Part 5 - Medical Crisis
May 10, 2005- Bush Administration Releases Final Rule Governing Reimbursement to Care
Providers for Undocumented Immigrants.
Bush gives $1 billion dollars in taxpayer money for illegal alien medical care. President
cowers to pressure from illegal immigration advocates
CMS issued final rules on a provision in the new Medicare law that will provide additional
funding over four years to cover the cost of care for undocumented immigrants.
Under the program, the federal government will offer U.S. hospitals $1 billion over four
years to cover the cost of emergency care for uninsured patients, regardless of their
citizenship status.
The Bush administration had planned to require hospitals to ask patients directly about
their immigration status, but the administration reconsidered amid criticism from
hospitals and immigrant advocacy groups that the requirement would prompt immigrants to
avoid necessary care. Under the final rules, hospitals cannot ask patients directly
whether they are undocumented immigrants. However, hospital staff will be required to ask
patients whether they are eligible for Medicaid, whether they have a border-crossing card
and whether they are foreign-born. Hospital staff do not have to ask the questions when
patients voluntarily admit that they are undocumented immigrants. In such cases, hospitals
staff can check a box and sign a form.
"In no circumstances are hospitals required to ask people about their citizenship
status," CMS Administrator Mark McClellan said. According to the rules,
"Hospital and other provider personnel may not selectively screen individuals
regarding their eligibility status on the basis of race, color or national origin."
Hospitals will have to make photocopies of documents that indicate the immigrant status of
patients, although in most cases they will not have to submit the documents to the federal
government. McClellan said that the federal government will not use information about
undocumented immigrants obtained from hospital visits in "routine civil immigration
proceedings."
Reimbursement
Under the program, hospitals can apply for reimbursement for emergency care provided to
undocumented immigrants from the time patients arrive until they are considered
stabilized. However, hospitals must seek reimbursement from other sources, such as
Medicaid and private health insurers, before they apply for reimbursement under the
program
The federal government has allocated $250 million for each year of the program. The
federal government will distribute two-thirds of the funds among all states and the
District of Columbia based on their relative estimated percentages of the total number of
undocumented immigrants. The six states with the largest number of apprehensions of
undocumented immigrants for each fiscal year will receive the remainder. For FY 2005, the
six states are Arizona, California, Florida, New Mexico, New York and Texas. Under the
program, California for FY 2005 will receive $70.8 million -- the largest amount --
followed by Texas with $46 million, Arizona with $45 million, New York with $12.5 million,
Illinois with $10.3 million and Florida with $8.7 million
Reaction From Hospitals
Don May, vice president of policy for the American Hospital Association, said that the
program likely will help the finances of hospitals located near the U.S. border. He added,
"I don't know if it will completely change their financial picture, but for those
hospitals on the border, this is going to make a difference in ensuring they are there to
treat the patients, not just the undocumented ones, but all the patients living in those
communities". May also said that hospitals have concerns about how the federal
government will process reimbursement claims under the program. Jan Emerson, a
spokesperson for the California Hospital Association, said that California provides
$500 million in emergency care for undocumented immigrants annually - seven times the
amount of federal funding the state will receive under the program. However, she added,
"This is a highly symbolic first step. The federal government is finally
acknowledging that it has a responsibility to pay for health care" provided to
undocumented immigrants
Amanda Engler, a spokesperson for the Texas Hospital Association, said, "We're happy
the federal government is finally recognizing the tremendous burden that uncompensated
emergency care to undocumented immigrants places on hospitals and making this money
available, but when you look at a hospital's total expenses, it's a fairly insignificant
amount"
Reaction From Immigrant Advocacy Groups
Cecilia Munoz - vice president of the National Council of La Raza (The Race), a Latino
civil rights group - said that the new rules are an improvement over the original plan.
However, she added that "hospitals will have to ask questions about immigration
documents. That will create a perception in the Latino community that you have to
show your papers in order to get emergency care. That's a misperception, but it may be
enough to deter some people from seeking care"
According to the Los Angeles Times, immigrant advocacy groups maintain that the federal
government should use statistical formulas to determine the allocation of funds under the
program, rather than require hospital staff to ask questions related to the immigration
status of patients
Reaction From Lawmakers
Sen. Dianne Feinstein (D-Calif.) said that the program will "help keep the doors of
California's safety-net hospitals open. This funding comes at a crucial time, when nine
California hospitals have closed in the past year, due in part to a spike in costs
associated with care" for undocumented immigrants. Sen. Kay Bailey Hutchison
(R-Texas) said, "The funding provides relief, but it does not resolve the underlying
problem - verifying the extent of illegal immigrant care and eliminating fraud with the
system" http://www.kaisernetwork.org
News for Bush Administration
and the Public - 4 Part News and Facts
News 1- Medical Care under Bush Illegals benefit - Not
US Citizens
News 2- NOW under the Bush Administration Your Medical Emergencies
News 3- Federal Government Sued States Cut Your Medical
Care
News 4- Recommendations and Solutions
for the Bush
Medical Crisis |
