Bill would require fingerprinting of undocumented aliens by ER staff

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>Imperial Valley (Calif) Press, Saturday, January 24, 2004
>
>Bill would require fingerprinting of undocumented aliens by ER staff
>
>By MICHAEL A. SALORIO, Staff Writer
>
>
>WASHINGTON, D.C. - Emergency room staff would have to fingerprint or
>photograph any undocumented immigrant they treat and report the
>patient to the Department of Homeland Security to begin deportation
>procedures if a bill introduced here Wednesday is enacted.
>
>Rep. Dana Rohrabacher, R-Huntington Beach, introduced House Resolution
>3722, also referreds to as the Undocumented Alien Emergency Medical
>Assistance Amendments of 2004.
>
>The bill seeks to amend section 1011 of the recently enacted Medicare
>Prescription Drug, Improvement and Modernization Act of 2003. Section
>1011 provides $1 billion to reimburse hospitals for the costs of
>treating undocumented immigrants. The bill would impose conditions on
>federal reimbursement of emergency health services furnished to these
>patients.
>
>The U.S.-Mexico Border Counties Coalition funded a study in 2000 that
>found the 24 counties adjacent to the Mexican border spent $190
>million to provide emergency care to undocumented immigrants that
>year. Of all the border states, California spent the most treating
>undocumented immigrants with unreimbursed expenditures at $79 million.
>Texas came in second with $74 million, Arizona at third with $31
>million and New Mexico fourth with $6 million.
>
>In a December 2003 story published in the Press, El Centro Regional
>Medical Center chief executive officer David Green said the hospital
>incurs an estimated $1.7 to $2 million annually treating undocumented
>immigrants.
>
>In that same story, a hospital official said 80 percent of those costs
>are incurred by the hospital's emergency room where an average of 10
>undocumented immigrants were treated each month in 2003 and 14 a month
>in 2002.
>
>Personnel with Pioneers Memorial Hospital in Brawley were unable to
>provide the level of losses incurred by the hospital's emergency room
>treating undocumented immigrants. Additionally, the number of
>undocumented immigrants treated each month in the hospital's emergency
>room was unavailable.
>
>Rohrabacher was opposed to the Medicare bill passed last year because
>of the $1 billion in funding it provided to hospitals for
>reimbursement of their costs associated with treating undocumented
>immigrants.
>
>Federal law mandates hospitals treat anyone requiring emergency care
>and prohibits a patient being denied treatment on the basis they
>cannot afford to pay. The $1 billion in the Medicare bill marked the
>first time the federal government made money available to hospitals to
>reimburse their costs incurred by treating undocumented immigrants.
>
>GOP leaders promised Rohrabacher they would bring his immigration
>proposal to a vote this year in exchange for his vote on the Medicare
>bill.
>
>"I opposed that and I was not going to vote for the Medicare bill
>because of that, but the leadership in the House agreed that if I
>would vote for the Medicare bill, that I could write legislation that
>would, in some way, mitigate the damage that I felt was inherent in
>providing U.S. tax dollars officially to pay for services, health
>services, for people who have come to this country or are currently in
>this country illegally," said Rohrabacher during his speech on the
>House floor introducing his legislation.
>
>"Our health care system, our emergency rooms are breaking down under
>the pressure and the strain of illegal immigrants. And that is what
>leads me to the legislation which I introduced today," said
>Rohrabacher.
>
>Hospitals would still be eligible for federal funding for treating
>undocumented immigrants under Rohrabacher's bill. However, in order to
>be reimbursed hospitals would have to ask patients if they are U.S.
>citizens or not.
>
>If the patient answers they are a U.S. citizen, no further action is
>required by the hospital. If the patient answers he or she is not a
>citizen, the hospital would then fingerprint or photograph the patient
>and contact the Department of Homeland Security to report the
>patient's immigration status, address and the name of their employer.
>
>The bill directs the Department of Homeland Security to begin
>deportation proceedings against any patient who is an undocumented
>immigrant. Employers of these patients would be required to reimburse
>the federal government for the Medicare money paid to hospitals.
>
>Dr. Michael Berger, emergency room director at Pioneers Memorial, said
>hospital staff would be required as a matter of law to follow the
>provisions of Rohrabacher's bill if it were to be enacted.
