Illegal Aliens on the Healthcare

¶ … Illegal Aliens on the Healthcare System

Running Page: INSULT to INJURY

Illegal Aliens' Impact on U.S. Health Care System

The chronic problem of illegal immigrants' sharing costly, abundant and expert healthcare services system with citizens has mounted through the years. One reason is the lack of effective legislations to modify immigration laws. Another is a duality of federal policy, which vows to serve the interests of citizens and which declares an "open-door" policy to the world. California and Maryland register large populations of illegal aliens who not only share their taxpayers' social benefits. They can also secure what, in some cases, is not available even to these taxpayers themselves. A thorough study on the current situation and past efforts is warranted and more than timely.

Introduction

The dual problem of illegal immigration and illegal immigrants' impact on the healthcare system of the U.S. should have been the sharp focus of the President's 2006 State of the Union Address. The message was to deliver stronger immigration enforcement and border protection in order to keep American economy competitive. Undocumented aliens have been attracted to ease with which to enter the mainland and take advantage of its wealth and wealth of services. Legislations have not been responsive to changes so that legal residents have been shouldering health costs for illegal aliens. California alone has been burdened with the almost-daily entry of illegal aliens. Maryland also raised its voice over increasing healthcare costs its citizens for the treatment of illegal immigrants.

This study will endeavor to establish the countrywide trend in illegal immigration from the 50s to the present, enumerate the measures that have been taken to solve or address the problem, list the arguments for and against subsidizing healthcare for illegal aliens, determine the extent of illegal immigration in California and Maryland through a survey and assess the effectiveness of current legislations and other measures with the end-view of recommending adjustments or modifications in responding to the problem or crisis.

The results and recommendations of the study are timely and will be helpful as inputs to the decision-making function of legislators and other authorities who have a hand or a say in the management of the problem.

Literature Review

Sanders, Robert, et al. Policy Point-Counterpoint. 2 pages. International Social Sciences Review: Pi Gamma Mu, March 22, 2006

The authors write that illegal immigration adversely and profoundly affects public agencies and free societies, specifically the United States. Every year, approximately 400,000 illegal immigrants enter the U.S. There are currently 4-12 million illegal alien residing and sharing federal and state benefits with U.S. citizens. The Welfare Reform Law of 1996 denied them virtually all benefits. California voters passed the Save Our Land State Amendment in 1994 to deny them of public social and welfare services, public non-emergency healthcare and public education. Opponents contend that these moves violate federal immigration law, the right to due process and the provisions of the Equal Protection Clause of the 14th Amendment, which guarantees free education to the children of illegal aliens. Supporters of the prohibition say that households of illegal alien drain the federal government of approximately $26 billion worth of social services and criminal justice system expenses every year. Those who lobby for the health care provision for illegal aliens argue that these illegal aliens contribute to the overall tax base. Depriving them of health care benefits will also increase crime and contribute to public health problems or make these problems worse.

Stoil, Michael J. The Immigration Issue Burns Long-Term Care, Too. 2 pages. Nursing Homes: Medquest Communications, Inc., LLC, 2006

The author notes that President George Bush's State of the Nation Address of 2006 focused on immigration reform, specifically the Immigration Act of 1990. This legislation ironically created today's problem of illegal immigration. It set visa limits in response the worst recession of the time but a decade of huge expansion and demand for low-income, hourly and seasonal workers followed. This attracted at least 11 million foreign nationals, mostly illegal ones, to fill the vacancies. The situation had changed since then. Unemployment went down and the demand for low-income, incidental employees fell below 5%. The few amendments to the Immigration Act between 1991 and 2001 neither responded nor addressed the change in circumstances. The government may now be more aware of the problem of illegal immigration and its overall impact. But its repeated global declaration of "keeping an open door" is clearly a major cause of the problem it wants to solve or prevent.

Boulet, Jim, Jr. Democrats' Forked Tongue on Health Care, National Security. 2 pages. Human Events: Human Events Publishing, Inc., November 22, 2004

Hospitals have been pressured to first determine if a patient seeking medical treatment has the legal right to it. These initiatives, however, were opposed as interfering with medical urgencies. American taxpayers shoulder the cost of health care and medical treatment of illegal aliens. One form is the four-year $1 billion subsidy from the government for at least part of their hospital treatment without needing to ask about their immigration status. An example given in the Washington Post is the case of Houston's Harris Country Hospital District, which spent $330 million to treat and immunize illegal immigrants for three years.

