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Subscribe to RSSFor years, Sonia Limas would drag her daughters to the emergency room whenever they fell sick. As an illegal immigrant, she had no health insurance, and the only place she knew to seek treatment was the hospital — the most expensive setting for those covering the cost.
The family's options improved somewhat a decade ago with the expansion of community health clinics, which offered free or low-cost care with help from the federal government. But President Barack Obama's health care overhaul threatens to roll back some of those services if clinics and hospitals are overwhelmed with newly insured patients and can't afford to care for as many poor families.
To be clear, Obama's law was never intended to help Limas and an estimated 11 million illegal immigrants like her. Instead, it envisions that 32 million uninsured Americans will get access to coverage by 2019. Because that should mean fewer uninsured patients showing up at hospitals, the Obama program slashed the federal reimbursement for uncompensated care.
But in states with large illegal immigrant populations, the math may not work, especially if lawmakers don't expand Medicaid, the joint state-federal health program for the poor and disabled.
When the reform has been fully implemented, illegal immigrants will make up the nation's second-largest population of uninsured, or about 25 percent. The only larger group will be people who qualify for insurance but fail to enroll, according to a 2012 study by the Washington-based Urban Institute.
And since about two-thirds of illegal immigrants live in just eight states, those areas will have a disproportionate share of the uninsured to care for.
In communities "where the number of undocumented immigrants is greatest, the strain has reached the breaking point," Rich Umbdenstock, president of the American Hospital Association, wrote last year in a letter to Obama, asking him to keep in mind the uncompensated care hospitals gave to that group. "In response, many hospitals have had to curtail services, delay implementing services, or close beds."
The federal government has offered to expand Medicaid, but states must decide whether to take the deal. And in some of those eight states — including Texas, Florida and New Jersey — hospitals are scrambling to determine whether they will still have enough money to treat the remaining uninsured.
Without a Medicaid expansion, the influx of new patients and the looming cuts in federal funding could inflict "a double whammy" in Texas, said David Lopez, CEO of the Harris Health System in Houston, which spends 10 to 15 percent of its $1.2 billion annual budget to care for illegal immigrants.
Realistically, taxpayers are already paying for some of the treatment provided to illegal immigrants because hospitals are required by law to stabilize and treat any patients that arrive in an emergency room, regardless of their ability to pay. The money to cover the costs typically comes from federal, state and local taxes.
A solid accounting of money spent treating illegal immigrants is elusive because most hospitals do not ask for immigration status. But some states have tried.
California, which is home to the nation's largest population of illegal immigrants, spent an estimated $1.2 billion last year through Medicaid to care for 822,500 illegal immigrants.
The New Jersey Hospital Association in 2010 estimated that it cost between $600 million and $650 million annually to treat 550,000 illegal immigrants.
And in Texas, a 2010 analysis by the Health and Human Services Commission found that the agency had provided $96 million in benefits to illegal immigrants, up from $81 million two years earlier. The state's public hospital districts spent an additional $717 million in uncompensated care to treat that population.
If large states such as Florida and Texas make good on their intention to forgo federal money to expand Medicaid, the decision "basically eviscerates" the effects of the health care overhaul in those areas because of "who lives there and what they're eligible for," said Lisa Clemans-Cope, a senior researcher at the Urban Institute.
Seeking to curb expenses, hospitals might change what qualifies as an emergency or cap the number of uninsured patients they treat. And although it's believed states with the most illegal immigrants will face a smaller cut, they will still lose money.
The potential impacts of reform are a hot topic at MD Anderson Cancer Center in Houston. In addition to offering its own charity care, some MD Anderson oncologists volunteer at a county-funded clinic at Lyndon B. Johnson General Hospital that largely treats the uninsured.
"In a sense we've been in the worst-case scenario in Texas for a long time," said Lewis Foxhall, MD Anderson's vice president of health policy in Houston. "The large number of uninsured and the large low-income population creates a very difficult problem for us."
Community clinics are a key part of the reform plan and were supposed to take up some of the slack for hospitals. Clinics received $11 billion in new funding over five years so they could expand to help care for a swell of newly insured who might otherwise overwhelm doctors' offices. But in the first year, $600 million was cut from the centers' usual allocation, leaving many to use the money to fill gaps rather than expand.
There is concern that clinics could themselves be inundated with newly insured patients, forcing many illegal immigrants back to emergency rooms.
