Where illegal aliens & health care collide

Illegal aliens often seek medical care in hospital emergency rooms. So imagine that Jane, a hypothetical illegal alien, went to a Houston, Texas emergency room with something as simple as the flu. The hospital doctors and nurses review her symptoms, maybe observe her overnight, possibly prescribe medicine and release her the next day.

The law requires that the hospital provide medical treatment for Jane even if she can’t pay. The Emergency Medical Treatment and Labor Act (EMTALA), an unfunded mandate, requires hospitals to treat those who need emergency rooms care regardless of immigration status. In the case I’ve described Jane received care but the hospital received no payment from Jane because she is poor and uninsured. Since Jane is neither a citizen nor an immigrant, she’s ineligible for Medicare (government health coverage for the elderly) or Medicaid (government health coverage for the poor) assistance.  Cue, Obamacare.

During the Obamacare debate, opponents and defenders understood that his new program would cover the uninsured but questioned if it would also insure illegal aliens. Through Obamacare, uninsured are eligible to purchase health coverage on federal or state exchanges. However, participation in the exchanges requires proof of citizenship. Jane, therefore, doesn’t qualify.

Before Obamacare, Jane had to get emergency room treatment.  Now, under Obamacare, Jane must still seek treatment through an emergency room but the hospital is still not getting paid. This scenario is common. Health care costs are inordinately borne by the states with the highest illegal alien populations.

Eight states contain two-thirds of the total U.S. illegal alien population. They are: California, Texas, Florida, New York, Illinois, Georgia, New Jersey and North Carolina. In these states alone, the federal government paid over $80 billion in healthcare expenses. In most cases, this represents more than 50 percent of all healthcare expenses in any individual state. The remaining 50 percent is funded through individual and corporate taxation. Mississippi Governor Haley Barbour, “Medicaid is a top budget item for states….”

A floundering, struggling economy can wreak havoc on state budgets. When residents lose jobs, less tax revenue is generated. At the same time, more people enroll in Medicaid to offset medical expenses. Higher Medicaid enrollment means higher state costs. Therefore, a state with more citizens enrolling in Medicaid and with a high illegal alien population receives a double-whammy. To solve the Medicaid budget issue, the Republican Governor’s Association (RGA) proposed 31 solutions to tackle the soaring costs of care; the fifth solution is key.

Solution 5 from the RGA reads, “Require the federal government to take full responsibility for the uncompensated care costs of treating illegal aliens.”

Since 1986, the federal government through EMTALA has required hospitals to treat those who seek emergency room care. Hospitals do not gather citizenship status from emergency room patients. However, if the federal government were to pick up illegal alien hospital costs, especially those from states with high illegal alien populations, those freed up monies could be applied to other services for legal residents like education and public safety.

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