Payments to Help Hospitals Care for Illegal Immigrants
By Robert Pear
The New York Times
May 10, 2005
The Bush administration announced on Monday 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 Tuesday 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.
Dr. Mark B. 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.”
The Bush administration abandoned a proposal that would have required many hospitals to ask patients if they were United States citizens or legal immigrants.
http://www.nytimes.com/2005/05/10/politics/10health.html
From CMS: Section 1011. Federal Reimbursement of Emergency Health Services Furnished to Undocumented Aliens:
http://www.cms.hhs.gov/providers/section1011/
Comment: Using federal tax funds to pay for medical care for undocumented residents is certainly highly controversial and will provoke considerable comment, much of it negative. But another perspective should be included in the debate.
California will be receiving the largest allocation of these funds, representing the magnitude of the immigrant problem within the state. When the participants in the Health Care Options Project studied the various models of reform for California, the costs of care for undocumented residents were a consideration.
The team of physicians from the University of California at San Francisco that developed one of the single payer models elected to include undocumented residents in their proposal. An independent microsimulation of their model demonstrated that truly comprehensive care could be provided for absolutely everyone, including the undocumented, while reducing health care costs for Californians by over $7 billion.
If the undocumented were excluded from coverage, the costs of these emergency services would still have to be picked up, either by cost shifting or through government subsidization. Providing affordable access to routine care and preventive services would offset at least part of the costs of expensive emergencies that could have been averted through the provision of more timely and appropriate care, not to mention reducing the costly administrative burden of a fragmented system of funding care. Besides, if establishing a single system meant that we had a more effective and less expensive system for the rest of us, would we really begrudge the fact that everyone would be included?
The physician authors of the UCSF proposal (J. Kahn, V. Lingappa, K. Farey, T. Bodenheimer, K. Grumbach, D. McCanne) believe that everyone should have affordable access to health care. It is reassuring to see that Congress and the Bush administration agree, to a certain extent, that no person should be refused care when really in need, and that the government should use public funds to help ensure access to that care.
In no way have we begun to resolve the debate over undocumented immigration. But, with the support of a conservative government, we have moved much closer to the principles that everyone should have access to health care, and that it should be funded in a more equitable manner. That’s a great leap forward on the path toward health care justice.