Limas, 44, moved to the border town of Alamo 13 years ago with her husband and three daughters. Now single, she supports the family by teaching a citizenship class in Spanish at the local community center and selling cookies and cakes she whips up in her trailer. Soon, she hopes to seek a work permit of her own.
For now, the clinic helps with basic health care needs. If necessary, Limas will return to the emergency room, where the attendants help her fill out paperwork to ensure the government covers the bills she cannot afford.
"They always attended to me," she said, "even though it's slow."
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Leave a Comment:
Close your emergency rooms to the general public....problem solved.
Good idea although highly illegal to do it.
I remember being in a hospital in Portland, Oregon in 1989, and seeing a sign to this effect in the emergency room, basically stating that they had already reached the cap, and anyone needing help who couldn't pay had to go somewhere else. I was there for an ultra-sound, and had insurance. It's 25 years later, and I no longer have health insurance (my most recent policy was inadequate anyway), and I'm an unemployed citizen.
If other countries have such wonderful health insurance, why would anyone want to come here and risk not being helped? (I'm thinking of the cancer girl whose parents took her out of a U.S. hospital and back to Mexico, where she is reportedly receiving excellent and affordable care.)
You shouldn't have to compete with illegal immigrants to get treatment
I live in Texas, and have full coverage health insurance. The last time I went to the emergency room at my local hospital, I sat there for four hours waiting to be treated, at 2:00 am in the morning, with blood streaming down my leg. The reason....too many illegals to be treated for ailments that could and should be treated in a doctors office. I complained that paying "customers" should be treated before free loading customers and the administration staff got angry with my statement, and told me to go sit down and continue waiting. I decided to just leave the ER, and take a chance with my family doctor the next morning. My doctor was very upset when I showed up at his office the next morning, because the wound I had required 13 stitches, and according to him, should have been a priority at the hospital, and under normal circumstances, he would have sent me to the ER for treatment, but understood the situation, and fixed me up in his office. In Texas some of the best doctors work in the ER, and their services are going to people that pay nothing, just does not seem right! Meanwhile my insurance rates continue to skyrocket!
If an illegal shows up in the ER for anything but a life threatening emergency he should be examined and discharged without treatment. That would stop the ER from being overworked by people that should be seen in a doctor's clinic.
Oldman, Keep making up your stupid BS stories poeple here are dumb enough to believe them.
Get every single one of them OUT OF HERE!
Break the law, use social services for 13 years and then complain. Is this a great country or what?
If you don't believe these are wonderful people, take a walk in East LA one night.
I am sorry but if you and your family are in this country illegally, then I could care less. Go back to where you came from or pay out of pocket for your health care. Why should the citizens of America pay for your health care. If the purpose of this article was it get sympathy, it is not working.
I'm wondering if the Republicans are so hell bent on destroying this Country if they might consider including a provision for Grey Hound Buses for all illegals to be sent back to wherever they came from. Strictly humanitarian. After all the Country they came from can't be that bad. I see Americans lining up everywhere to go to all these Countries for vacations. Kind of suspicious if you ask me. Rich Americans going South. I'm baffled.
Please don't break into another country, pop out babies and expect to be given everything. Wrong is wrong and unfortunately these illegal alien activists and politicians never seem to understand that. Someone is footing the bill for you and your kids to get medical care. Go back to Mexico wait in line and I will welcome you here.
The AZ laws should apply to asking about "papers" if we are wondering if they are legal or not. If not, oh well... INS is waiting for you. If the person is dying right there, that's different but if they come in with the flu, sorry!
This asking about status is not just for Hispanics. They always make everything about them!!! There are tons of illegals from China in CA. TONS OF THEM! Hispanics make them to be the fall guy. Please. Boo Hoo on you.
However in post #1, they should straighten out their own country. Illegals are just that... ILLEGAL! They deserve NOTHING in benefits from this country. Nothing. Prop 146 put this into law in CA with over 60% approval. The Supreme Court said it was unconstitutional. Well, we can fix that if we wanted to.
If you're illegal you don't get free healthcare. Haul your illegal butt back across the border where you came from. I'm tired of paying taxes for a bunch of criminals who claim they deserve a free ride. ILLEGAL MEANS YOU BROKE THE LAW...GO TO JAIL OR GO HOME!!!