Dembeck, Chet. Maryland Lawmakers Want Impact Studies on Influx of Illegal Aliens. 2 pages. The (Baltimore) Daily Record: Dolan Media Newswires, January 26, 2004

Dembeck reports that Maryland legislators want to know how the 56,000 illegal aliens in the State are affecting the welfare of its people, specifically its health care system. Their legislations, if passed, would create two task forces. One of them would deal with the pressure imposed by illegal aliens on the State's health care system. More and more illegal immigrants have been coming to emergency rooms for treatment every day. In one hospital alone, unpaid care increased from $11 million in 2002 to $14.8 million in 2003. Overall hospital rates would have to be raised to cover the increase. The increase, however, could not be accounted for entirely by illegal aliens who received care.

Hanson, Gayle. Illegal Aliens Bilk Sick U.S. System. 7 pages. Insight on the News: News World Communications, Inc., April 18, 1994

Illegal aliens are not only sharing health care benefits but, in some cases, also receive benefits not enjoyed by American citizens themselves. California Governor Pete Wilson joined hands with the governors of Texas, Florida, New York, Illinois, New Jersey and Arizona to compel the federal government to pay the State $7.5 billion yearly to care for these States. Governor Wilson's investigators reported that many illegal immigrants would take advantage of California's abundant social services, which are paid for my taxpayers. High and continuously increasing health costs shared by the aliens with the citizens have unjustly deprived the latter of the health services they need and deserve, according to the Governor. Statistics said that California has more than 2 million illegal immigrants, which accounted for more than half of the country's total. The State pays for the health care services of the immigrants but also that of their American-born children. In 1992 alone, 96,000 babies were born to undocumented women alien immigrants under Medi-Cal coverage. As it stood, 40% of all publicly funded births went to them. Because these babies were American, they were immediately eligible to a wide range of public assistance. In most cases, their mothers were also entitled to the benefits.

California claimed $3.6 million, or nearly half, of the $7.5 billion total charged to the federal government for the social services rendered to undocumented aliens. These were mainly health care services. It started when Congress passed the Omnibus Budget Reconciliation Act in 1986, which required the States to provide emergency medical and childbirth services to all illegal aliens through the Medicaid programs. As a consequence, the California's free medical care increased 18 times. Two years later, the State paid $22 million for the health care services of 31,600 illegal immigrants. They were required to declare their intention to remain in the United States by presenting a utility bill or a driver's in securing the services. In 1994, California spent close to $400 million caring for 390,000 illegal aliens. Governor Wilson said that the federal government should take steps to control U.S. borders and contain massive illegal immigration. He urged the federal government to ease taxpayers of the burden and reimburse them the costs of its failure. He also emphasized that the U.S.-Mexico border is porous and thousands of illegal aliens could cross it every day. These aliens worked, went to school and, in some cases, even committed crime in the mainland.

Clarke, Richard L. The Health Security Act - Good News, Bad News. 2 pages. Health Care Financial Management: Healthcare Financial Management Association, 1994

Clarke applauded and deplored the then proposed Health Security Act by former President Bill Clinton. It guaranteed universal healthcare coverage for all Americans, ease in preparing paperwork and delivery system, the control of the costs, individual choice of coverage and providers of health care and other features of high-quality service worth the consumers' expense. It was good news. But it was bad news to healthcare providers in areas with large populations of alien immigrants. The benefits did not link up with the funding employers or the government to pay for the benefits. It did not offer enough incentives for the choice of a healthy lifestyle or the available health care services. It needed to simplify administrative procedures. It relied too much on government regulation and too little from public sector's initiative. And it provided few incentives to study the effectiveness of its procedures and outcomes. These comprised the bad news.

Eichstaedt, Peter. National Healthcare: Breakthrough or Pipedream? 3 pages. New Mexico Business Journal: The New Mexico Business Journal, November, 1993

The author commends former President Clinton's health plan as noble, high-quality and cost-effective for all Americans. It would require the employer to pay 80% of the health cost and the employee to bear the 20%. The plan, however, failed to address rural health care and health care for the uninsured, such as illegal aliens. The problem of undocumented aliens was strongest in El Paso, Las Cruces in New Mexico. Some hospitals, which treated these aliens, did not get paid under Clinton's health plan.

Research Method

This study will use mainly the descriptive-normative method of research in recording, describing, interpreting, analyzing and comparing data gathered from authoritative and recent sources of information. It may also use a complementary questionnaire or survey method in gathering responses and other information from and about the sample population. The sample will consist of individual respondents chosen at random in select hospitals and clinics in California and Maryland with large populations of illegal aliens.

