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A just released U.S. House of Representatives Homeland Security Committee report explores the unreimbursed costs which illegal immigration imposes on our nation’s hospitals. The full 55 page summary of this report can be read at:
https://homeland.house.gov/media/2023/06/CHSPreliminaryReportFINAL.pdf
The whole report summary is too long to reproduce here, but the two report sections pertaining to unreimbursed health care costs are:
I. Health Care, Particularly Emergency Services, for Illegal AliensHospital and emergency room care for illegal aliens is one of the most significant expenses. The Emergency Medical Treatment and Labor Act (EMTALA) requires public hospitals to provide emergency medical services to individuals regardless of their ability to pay for those services.
Illegal aliens, most of whom have no form of health insurance, often rely on emergency rooms and services as a source of free or cheap health care. Consequently, this has led to significant costs for hospitals because providers are often not reimbursed for these services.
In a January 2021 filing challenging the Biden administration’s deportation moratorium, Texas Attorney General Ken Paxton wrote that his state alone was required to pay anywhere between $62 - 90 million per year to cover illegal aliens under its Emergency Medicaid program.
He also pointed out that between 2006-2008, uncompensated costs borne by Texas state hospitals providing care to illegal aliens ranged from $597 million to $717 million. That’s as much as $1.03 billion in May 2023 dollars.
Data released by the state of Florida, meanwhile, showed that illegal aliens cost hospitals about $312 million in FY21, with hospitals only receiving around $103 million in reimbursements.
Illinois is also facing a massive cost surge in providing care for illegal aliens. According to Politico in May 2023, “A state program that offers health benefits to undocumented adults is ballooning.
When it was started a few years ago, lawmakers estimated it to run from $2 million to $4 million. Now health officials say the state needs more than $1.1 billion to keep it running,” because the number of aliens using the service was far more than the state planned for.
II. Specific Cases of the Border Crisis Burden Placed on Providers
Dr. Robert Trenschel, CEO of Yuma Regional Medical Hospital, recently told the House Committee on Homeland Security that the influx of aliens seeking medical services has swelled over the past two years, that most do not have insurance or money to pay for services, and that many arrive suffering from major illnesses or ailments:
“Some migrants come to us with minor ailments but many of them come in with significant disease. We have had migrant patients on dialysis, cardiac catheterization and in need of heart surgery. Many are very sick. They have long-term complications of chronic disease that have not been cared for. Some end up in the ICU for 60 days or more. One of the largest cohorts we have seen are maternity patients who present with little or no prenatal care. These higher risk pregnancies and births result in higher complication rates and longer hospital stays.”
The hospital often provides transportation costs and hotel rooms, as well, and incurred more than $26 million in unreimbursed medical costs from December 2021 to November 2022 alone.
Many hundreds of useful references can be found at the report's hyperlink, above.
When a system is breaking down, some common sense is really good to see.
June 2023
Last week, FAIR submitted a formal statement of opposition to a proposed regulation by the Biden Administration that would expand eligibility for healthcare benefits to illegal aliens with deferred action under the Deferred Action for Childhood Arrivals (DACA) program. In its statement, submitted as a comment to the Department of Health and Human Services, FAIR called for the regulation to be withdrawn.
The Biden Administration announced in April that DACA recipients would soon be eligible to apply for benefits under the Affordable Care Act (ACA) and some Medicaid programs. According to the proposed rule, issued soon thereafter, DACA beneficiaries will soon be eligible for multiple federal and state health care benefits. Those benefits would include access to ACA healthcare exchanges (commonly known as Obamacare), Medicaid, and the Children’s Health Insurance Program (CHIP) for pregnant women and children.
Remarkably, the Biden Administration is granting access to these health care benefits, just as federal courts appear poised to strike down DACA altogether. The Fifth Circuit Court of Appeals has already ruled that the DACA program is unlawful. Our laws clearly provide that Congress holds authority over immigration law and that the Obama Administration acted unlawfully in creating DACA. Proceeding to expand benefits eligibility for DACA recipients not only perpetuates the unlawful program but also provides benefits to recipients that they may come to rely on, only to have them rescinded.
Expanding benefits in this way is not only contrary to our immigration laws but would also raise the costs borne by American taxpayers due to illegal immigration. Just this year, FAIR released a study on the fiscal costs of illegal immigration, which is currently the only comprehensive examination of the financial impact of illegal immigration in the United States. FAIR’s study found that illegal immigration is a net cost to taxpayers of about $151 billion per year.
As highlighted in FAIR’s cost study, the U.S. government already spends more than $23 trillion dollars annually on federal medical expenditures, including for Medicaid. Some of that money is spent on illegal aliens because some programs expressly allow illegal aliens to be eligible. For example, the Affordable Healthcare Act, otherwise known as Obamacare, generally provides that any alien who is “lawfully present” is eligible. The term “lawful presence” naturally includes green card holders and legal guest workers, but it also includes parolees (with some exceptions) and other aliens whose deportations have been deferred through formal or informal programs such as Temporary Protected Status, withholding of removal, deferred enforced departure, and deferred action – with the exception of DACA beneficiaries.
Due to a lack of transparency, however, it is impossible to estimate exactly how many illegal aliens participate in the ACA now, and what level of federal subsidy they receive. Still, it is clear that expanding eligibility for federal and state benefits to DACA recipients will place an even greater burden on American taxpayers.
Given the illegality of DACA, and the costs related to further expanding healthcare benefits to illegal aliens, FAIR strongly recommended in its comment that the Department of Health and Human Services (HHS) remove DACA recipients from the definition of “lawfully present” for the purposes of benefits eligibility.
To read FAIR’s full public comment, click here.
Joe Chatham joined FAIR in 2022, bringing significant congressional, campaign, and nonprofit experience to the organization. As part of FAIR’s influential government relations team, he helps manage Capitol Hill outreach and policy, advocating for a secure border and a just, equitable legal immigration system.
Before joining FAIR, Joe worked with a large range of organizations, from congressional offices and political campaigns, to intergovernmental organizations and think tanks. Most recently, he served as counsel to Rep. Ken Buck (R-CO), where he handled the representative’s immigration portfolio for the House Committee on the Judiciary.
He holds a Bachelor of Arts from the University of Michigan, a Master in Public Administration from the Harvard Kennedy School, and a Juris Doctor from Yale Law School.
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