Seems to me that 11 million or so illegals in the US, if educated, trained and handed a rifle, could return to their wonderful home country and maybe, just maybe, take action and improve their own homeland.
Good, free is it at clinics? Not so I and everyone else who work pay for that, for them and get no thanks. If they went to clinics instead of emergency rooms well that saves me money but I really don't want to pay for them now or ever! Wake up politicians that's my hard earned money.
Can't say that I care. If you are illegal, then you shouldn't be sucking up my tax payer money for anything. As a taxpaying US citizen for the last 32 years, I don't have access to free or low cost medical care. I also don't have affordable access to insurance.
I do however has cancer. The initial surgery has been done , not free I might add, because and ONLY because it was life threatening. However I can not afford any of the follow up care so I am not getting it.
So I really don't care about your illegal butt not getting free health care.
PeteMT: Since Uncle Sam likes communist China and Vietnam very well then why not a communist Mexico.
I... I don't get it.
I was suggesting that maybe Mexico needs another revolution. Since Communist China and Vietnam are OK with Uncle Sam maybe a Communist Mexico would be an improvement.
The Hospital charge us and our insurance more to pay their bills, this ain't flying anymore.
I have no sympathy for this woman what so ever. I live in phoenix In the last 15 years this town has been turned into a Mexican slum. You drive through mid town and all the signs are in Spanish, all the schools give away millions of dollars in free meals to their kids. The crime the drugs and all the violence. We have drop houses here that the cops sometimes find with 70-100 people locked inside. The Feds won't even come to get them anymore.
I say to hell with them round them all up and send them back across the boarder. Then Close the damn thing up.
There are so many people here in Texas illegally. Why should i work and have to pay out the butt for mine and my children's insurance and they get to come take it for free. BS. They need to not let any of them come over here legally or not legally. Start shooting them when they cross the boarder and they will cut that crap out real fast.
The answer is simple for the american-citizenship-experience thieves - go home if you want medical care. There should be absolutely no dime spent on any illegal alien by any taxpayer. These felons need to be deported immediately and should stop mooching.
Most Americans cannot begin to imagine the money and resources being squandered to provide benefits such as completely free health care for illegals. Emergency rooms packed with routine ailments while true emergencies have to wait, medical care that would bankrupt a US citizen being given away absolutely free. Pregnant women with vague phantom stomach pain, all her closest friends and family in tow, to find out the sex of the baby. (Some have established a policy of not allowing any one to look and not revealing the sex, just to cut down on the free ultrasounds) Every bump, scrape and sniffle - go the emergency room. Why not? Its free and simple, no questions asked. Some come over the border only to check in to American hospitals.
END IT. End all the foodstamps, housing assistance, free schooling, free meals- and lets see just how fast they will "self-deport". I am sick of providing a free ride for illegals when my own family and many others across America are struggling.
Hate to say it but I have seen the same thing. My wife recently put a piece of wood through her foot and has to go the ER. It was late in the afternoon and there we about 6-7 people there. 2 groups were foreign and I have no idea if they had insurance, illegal legal. But the little boy that went up right when we got there I could hear the nurse question him. He basically had a cold. There was another young boy their with his elders and he had a headache. that was it. He didn't hit is head, no trauma. So 25% of the people in the ER was there for a cold and a headache.
Then this latina breeder will die or go home!
I don't care which.
I was shocked when I recently took one of those on-line tests and the result said I was a "liberal". I guess I am liberal enough to care for the woman's kids, but conservative enough to send 'em all home. I also like the suggestion above to deduct the health care from foreign aid.
I do not want to have to pay for illegals to get health care of any kind. I had to work hard at a job I didn't particularly like in order to get my health care. I had to go to school. I didn't listen to a Pope who wanted me to be continually pregnant. If my money is going to go to uninsured getting healthcare, it better be Americans - either born here or made through the proper LEGAL process.
"Health reform threatens clinic care for illegals"
Good! Finally a positive headline about ObamaCare. Long overdue!
Well that's just terrible! These illegals who come here and breed like cockroaches can't get free health care while American citizens have to pay through the nose for insurance.
Boo hoo. I really give a Sh!t.
They've done their part in electing the big O for a second term. That's all he wanted them to stay for, so now it's time for them to go back to their little crap-hole country.
Perhaps we need to charge the country of origin for these peoples health care cost, and if the countries do not pay we put tarriffs on their goods to take care of the cost.