Published May 11, 2005
U.S. pays for care of illegal aliens
Treatment money for border states
Tuesday, May 10, 2005
By ROBERT PEAR
THE NEW YORK TIMES
WASHINGTON -- The Bush administration said yesterday that it would start paying hospitals and doctors for providing emergency care to illegal immigrants.
The money, totaling $1 billion, will be available for services provided from today through September 2008. Congress provided the money as part of the 2003 law that expanded Medicare to cover prescription drugs, but the new payments have nothing to do with the Medicare program.
Members of Congress from border states had sought the money. They said treatment of illegal immigrants imposed a huge financial burden on many hospitals, which are required to provide emergency care to patients who need it, regardless of their immigration status or ability to pay.
Under the new program, hospitals are supposed to ask patients for documents to substantiate payment claims. But Dr. Mark McClellan, administrator of the Centers for Medicare and Medicaid Services, said a hospital should not directly ask a patient "if he or she is an undocumented alien."
Instead, he said, hospitals can try to establish a patient's status by analyzing the answers to "indirect questions": Is the person eligible for Medicaid? (If so, payment is generally not available under the new program.) Has the person reported a foreign place of birth? Does the person have a border-crossing card like those issued to Mexican citizens? Does the person have a foreign passport, a foreign driver's license or a foreign identification card?
The Bush administration abandoned a proposal that would have required many hospitals to ask patients if they were U.S. citizens or legal immigrants.
"In no circumstances are hospitals required to ask people about their citizenship status," McClellan said yesterday.
Hospital executives and immigrant rights groups had said such questions would deter illegal immigrants from seeking care and could lead to serious public health problems by increasing the spread of communicable diseases.
Cecilia Munoz, a vice president of the National Council of La Raza, a Latino civil rights group, said the new requirements were an improvement over the original proposal but would still discourage some immigrants from seeking treatment.
"Hospitals will have to ask confusing, highly technical questions about immigration documents," Munoz said. "That will create a perception in the Latino community that you have to show your papers in order to get emergency care. That's a misperception, but it may be enough to deter some people from seeking care."
The new program is run by the Department of Health and Human Services. McClellan said the department would not provide information about illegal immigrants to law enforcement officials for use in "routine civil immigration proceedings." But in rare cases, he said, the information may be used in criminal investigations.
The largest allocations this fiscal year are going to California, which will receive $70.8 million; Texas, $46 million; Arizona, $45 million; New York, $12.3 million; Illinois, $10.3 million; Florida, $8.7 million; and New Mexico, $5.1 million.
snowfreeze, BSN, RN
OK, we have always offered care to anyone who needs it. I think, yeh we have.
RosesrReder, BSN, MSN, RN
Anyone and everyone who is need of medical attention should be able to regardless of their immigration status. I think it is the humane thing to do. Also, you never know or are able to prove with certainty that an alien will not be discriminated because of their status, once the hospital finds out.
It is just my opinion. One thing is providing benefits like food stamps and other aid.......but another is medical treatment. Treatment should be available regardless. Anything else is just extra IMO.
But who has paid? The hospital pays, in the form of giving free care (write-off). This states that government funds would pay. That's the difference. I agree we need to treat the illegal immigrants--this way the care would be PAID for.
in the past 'cost-shifting' has paid for care to those who can't/won't pay. its good that the feds are going to kick in a little money but it isn't what really needs to be done. they should really try enforcing immigration law, controlling the borders, and simplifying the immigration process to allow more people to come into the country legally without a 12-24 month legal fight that costs a few thousand dollars in legal expenses.
VivaLasViejas, ASN, RN
As one who grew up less than 40 miles from the Mexican border, I've been hearing about this all my life, and frankly, it gets pretty boring. The ONLY way to stop illegal immigration is for Mexico to become a decent place to live.......get rid of police and government corruption, stop concentrating the country's wealth in the hands of a few, provide a good education and family-wage jobs to its citizens.
We all know that's not going to happen. The country's political system is so deeply entrenched that it would take an attitude adjustment the size of Texas to push it aside and start over again, and I don't think the people have the will or the energy to do so.........not when they have to fight just to stay alive from day to day. I wish our government would divert some of its attention---and funding!---from nation-building half a world away to our southern neighbors; perhaps if we were as aggressive about bringing down corrupt governments closer to home as we've been in Iraq, we might have fewer problems with illegal immigration. :stone
But then, we know THAT'S not going to happen either. So as long as we're going to look the other way while people slip into the country illegally, it's our duty to at least make sure they are treated humanely. That doesn't mean handing them everything on a silver platter, but it does mean providing emergency medical care, and that has to be paid for somehow.
