Posted on 11/30/2003 2:57:17 PM PST by sarcasm
A California representative's plan to turn doctors and nurses into ad hoc immigration agents to qualify for federal funding is less than a week old _ but already it's drawing fire from border health care officials, the Mexican government and members of his own party in Washington, D.C.
Rep. Dana Rohrabacher, R-Huntington Beach, voted last week for $1 billion in federal reimbursements to hospitals with a high number of patients who are in the country illegally, despite his beliefs that federal tax dollars should not pay for their health care.
In exchange for that vote, Rohrabacher said he will file legislation early next year that would require those hospitals to turn over their undocumented patients to immigration officials at the Department of Homeland Security before they can be reimbursed for caring for them.
"My proposal is anybody who gets their health care funded by the federal government who is illegal should be immediately reported to [immigration officials] and put on an expedited deportation list," Rohrabacher said. His district was the birthplace of California's controversial Proposition 187 in 1994, which would have cut off public services to undocumented immigrants but was later declared unconstitutional.
Upon hearing about the plan, Miguel Escobar, the Mexican consul in Douglas, Ariz., heaved a big sigh.
"Oh, I don't believe this," he said. "This would not be precisely the most humanitarian way of dealing with people who are injured, by turning them over to the Border Patrol."
Hospitals are not allowed to ask for the citizenship status of their patients but are required by federal law to treat anyone who enters an emergency room, regardless of their status or whether they can pay for their care. Immigrants without legal status, the majority of whom don't have health insurance, often go to emergency rooms for nonemergency services because it is difficult and, in some cases, illegal for them to get care in a clinic or doctor's office.
Rohrabacher said he would also, in the same legislation, propose a change in federal rules to require hospitals only to stabilize undocumented patients long enough for them to discharge the patient to a facility across the border.
The result, Rohrabacher said, would be twofold: People would be discouraged from entering the United States to get free medical services, and hospitals wouldn't have to bear the burden of ongoing treatment.
"We have limited resources, and they should be used for our own people and not for illegal immigrants and not for people who sneak across the border for one day to get a free operation," he said. "We definitely have to care for people in an emergency, but you only care for them enough to sustain them so they can get back across the border for their treatment."
Strapped hospital districts with high immigrant populations have been increasingly vocal in their complaints of rising unreimbursed costs associated with caring for those patients. A recent study by the U.S.-Mexico Border Counties Coalition estimated that 77 border-area hospitals spent nearly $200 million in 2000 on emergency care for undocumented immigrants.
The debate over the rights of undocumented immigrants to have access to health care in the United States came to a head Tuesday when Washington lawmakers sent a Medicare overhaul bill to President Bush that included $1 billion in funding for hospitals that are hardest hit by illegal immigration.
Hospitals hailed the legislation but now wonder how they would be able to handle the increased paperwork, avoid discrimination lawsuits and address public-health issues if Rohrabacher's plan becomes law.
"It does put us hospital employees in the position of policing, and I think there are just a number of problems with that," said Carla Luggiero, a lawyer and a registered nurse and the senior associate director of federal relations for the American Hospital Association in Washington, D.C.
At Thomason General Hospital in El Paso, officials still remember a lawsuit they lost several years ago when they asked the citizenship status of their patents. Hospital spokeswoman Margaret Althoff-Olivas said Rohrabacher's proposal is rife with liability concerns.
"You put five people standing next to each other, and you're a nurse or doctor," she said. "Are you going to point to one and say, `That person is in the country illegally. I can just tell.' "
Health care providers also say that it could create public-health problems if immigrants are afraid to seek treatment for contagious illnesses, or if they delay treatment for an illness that later becomes even more costly to treat.
"That legislation sounds like it would run counter to what we propose to do to take care of patients," said George Massi, associate administrator for Ben Taub Hospital in Houston. "It seems to me that if that becomes the situation, folks would not want to come to the ER to be cared for, and that just exacerbates the problem."
Officials with the U.S. Bureau of Customs and Border Patrol declined to comment on the proposal.
Although the congressional leadership agreed to allow a floor vote on Rohrabacher's legislation, one key Republican lawmaker said there are better ways to enforce existing immigration laws.
"I'm not sure that doctors and nurses ought to be commandeered by the federal government to help enforce immigration laws," said U.S. Sen. John Cornyn, R-Texas, who pushed for the reimbursements and is co- sponsoring legislation creating a guest-worker program for Mexican migrants.
I agree 100%. The majority of Americans are fed up with illegal immigration, and would vote for a candidate who promised a solution. Bush doesn't want it solved.
The illegal aliens are already subsidized: by the state and local hospitals, who are required by Federal law to treat illegals. All the bill did was shift the burden to Feds, where it belongs, since it is the Feds who control immigration policy and force the hospitals to treat patients.
Rohrabacher is second only to Tancredo in fighting for immigration reform. He's been fighting for it his whole career. If anyone in the House has Cajones, it's Rohrabacher.
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