As Congress considers different reform proposals, one sizable group of the uninsured appears destined to remain outside the reform conversation no matter what plan becomes law.
Out of the debate
Immigrants are missing quotient in reform talks
Illegal immigrants make up a large share of the people living in the U.S. without health insurance, and a large share of the associated costs of treating the uninsured. Yet care for illegal immigrants is not likely to be a part of a health reform package.
The Pew Hispanic Center, a think tank funded by the nonpartisan Pew Charitable Trusts, reports that illegal immigrants accounted for 17% of the 45.7 million people in the U.S. without health insurance in 2007. Those immigrants children, some of whom were born in the U.S., represent another 4% of the pool of uninsured residents.
Although researchers at the RAND Corp. have found that undocumented immigrants tend to use healthcare services at lower rates than the insured population, immigration critics like the Federation for American Immigration Reform say they tend to use costly emergency care more often and have worse outcomes because of a lack of preventive and follow-up care.
Yet dealing head-on with unauthorized immigrants financial impact on the healthcare system appears politically untenable. An aide to Senate Finance Committee Chairman Max Baucus (D-Mont.) reiterated the senators stated position that healthcare reform is not the place for immigration reform. He added that reform will minimize only a large part of the problem of uncompensated care.
Those who provide healthcare to the uninsured are urging congressional leaders to begin talking in real terms about what illegal immigrants cost and how to pay for their care. We will continue to lobby to make sure there is funding for coverage of undocumented immigrants. But I think we know thats a pretty heavy lift, Catholic Health Association Senior Director of Public Policy Kathy Curran said at a legislative June 8 update during the groups annual assembly in New Orleans.
When an uninsured illegal immigrant walks into an emergency room in Texas needing care, no one typically asks to see a green card. But Texas Hospital Association policy analyst Ernie Schmid said the process of gathering information such as Social Security numbers can reveal their status as an undocumented immigrant. And then? We go ahead and take care of them, Schmid said.
Texas funds much of its immigrant population care with disproportionate-share hospital funds, which are potentially on the chopping block in Washington. Im a little upset that Congress has not recognized that there are a lot of people who dont fit into the traditional insurance model, Schmid said. We are going to take care of them. So figure out a mechanism to pay for it. Its not that hard to do.
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