However, I do not support the idea of making hospitals ask people about their citizenship status........immigrants won't go there for fear of being deported, and disease will spread like wildfire through their communities, causing even greater expenses in the long term. :stone
I don't know what the answer is. But turning ER staff into INS officials isn't it.
We don't really want illegal immigration to stop. If it did, we'd have to pay much higher prices for a lot of things. Frankly, I bet there are many illegal immigrants who contribute more to this country financially than many American born citizens and I have no problem with them getting healthcare.
Spidey's mom, ADN, BSN, RN
I heard a response to that the other day . . . . that if illegal immigration stopped, our food prices might go up BUT our taxes would go down due to not having to deal with the fallout of illegal immigration . . so it would all equal out.
I heard a response to that the other day . . . . that if illegal immigration stopped, our food prices might go up BUT our taxes would go down due to not having to deal with the fallout of illegal immigration . . so it would all equal out. steph
Yeah, sure. If you believe the government would actually lower taxes because they don't have anything else they want to spend that money on (like Iraq?) :chuckle . Are you wearing your rose colored glasses this morning;)? Plus many illegal immigrants pay taxes because they use fake SSNs to work.
unknown99, BSN, RN
The ONLY way to stop illegal immigration is for Mexico to become a decent place to live.......get rid of police and government corruption, stop concentrating the country's wealth in the hands of a few, provide a good education and family-wage jobs to its citizens. But then, we know THAT'S not going to happen either. So as long as we're going to look the other way while people slip into the country illegally, it's our duty to at least make sure they are treated humanely. That doesn't mean handing them everything on a silver platter, but it does mean providing emergency medical care, and that has to be paid for somehow.However, I do not support the idea of making hospitals ask people about their citizenship status........immigrants won't go there for fear of being deported, and disease will spread like wildfire through their communities, causing even greater expenses in the long term. :stone I don't know what the answer is. But turning ER staff into INS officials isn't it.
I agree 110%!!! I could not have said this better myself! Thank you for the great post.
I'll believe it when I see it. The vast majority of these costs have always been absorbed by the states with the most undocumented immigrants, and it really should be a national responsibility. Being in a border area, this issue gets frequent discussion.
True. I saw a special on TV once, and I believe it was about that hospital where the late President John F. Kennedy was taken and pronounced dead when he was assasinated. The name escapes me, right now.
But, anyway, it was about how they had more high risk births than any other hospital in the nation, and many of the moms were illegal aliens from Mexico who came to the U.S right near term having had absolutely no prenatal care, and literally showed up on the doorstep of their high risk prenatal clinic. I wonder how they even knew about it, unless they had relatives and freinds from back home who had done the exact same thing? Of course, now that the baby would be born here, the baby would be a U.S citizen, and I guess the family could stay.
But the program went on--it was a documentary of this one high risk illegal mom who, on her first ultrasound at this prenatal clinic (indeed, her first prenatal visit in her life) it was discovered that she had multiple fetuses. A staggering amount of money was spent to hospitalize her at that moment and plan for a team to deliver these multiple babies by C-section when the time came, (something like 6 weeks later) and I am certain they were all cared for in the hospital's NICU afterwards. Of course, this was all courtesy of U.S. taxpayers.
I don't know what the solution is. There are times that I listen to Michael Savage and believe all he says about protecting our "Borders, Language and Culture." There are other times when my liberalism kicks in and I feel that, if those poor illegals can make it across the border, more power to them. In fact, I was driving across the desert from San Diego, headed to Brawley, CA, and on the way back I was hoping that I would run across a caravan of illegals, so that I could stash them ion my trunk and get them safey across the checkpoint. Would that have been wise? No, but I feel for any human being or animal that is out in the desert, without food or water, (they have been known to drink the water that is in tanks for overheated radiators, perhaps not being able to read Spanish, let alone English, warning against the practice) trying despearately to seek a better life.
I'd rather pay taxes, I think, for hard working people coming here illegally to seek a better life for their families than I would for lazy citizens who would defraud or even depend on welfare and carelessly have one baby after another----by multiple deadbeat or even unknown dads--rather than work for a living or acquire some career skills.
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