>
>Berger said that although the bill might make undocumented immigrants
>apprehensive in coming to the hospital to receive treatment, word
>would quickly spread that all they would have to do is answer 'Yes' to
>the citizenship question since there is no requirement the hospital
>verify patients are citizens if they answer so.
>
>"It doesn't seem to have much teeth. If you just ask people and ask
>for no proof ... it's kind of hollow. ... Bottom line, this seems like
>a weak bill. ... Your heart is in the right place but your head isn't,
>Mr. Congressman," said Berger.
>
>Elise Bryant, spokeswoman for El Centro Regional, said the hospital
>had no official position on the proposed legislation in light of the
>proximity to the date it was introduced.
>
>Bryant added Rohrabacher's legislation might conflict with the
>Emergency Medical Treatment and Labor Act of 1986 that prohibits
>hospitals from asking patients financial status questions, under which
>citizenship queries would fall, until after the patient has been
>treated.
>
>Rohrabacher on the House floor said: "It is just a couple of more
>questions to be asked routinely in the process in which they are
>already being asked questions before they treat patients."
>
>"The way it reads, the congressman is proposing upon admission they
>ask whether they are a citizen. That would violate EMTALA," said
>Bryant.
>
>Jan Emerson, spokeswoman for the California Healthcare Association, an
>association of hospitals whose members include El Centro Regional and
>Pioneers Memorial, said the organization is opposed to Rohrabacher's
>legislation.
>
>"When a person comes into an emergency room under current legislation
>we're not allowed to ask a patient if they have health insurance or if
>they are a citizen. We first must treat them," said Emerson.
>
>The legislation is not practical because undocumented immigrants would
>figure out they only have to answer "Yes" to the citizenship question
>and give a false address and phone number, added Emerson.
>
>"Our mission is not to be the INS. Our mission is to heal. Our job is
>not to be an INS agent. It's the federal government's job," said
>Emerson.
>
>Rep. Bob Filner, D-Chula Vista, said the purpose of hospitals is to
>heal patients and not to be a law enforcement agencies. Filner added
>he doubts the bill will become law.
>
>"Hospitals are there to treat the sick and injured and not there to be
>police agencies. ... It's an incredibly mean-spirited approach to a
>real problem. What we need to do is reimburse hospitals for treating
>anyone that is undocumented and have a policy with Mexico that would
>help them bring down their rate of emigration. This is a horrible
>bill," said Filner.
>
>Rohrabacher's bill has been referred to the House Committee on Energy
>and Commerce. A date has not been set for a vote on the bill by
>committee members for referral to the floor for a full vote.
>
> >> Staff Writer Michael A. Salorio can be reached at 337-3441 or
>msalorio [at] ivpressonline.com
>
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>Washington Times, November 27, 2003
>
>
>House will vote on alien reporting
>
>By Stephen Dinan THE WASHINGTON TIMES
>
>As part of the horse-trading to win votes for the prescription-drug
>bill, House Republican leaders promised to hold a vote on a bill
>requiring hospitals that treat illegal aliens to report them to
>federal authorities.
>
>The Medicare overhaul bill, which passed the House on Saturday and the
>Senate on Tuesday, includes $1 billion to reimburse hospitals for
>treating indigent illegal immigrants.
>
>But in exchange for supporting the bill, Rep. Dana Rohrabacher,
>California Republican, extracted a promise from House Speaker J.
>Dennis Hastert of Illinois to allow a vote on making hospitals report
>illegal aliens. "I told leadership that if they wanted my vote
>they would have to mitigate the damage that is done by financing
>illegal immigrant health services. They needed my vote, so they took
>the deal," Mr. Rohrabacher said in a statement.
>
>He initially had voted against the $395 billion bill on Saturday
>morning, but he reversed himself during the three-hour delay that
>Republican leaders used to persuade several party members to switch
>their votes, saving the bill.
>
>Federal law says hospitals cannot turn patients away, even if they are
>unable to pay and even if they are not U.S. citizens. Sen. Jon
>Kyl, Arizona Republican and a member of the House-Senate committee
>that wrote the final compromise Medicare bill, included the money to
>reimburse hospitals, which spend an estimated $1.45 billion a year on
>uncompensated treatment for illegal immigrants.
>
>"This puts many of them on the brink of bankruptcy or, at a minimum,
>[they´ll have to] cut back on many of the services they provide us,"
>Mr. Kyl said. "Without this reimbursement, they are not going to be
>able to take care of us." A hospital in San Diego was forced to
>close after losing more than $5 million a year in unreimbursed medical
>care, much of it for illegal immigrants, and other hospitals have
>reported losing millions of dollars a year in uncompensated care.