Findings and Conclusion

The message of President George W. Bush's 2006 State of the Union Address was keeping American economy competitive through stronger immigration enforcement and border protection (Stoil 2006). Shortly afterwards, he promoted immigration reform as the focus of his domestic legislation. Heated debates ensued as a result of the inconsistency. Intents and attempts at evaluating and modifying the immigration have been going on in Washington in the last two decades. The last major change was the Immigration Act of 1990, which created the three categories of legal immigrants, namely, family-sponsored immigrants, employer-based immigrants, and the so-called "diversity" immigrants, who sponsor themselves. The Act set annual limits to the number of visas for each category, a quota for each country and a bipartisan Commission on Legal Immigration Reform to work on the technical aspect of a rational immigration policy. The Commission recommended a more effective system of verifying work authorization in an attempt at reducing illegal immigration. However, it failed to develop a basic law, which would match employment and family reunification needs. As a consequence, the Immigration Act of 1990 ironically induced the current illegal immigration problem. Visa issuances were limited at a period of worst recession. But right after, the economy rapidly and vigorously expanded.. The demand for low-income, hourly workers and seasonal employees attracted at least 11 million foreign nationals for these jobs in recent years. Laws from1991 to 2001 did not recognize or sufficiently address the change in circumstances. From 1996 to 2003, less than five or six bills per year were presented in Congress, which addressed immigration issues. Few of these immigration reform bills tended to further restrict legal immigration and imposing criminal penalties for illegal aliens. The President and Congress might come to terms more deeply with the reality of illegal immigrants on account of all their adverse effects on the population. But the declaration that America must keep an open-door policy has screened the sore facts, which led to the development of current immigration problems (Stoil).

An honest and thorough review of the history of the United States reveals that it was built primarily by immigrants who sought a better life for themselves and their family through productive industrial pursuits (Sanders et al. 2006) and by establishing a culture of diligence and efficiency. Almost anyone could migrate to the U.S. until the late 19th century. That early, the federal government began attempts to control the influx of aliens through different legislations. Western and Northern nationals were the beneficiaries of these legislations. Restrictions were aimed at non-whites. The Chinese and the Japanese were prohibited from entering the U.S. Then other Asian workers were observed to work at most railroad and mining jobs at lower wages. President Theodore Roosevelt tried to negotiate with Japan to suspend immigration in exchange for non-segregated education for Japanese children then in California. Congress enacted three laws, meant to preserve the true "character" of the nation. These were the Emergency Immigration Act of 1921, the National Origins Act of 1924 and the Displaced Persons Act, which restricted the entry of "undesirable" aliens to the U.S. (Sanders, et al.).

The Immigration Act of 1965 allowed almost equal numbers of aliens from all over the world to enter the United States but reduced those coming from Latin America (Sanders, et al. 2006). This increased the number of illegal aliens from Mexico and South and Central America, who fled from poverty, civil discord and political persecution. The Refugee Act of 1980 gave them legal entry but retained severe restrictions on social service program budgets of Southwest border and some coastal states. Responding to the heated anti-immigrant sentiments and the accompanying economic problems, Congress enacted the Immigration and Reform and Control Act of 1986, which sanctioned employers who would knowingly hire illegal immigrants. It also provided for an amnesty program, which legalized illegal aliens who had been living in the U.S. For at least four years. The Immigration Act of 1990 allowed a 40% increase in immigration. Then Congress passed the Immigration Act of 1996, which increased the number of border patrol agents and restrict the provision of social services to illegal aliens from Mexico (Sanders, et al.).

In comparison with about one million legal immigrants every year, there are about 400,000 who enter the U.S. illegally (Sanders, et al. 2006). Statistics say that there may be 4 to 11 million illegal aliens now living in the country. Federal and State laws have been passed to deny social service benefits to these illegal aliens. The Welfare Act of 1996 virtually deprived them of all benefits, including Supplemental Security Income. They could have only temporary housing, emergency medical assistance, and disaster relief. California passed the 1994 Save Our State Amendment, which denied public social and welfare service, public non-emergency healthcare and public education to illegal aliens. This law has been contested as violating federal immigration law, due process and the provisions of the Equal Protection Clause of the 14th Amendment by denying free education to the children of illegal aliens. Proponents, however, insisted that such programs actually attract illegal immigration. Illegal aliens cost the federal government approximately $26 billion in social services and criminal justice system expenditures each year. Advocates who take the side of illegal aliens contend that they contribute to the tax base, as most of them come to the U.S. To work. They add that depriving illegal aliens of access to public education and healthcare will tend to increase crime and public health problems. These are among the arguments raised in debates for and against programs, which provide or deny social services to illegal aliens (Sanders, et al.).

