|Implemented in this survey?|
On February 2003, the Local Emergency Health Services Reimbursement Act of 2003 was introduced in the U.S. Congress. The legislation would amend the Balanced Budget Act of 1997 to authorize the government to reimburse state and local hospitals for the uncompensated care they provide to undocumented immigrants.
On February 13, 2003, the "Local Emergency Health Services Reimbursement Act of 2003" was introduced in the U.S. Congress. Introduced in both the House and the Senate by a bi-partisan group of senators and representatives, the legislation would amend the Balanced Budget Act of 1997 to authorize the federal government to reimburse state and local hospitals for the uncompensated care they provide to undocumented immigrants. The bill would allocate $1.45 billion annually in healthcare reimbursements. California would get the biggest reimbursement because it has more undocumented immigrants than any other state.
Across the country healthcare providers are struggling to get enough revenue to cover their costs. Areas with high numbers of immigrants - legal and illegal - feel an extra burden because a 1986 federal law requires hospitals to provide emergency care to all patients - regardless of their ability to pay. Undocumented, or illegal, immigrants are not eligible for public programs that would compensate the hospitals for the emergency care they provide.
Immigrant Health in General
According to a nationwide study published in November of 2002 by the Center for Immigration Studies, California bears a disproportionate burden and/or responsibility in caring for immigrants' health. California has the greatest number (9,118,000) and percentage of immigrants (26.4 %) compared to all other states.
Furthermore, one-third of immigrants do not have health insurance (2.5 times the rate for natives) and immigrants who arrived in the U.S. after 1989 and their U.S.-born children account for 95 percent (7.5 million) of the 7.8 million increase in uninsured since 1989. Immigrants with no health insurance are less likely to seek preventative care, and are more likely to turn up for expensive emergency care with acute illness or injuries.
Immigration rates are likely to increase, so the costs of uncompensated care for many counties will continue to grow. The high levels of uncompensated care can threaten the viability of emergency healthcare facilities. Communities will suffer if emergency facilities close. In addition, some reports show that counties with high rates of uncompensated care are unable to provide "charity care' for local residents.
Legislation (S 412 and HR 819)
The legislation that was proposed this February (Senate Bill 412 and House of Representatives Bill 819) does not address immigrant health issues broadly, instead it is specific to illegal immigrants.
Legislators argue that because the federal government is responsible for controlling illegal immigration, it should also be responsible for helping communities shoulder the financial burden of illegal immigration. There is precedence for this: the State Criminal Alien Assistance Program (SCAAP) is a federal program that reimburses local communities for the costs associated with incarcerating illegal immigrants.
This legislation is an expansion of a bill proposed last fall that would provide federal funds to border states was proposed. According to the original bill, 24 counties on the Southwest border incur $200 million annually in uncompensated costs for illegal immigrants. This session the new bill was expanded to include all states, not just states along the border, with a disproportionate share of immigrants. The expanded bill is expected to have more political support and thus a greater chance of being passed.
California Senators Dianne Feinstein and Barbara Boxer (both Democrats) support this legislation. Senator Feinstein reports that last year "California spent an estimated $980 million on emergency medical services for undocumented immigrants."
|Medienpräsenz||sehr gering||sehr hoch|
Legislation that has the federal government reimburse states for costs associated with illegal immigration has been proposed before, but according to reports the efforts surrounding this latest
proposal for reimbursement on healthcare costs are better organized, funded and politically supported than in the past.
The intention of the legislation is to help fill in some of the gaps in the United States' healthcare system. Specifically, the gap that exists in funding because illegal immigrants who are injured in the US are guaranteed emergency healthcare - care for which hospitals and counties are uncompensated.
|Implemented in this survey?|
The idea of the federal government helping communities shoulder the health expenses of large immigrant populations can be traced to the federal government's financial assistance for incarceration
of illegal immigrants (State Criminal Alien Assistance Program, or SCAAP).
Passed in 1986 SCAAP didn't start reimbursing states until 1994. According to some accounts, it took much effort from California's then-Governor Pete Wilson to get the money.
The main proponents of this legislation have been legislators - on behalf of state and local hospitals - in states that have a large amount of uncompensated care (particularly border states).
There are many different groups of people who would be affected by this legislation if it passes:
So far the media coverage of this proposed legislation shows that the issue is not extremely contentious. While similar bills have failed to pass in earlier sessions, some believe that this bill has the broad support needed to pass. The stumbling block that journalists suggest is opposition from the White House. They believe the President may not support the legislation. And, it is likely, that during this economic downturn and war, legislation that calls for extra federal spending will not get a lot of support.
Yes. It is already a proposed bill in front of both the U.S. House and Senate. On February 13, 2003 the Senate bill was referred to the Senate Committee where it was read twice and
then sent to the Senate Committee on Finance. The House bill was referred to the House Subcommittee on Health for "a period to be determined by the Chairman."
If the bills - which are identical - pass both the House and Senate the bill will go to the President for approval.
All of the stakeholders described in 5.2 would be involved in the adoption process. If the bill passes it is likely that the first hurdle will be getting the federal government to release the money.
The legislation does not have a stated mechanism for review, but it is likely that the legislators and policy analysts from states who get reimbursements will analyse its impact on the state and
local hospitals and the communities overall. It is also likely that if there are any problems with the legislation, analysts and stakeholders will raise the issue publicly.
People have not suggested that this legislation - if passed - would have any undesirable effects. What people might argue is that the money the legislation would allocate could be better spent in other ways.
It seems likely that if this legislation passes it will help state and local hospitals meet their objective of staying financially viable as they provide care to undocumented
The legislation would reduce the uncompensated costs, thereby reducing the burden of providing care to undocumented immigrants and, possibly, improving the quality of care that is made available to undocumented immigrants and the communities as a whole.