>Hospitals and health care associations have demanded that the federal
>government pay for what they see as an unfunded mandate for care.
>
>The Medicare bill allocates $250 million a year from fiscal year 2005
>through 2008 for reimbursement, to be divided among hospitals by a
>formula and rules to be worked out by the Bush administration.
>California and Texas expect to get about $70 million a year and $50
>million a year, respectively, and Arizona would receive from $40
>million to $45 million, according to senators from those states.
>But some members of Congress who support stricter immigration controls
>object to the funding, saying the money will just bolster the
>incentives for illegal aliens to continue to enter the United States.
>
>"Writers of this Medicare bill have apparently never seen the movie
>'Field of Dreams' - if you build an illegal alien entitlement program,
>they will come," said Rep. Tom Tancredo, Colorado Republican, who
>rallied fellow members to oppose the provision. Mr. Tancredo and
>other opponents recently have begun to try to punish jurisdictions
>that accept cards issued by foreign governments as valid
>identification or that allow illegal aliens to obtain driver's
>licenses, arguing that those jurisdictions are creating some of the
>incentives that draw illegal aliens and are helping them avoid
>detection by allowing them the means to integrate into society.
>Mr. Rohrabacher's proposal would require hospitals to report to
>authorities within hours of treatment that health care is being
>provided to illegal immigrants. The Border Patrol would then be
>required to put the illegal immigrants on a list for expedited
>deportation.
>
>The deal was that the legislation would be included either as part of
>the omnibus spending bill now pending in Congress or as a stand-alone
>bill to be voted on early next year. The final language of the
>omnibus bill was settled on Tuesday and the provision is not part of
>it, so Mr. Rohrabacher's office now expects a vote next year on a
>separate bill.
>
>Laurie Lange, vice president of public affairs for the Arizona
>Hospital and Healthcare Association, said she hadn't seen Mr.
>Rohrabacher's proposal, but she said hospitals don't want to get mixed
>up with immigration issues. "Health care providers are in the
>business of proving health care, not in the business of determining
>the citizenship status of our patients," she said. Hospitals say
>they aren't supposed to ask about immigration status, but some seem to
>find out anyway.
>
>Greg Pivirotto, president and CEO of University Medical Center in
>Tucson, told the Arizona Star this week that of 24 Mexican nationals
>admitted to that hospital last month, eight were in the United States
>illegally. And because hospitals are responsible for care until
>the patients are released, some hospitals already have arrangements to
>transport indigent Mexican patients to hospitals in Mexico once they
>are stabilized.
>
>For his part, Mr. Kyl said he understands Mr. Rohrabacher's position,
>but he is hoping to broker a different solution.
>
>"He's frustrated, we're all frustrated, about our inability to control
>the border," Mr. Kyl said. "The question is, do you cut off your nose
>to spite your face?"
>
>He said one reason he put the money for reimbursement in the bill was
>to "highlight to my colleagues the real nature of" the costs of
>illegal immigration.
>
>"I want to do it in a constructive way. I hope these other members of
>Congress want to deal with it in the same way," he said. "But there's
>no question this provision has generated interest, and I intended it
>to."
>
>He said he wants to craft something with Mr. Rohrabacher that will not
>punish hospitals that have to treat the patients. "I think the
>question here is whether the burden would be onerous, and therefore,
>the hospitals would never be able to participate in the program, or
>whether it would be reasonable," he said.
>
>
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>
>Inter Press Service News, January 30, 2004
>
>
>No Room for Ailing Aliens?
>
>Haider Rizvi
>
>
>NEW YORK, Jan 30 (IPS) - In a long line of patients outside the
>emergency room of a busy hospital here, Francisco Garcia finds it hard
>to stand on his two feet at ease as he waits his turn to see a doctor.
>
>"Give me... give me some medicine," he pleads in pain, his whole body
>erupting in trembles and shivers every now and then. "I can't wait...
>give me something".
>
>But Garcia must wait, as there are many others ahead of him that the
>nurses on duty are obligated to treat first. After about an hour, his
>name is announced, and he is off to the emergency room.
>
>He is lucky, perhaps.
