Boston Globe Examines Concern Over New Rules for Undocumented Immigrants
The Boston Globe on Thursday examined concerns from hospital officials and advocates for immigrants about proposed HHS guidelines that will require hospitals to ask patients about their immigration status to obtain federal funds for providing indigent emergency care (Buote, Boston Globe, 8/19). CMS officials last month announced the program, which will offer U.S. hospitals $1 billion over four years to pay for the emergency care of uninsured patients -- regardless of their citizenship. Through the program, the government aims to determine the number of undocumented immigrants who receive treatment from U.S. hospitals and ambulance services.
The government will distribute two-thirds of the funds among all states, and states with the largest number of undocumented immigrants will receive the remainder. For hospitals to receive the funds, they must ask uninsured patients whether they are U.S. citizens; lawful permanent residents; aliens with valid, current employment authorization cards; students, tourists or business travelers with nonimmigrant visas; or foreign citizens with 72-hour border crossing cards (California Healthline, 8/10).
"Philosophically, we don't think it's appropriate to inquire about a patient's immigrant status while they're seeking health care," Julie Corwin, a spokesperson for Massachusetts-based Hallmark Health, said. She added, "It could discourage people from seeking health care, and put their health in jeopardy." Lori Berry, executive director of the Lynn Community Health Center in Massachusetts, added, "Are we saying that we want our physicians to become a policing force? If so, should we also ask them to report individuals who are behind on their alimony payments?" She said, "As a health care provider, our primary focus should be medical care. If the legal system wants to crack down on immigration, there are other ways to do that.
These regulations would cause a moral crisis for our medical providers." The Globe reports that several health care providers also expressed concern about the logistics of tying federal reimbursement to hospitals' efforts to collect information about patients' immigration status, given the "busy nature" of hospital emergency departments. They also said that hospitals' expenses of adding additional staff to collect the information could offset the amount of federal aid they receive.
"If these regulations are implemented as proposed, hospitals will be seen as immigration enforcement agents," Ali Noorani, executive director of the Massachusetts Immigrant and Refugee Advocacy Coalition, said. She said that patients could be discouraged from seeking care, possibly resulting in the spread of contagious diseases in schools and workplaces.
Brian Rosman, policy director at Health Care for All, said, "These regulations could be implemented by using less intrusive methods that would not create obstacles to getting medical care." The Globe reports that the MIRA and other advocates are suggesting that instead of the regulations, health care providers should be allowed to use a formula to "estimate the costs that qualify for aid" (Boston Globe, 8/19).