Some States Provide Care to the Undocumented Immigrants
Several states are working to offer more services, including health care, to immigrants who are undocumented, sometimes "in defiance of federal rules," the Christian Science Monitor reports. In overhauling immigration policy in 1996, Congress "bowed out of funding many benefits for immigrants," leaving states to decide if they would cover them. In health care, the federal government will currently cover only emergency care for immigrants without documentation. However, there is a "growing movement of support for providing services to undocumented immigrants," Tatcho Mindiola, director of the University of Houston's Center for Mexican American Studies, said. For instance, Arizona is "struggling with the federal government" to continue to provide nonemergency health care services, such as dialysis, to undocumented immigrants. In November, state voters approved a proposition to expand Medicaid income eligibility, but as part of an agreement with the federal government to provide additional funding, Arizona had to agree to cease funding nonemergency care for undocumented immigrants (Axtman, Christian Science Monitor, 7/20).
Under the proposition, Arizona's Medicaid program will cover individuals whose eligibility is categorically linked to Medicaid (such as parents of Medicaid-enrolled children) up to 100% of poverty. The state will also cover individuals whose eligibility is not linked to Medicaid (such as single adults and women who are not pregnant) up to 100% of poverty. The current eligibility level for non-categorically linked individuals is 34%. The plan, approved by HCFA (now the Centers for Medicare and Medicaid Services) on Jan. 18, allows the state to "change the health care program so that it increases the federal government's share of the costs," leaving the state responsible for just $55.5 million of an estimated five-year, $790 million cost. As a result of the agreement, about 200 undocumented Arizona immigrants will be responsible for paying for nonemergency treatments out-of-pocket on Oct. 1. But Frank Lopez, a spokesperson for Arizona's Medicaid program, the Arizona Health Care Cost Containment System, said that the department views some nonemergency treatment as an "outgrowth of emergency care." He added, "If we don't provide those services, these patients will be back in the emergency room until we can stabilize them again. It's kind of like a revolving door" (Christian Science Monitor, 7/20).