>
>Garcia has no idea that if certain lawmakers in the U.S. Congress
>succeed in passing a proposed bill, a visit like this will become much
>riskier for millions of undocumented immigrants like him.
>
>The draft bill requires that undocumented immigrants must disclose
>their national identity and legal status before receiving emergency
>medical treatment at any hospital in the United States.
>
>"The hospitals need to ask patients if they are citizens of the United
>States. How about that?" said Republican Congressman Dana Rohrabacher
>while introducing his draft bill in the House of Representatives Jan.
>7.
>
>"If the patient says 'yes', no further action is required," he added.
>But if the patient says 'no', the hospital will be required to ask
>what country he or she is from and the patient's immigration status,
>according to Rohrabacher.
>
>The proposed law also requires hospitals to finger-print and
>photograph all undocumented immigrants who seek emergency medical
>help, and to hand them over to immigration authorities within two
>hours of treatment.
>
>"America has now become the HMO (health maintenance organisation, a
>medical services provider) to the world," said Rohrabacher in a
>statement. "Our healthcare system, our emergency rooms, are breaking
>down under the pressure and the strains of illegal immigrants".
>
>Currently, about 8 to 12 million illegal immigrants live and work in
>the United States, almost one-half of them from neighbouring Mexico.
>They are an essential cog in the country's economic wheel.
>
>A Medicare bill, also proposed by Rohrabacher's Republican Party (led
>by President George W. Bush) allocates about one billion dollars over
>10 years to reimburse hospitals that treat undocumented immigrants.
>
>But Rohrabacher would allow hospitals to receive the federal money
>only if they comply with his bill.
>
>"A hospital that does not want to receive federal funding under the
>programme in that Medicare bill does not have to participate in this,"
>he said.
>
>The politician's remarks have created waves of anger and resentment
>among medical professionals and immigrant support groups.
>
>"Hospitals have a mission to treat everyone who walks through their
>doors," says Tom Nickels, senior vice president of the American
>Hospital Association, which represents 5,000 U.S. hospitals.
>
>"Hospitals are not the border patrol. They care for the patient first
>and ask other questions later," he added in an interview.
>
>Doctors at Bellevue Hospital, where Garcia went for treatment, agree
>with Nickels.
>
>"We strongly oppose this legislation," Spokeswoman Pam McDonnell told
>IPS. "It makes no sense."
>
>She says Bellevue, which is staffed by the New York University Medical
>School, cares for patients, "regardless of their income or immigration
>status".
>
>Critics say the proposed legislation would force illegal immigrants to
>avoid seeking emergency treatment, even if they found themselves in a
>desperate situation.
>
>"The impact of such a policy would be disastrous," says Partha
>Banerjee of New Immigrant Community Empowerment (NICE), a rights group
>based in New York.
>
>"Immigrants who are already disproportionately represented among the
>nation's uninsured will avoid hospitals when they hear about the
>policy," he added in an interview.
>
>Banerjee fears Rohrabacher's bill would lead to "unnecessary deaths",
>and eventually increase hospital costs by forcing people to put off
>medical care until they are deathly ill.
>
>Others warn that closing doors on illegal immigrants could cause an
>increase in the cases of communicable diseases.
>
>The law would "put all members of local communities at risk as well as
>the affected individual", Rev Michael Place, president of the Catholic
>Health Association (CHA), warned Rohrabacher in a recent letter.
>
>But despite strong opposition from medical organisations and rights
>group, observers do not rule out the possibility of Rohrabacher's bill
>becoming legal reality.
>
>"It's likely that his bill will get through," says a member of the
>American Immigration Lawyers Association, which closely monitors
>legislative business. "Rohrabacher often influences other conservative
>congressmen".
>
>The draft bill suggests Garcia's ailment should not be seen as a
>medical emergency.
>
>"An emergency is if someone is in immediate danger of dying," says
>Rohrabacher, who thinks that many illegal immigrants receive "advanced
>treatment" financed by U.S. taxpayers' money.
>
>Garcia, a flower-man who works outside a Manhattan grocery store for
>four dollars an hour, says he fell sick because of cold weather. His
>job requires standing outside the store all night, sprinkling water on
>flowers and making bouquets.
>
>He says he is unaware of the debate on emergency treatment for
>immigrants like him.
>
>"There is no health insurance for me," Garcia says. "I have an ID, but
>that is not real. If they really passed this law, then, no, I am not
>coming here (the hospital) again."
>