anything about.

"Show it to our congressman, I guess. Tell him, 'Merry Christmas,' " Chisum said. "This is something we can look at the federal government and say, 'You guys ought to do a better job of guarding your borders or at least pay for 'em if you're going to allow them to come over here.' "

One of the most prominent critics of illegal immigration, Rep. Leo Berman, R-Tyler, said he is glad that Congress is getting the report.

"I'd like to bill the United States government," he said, "and have them pay Texas for the cost of the benefits that they require us to provide to illegal aliens."

But a report issued two years ago by then-Comptroller Carole Keeton Strayhorn said undocumented immigrants helped to support the state's economy. She said illegal immigrants in 2005 paid $1.58 billion in taxes while the state spent a total of $1.5 billion. Strayhorn said local governments spent $1.3 billion on indigent health care.

Rep. Coleman said he agreed with critics of illegal immigration that the report should be sent to Congress.

"Anything that can move the federal government to have a comprehensive immigration policy that works for this country is extremely important," he said.

Reporters Todd Ackerman, Peggy Fikac and Lisa Sandberg contributed to this article.

janet.elliott@chron.com