Michael A. Salorio, Imperial Valley Press Online, Jan. 24
WASHINGTON, D.C. — Emergency room staff would have to fingerprint or photograph any undocumented immigrant they treat and report the patient to the Department of Homeland Security to begin deportation procedures if a bill introduced here Wednesday is enacted.
Rep. Dana Rohrabacher, R-Huntington Beach, introduced House Resolution 3722, also referreds to as the Undocumented Alien Emergency Medical Assistance Amendments of 2004.
The bill seeks to amend section 1011 of the recently enacted Medicare Prescription Drug, Improvement and Modernization Act of 2003. Section 1011 provides $1 billion to reimburse hospitals for the costs of treating undocumented immigrants. The bill would impose conditions on federal reimbursement of emergency health services furnished to these patients.
The U.S.-Mexico Border Counties Coalition funded a study in 2000 that found the 24 counties adjacent to the Mexican border spent $190 million to provide emergency care to undocumented immigrants that year. Of all the border states, California spent the most treating undocumented immigrants with unreimbursed expenditures at $79 million. Texas came in second with $74 million, Arizona at third with $31 million and New Mexico fourth with $6 million.
In a December 2003 story published in the Press, El Centro Regional Medical Center chief executive officer David Green said the hospital incurs an estimated $1.7 to $2 million annually treating undocumented immigrants.
In that same story, a hospital official said 80 percent of those costs are incurred by the hospital’s emergency room where an average of 10 undocumented immigrants were treated each month in 2003 and 14 a month in 2002.
Personnel with Pioneers Memorial Hospital in Brawley were unable to provide the level of losses incurred by the hospital’s emergency room treating undocumented immigrants. Additionally, the number of undocumented immigrants treated each month in the hospital’s emergency room was unavailable.
Rohrabacher was opposed to the Medicare bill passed last year because of the $1 billion in funding it provided to hospitals for reimbursement of their costs associated with treating undocumented immigrants.
Federal law mandates hospitals treat anyone requiring emergency care and prohibits a patient being denied treatment on the basis they cannot afford to pay. The $1 billion in the Medicare bill marked the first time the federal government made money available to hospitals to reimburse their costs incurred by treating undocumented immigrants.
GOP leaders promised Rohrabacher they would bring his immigration proposal to a vote this year in exchange for his vote on the Medicare bill.
“I opposed that and I was not going to vote for the Medicare bill because of that, but the leadership in the House agreed that if I would vote for the Medicare bill, that I could write legislation that would, in some way, mitigate the damage that I felt was inherent in providing U.S. tax dollars officially to pay for services, health services, for people who have come to this country or are currently in this country illegally,” said Rohrabacher during his speech on the House floor introducing his legislation.
“Our health care system, our emergency rooms are breaking down under the pressure and the strain of illegal immigrants. And that is what leads me to the legislation which I introduced today,” said Rohrabacher.
Hospitals would still be eligible for federal funding for treating undocumented immigrants under Rohrabacher’s bill. However, in order to be reimbursed hospitals would have to ask patients if they are U.S. citizens or not.
If the patient answers they are a U.S. citizen, no further action is required by the hospital. If the patient answers he or she is not a citizen, the hospital would then fingerprint or photograph the patient and contact the Department of Homeland Security to report the patient’s immigration status, address and the name of their employer.
The bill directs the Department of Homeland Security to begin deportation proceedings against any patient who is an undocumented immigrant. Employers of these patients would be required to reimburse the federal government for the Medicare money paid to hospitals.
Dr. Michael Berger, emergency room director at Pioneers Memorial, said hospital staff would be required as a matter of law to follow the provisions of Rohrabacher’s bill if it were to be enacted.
Berger said that although the bill might make undocumented immigrants apprehensive in coming to the hospital to receive treatment, word would quickly spread that all they would have to do is answer ‘Yes’ to the citizenship question since there is no requirement the hospital verify patients are citizens if they answer so.
“It doesn’t seem to have much teeth. If you just ask people and ask for no proof … it’s kind of hollow. … Bottom line, this seems like a weak bill. … Your heart is in the right place but your head isn’t, Mr. Congressman,” said Berger.
Elise Bryant, spokeswoman for El Centro Regional, said the hospital had no official position on the proposed legislation in light of the proximity to the date it was introduced.
Bryant added Rohrabacher’s legislation might conflict with the Emergency Medical Treatment and Labor Act of 1986 that prohibits hospitals from asking patients financial status questions, under which citizenship queries would fall, until after the patient has been treated.
Rohrabacher on the House floor said: “It is just a couple of more questions to be asked routinely in the process in which they are already being asked questions before they treat patients.”
“The way it reads, the congressman is proposing upon admission they ask whether they are a citizen. That would violate EMTALA,” said Bryant.
Jan Emerson, spokeswoman for the California Healthcare Association, an association of hospitals whose members include El Centro Regional and Pioneers Memorial, said the organization is opposed to Rohrabacher’s legislation.
“When a person comes into an emergency room under current legislation we’re not allowed to ask a patient if they have health insurance or if they are a citizen. We first must treat them,” said Emerson.
The legislation is not practical because undocumented immigrants would figure out they only have to answer “Yes” to the citizenship question and give a false address and phone number, added Emerson.
“Our mission is not to be the INS. Our mission is to heal. Our job is not to be an INS agent. It’s the federal government’s job,” said Emerson.
Rep. Bob Filner, D-Chula Vista, said the purpose of hospitals is to heal patients and not to be a law enforcement agencies. Filner added he doubts the bill will become law.
“Hospitals are there to treat the sick and injured and not there to be police agencies. … It’s an incredibly mean-spirited approach to a real problem. What we need to do is reimburse hospitals for treating anyone that is undocumented and have a policy with Mexico that would help them bring down their rate of emigration. This is a horrible bill,” said Filner.
Rohrabacher’s bill has been referred to the House Committee on Energy and Commerce. A date has not been set for a vote on the bill by committee members for referral to the floor for a full vote.