The Health Security Act guaranteed universal healthcare coverage for all Americans (Clarke 1994). It promised to simplify healthcare paperwork and delivery systems, control health costs and promote individual choice of coverage plans and health care providers. The Act, however, did not tie up with funding available from employers who would pay the benefits or coverage. It did not provide appropriate incentives for the wise use of healthcare resources, had no economic incentives for the choice of lifestyles of healthcare services. It required simplification of administrative procedures, relied too much on government regulation and too little on public sector initiative and few incentives for medical research and technology advancement (Clarke).

More than half of almost 37 million U.S. citizens who have no health insurance have jobs but mostly work for small companies (Eichstaedt 1993). Former Bill Clinton's health plan was commendable, but it failed to address rural health care and health care for the uninsured. Among the uninsured are illegal aliens. The problem could be resolved only if the competing systems cooperated and if companies and health care providers shared the added costs (Eichstaedt).

According to an article published in the Washington Post, Americans pay millions of dollars to provide health care and medical treatment for illegal aliens (Boulet 2004). It said that the U.S. government would help subsidize a four-year $1 billion dollar program to shoulder some of the costs for treating illegal immigrants. Senator Jon Kyl sponsored the subsidy with funds in the Medicare bill. Houston's Harris County Hospital District, for example, spent $330 million to treat and immunize illegal aliens for a period of three years (Boulet).

Baltimore County Republican Delegates Patrick L. McDonough and Richard K. Impallaria wanted to know how the influx of illegal aliens has affected the welfare of the people of Maryland (Dembeck 2004). The Immigration and Naturalization Service said that there were approximately 56,000 illegal aliens in Maryland. Only 18 other States had bigger illegal alien populations, according to the INS. The citizens and other legal aliens were losing their jobs to illegal aliens, who were willing to accept lower wages. Moreover, the legislators felt that illegal aliens were also putting substantial pressure on the State's health care system. The Franklin Square Hospital Center, for example, reported that more and more illegal aliens were coming to its emergency room every day. It said that its uncompensated care rose from $11 million in 2002 to $14.8 million in 2003. A spokeswoman for the hospital, however, said that the increase could not be all attributed to illegal aliens. A spokeswoman for the Maryland Hospital Association remarked that, while illegal aliens appeared to have been a financial drain on hospitals, there were no hard statistics or facts to show how they had impacted the health care system of the State. The only certainty was that the increasing and unpaid bills would be compensated for by raising everyone's hospital rates (Dembeck).

Providing health care services to illegal aliens for free has not only drained taxpayers (Hanson 1994). There have been cases when these illegal aliens acquire these services and American citizens cannot. A classic case was that of a Hispanic, Hermillo Meave, who was ruled as eligible for a heart transplant for free at the Sharp Memorial Hospital in San Diego in September, 1991. The overall transplant cost of care was $1 million. Using fraud, Meave proved his eligibility and this meant that the cost would be borne by the State. Meave's case was a classic illustration of the condition of illegal immigrants who would take advantage of the expensive, State-funded social services, especially health care. California State officials noted that approximately 2,000 illegal aliens cross the border to the State every night. Yet the federal government had not done anything to contain the problem. Instead, the laws set up even attracted the illegal population (Hanson).

California Governor Pete Wilson joined the governors of Texas, Florida, New York, Illinois, New Jersey and Arizona in urging the federal government to pay the $7.5 billion annual expenditures for the illegal alien population (Hanson 1994). The governors noted and deplored that in some cases, illegal aliens could receive better benefits than American citizens. Governor Wilson announced that he had appointed more Medi-Cal fraud investigators to screen the tens of thousands. These people cross the border to take advantage of the State's abundant, but taxpayer-funded, social services. Increasing costs have unjustly deprived legal residents of services they themselves needed. The federal government should repay California's annual expense of $3.6 billion for the care of illegal aliens. The care included and spanned elementary and secondary education to prison cells, but mostly federally mandated health care. The Omnibus Budget Reconciliation Budget of 1986 required all States to provide emergency medical and childbirth services to all illegal aliens through Medicaid programs. The lure of free medical aid increased the number of illegal aliens 18 times. Records said that California spent $22 million to serve them. They could obtain the services by simply presenting a utility bill or a driver's license to establish residency or declare the intention to remain in the United States (Hanson).