Bill would force hospitals to report illegal immigrants

By: ERIN WALSH - Staff Writer | Tuesday, December 16, 2003 11:14 PM PST ∞

An Orange County congressman says he will introduce a proposal next month that would force hospitals to report illegal immigrants who come to the emergency room to the Immigration and Naturalization Service.

Opponents say that if approved, the bill could trigger a public health crisis, especially in areas with large immigrant populations such as North County. Scaring immigrants away from hospitals, they said, could cause unnecessary deaths and eventually increase hospital costs by forcing people to put off medical care until they are deathly ill.

Rep. Dana Rohrabacher, R-Huntington Beach, said Tuesday that he will introduce his plan next month in response to a new Medicare law that gives hospitals throughout the nation an estimated $1 billion over 10 years to treat undocumented aliens.

Rohrabacher was one of a few holdouts in a drawn-out fight over the $395 billion Medicare law. In return for his vote, Rohrabacher said he reached a deal with House of Representatives leaders to fast-track his INS proposal and bring it to a vote in January.

State and local health officials said they don't know how much support the proposal would garner in Congress, but they are preparing to fight.

"If a person can't come in because they're scared of being deported, they'll get sicker and sicker and get the community sicker and sicker," said Palomar Pomerado Health district's Jim Neal, who is in charge of making sure North County's largest hospital system follows federal laws. The district's two hospitals in Escondido and Poway spend more than $6 million a year treating undocumented immigrants.

"Every doctor we have has concerns that this is not good medical practice," Neal said Tuesday. "People think it could be just plain dangerous."

Taxpayers treating illegals

But Rohrabacher, a supporter of immigration reform and a member of the conservative wing of Republicans in Congress, said hospitals should not get taxpayer money for treating illegal immigrants unless they are willing to turn in undocumented patients to the INS.

"It's absolutely ridiculous that our own veterans and citizens can't get good health care but people who come here illegally get whatever they need from our hospitals," Rohrabacher said. "That $1 billion could turn into $50 billion in no time if we don't have some way of holding the numbers down."

Hospitals in the United States that offer emergency care must treat all patients who walk into the emergency room, regardless of their economic or immigration status, according to a 1986 federal law called the Emergency Medical Treatment and Active Labor Act. Under the law, hospitals cannot refuse to treat patients in emergency situations, including women in labor, for economic reasons or immigration status.

Hospitals would continue to be required to treat undocumented patients under Rohrabacher's proposal. But the bill, he said, would require hospitals to turn them over to immigration officials within two hours of providing treatment.

Medical groups all over the region and state said they will lobby against Rohrabacher's proposal, saying hospitals should not be forced to play the role of INS or Border Patrol agents.

"Our job is to provide care. It is not our job to be INS officials," said Jan Emerson, spokesperson for the California Healthcare Association, which represents about 500 hospitals throughout the state.

Opposition counts costs

The San Diego Medical Society and the head of a community clinic system called North County Health Services also said they oppose Rohrabacher's plan.

"The personal cost is that people could die from preventable or treatable problems," said Tom Gehring, executive director for the San Diego County Medical Society. "The community's cost is that if wait until they're bleeding or comatose or collapsed to go to the hospital, the cost of medical care will be astronomical."

Rohrabacher said giving undocumented immigrants health care without consequences encourages people to live in the United States illegally, creating a public health crisis on its own.

"If we end up giving free health care to anyone, we'll get more and more people bringing different diseases into our country," he said. "Now that is a health problem."

Rohrabacher's bill, which he said has not been drafted yet, will likely get to the House floor for a vote because of a deal the congressman made with leaders late last month during a debate over a GOP-backed Medicare bill.

According to Rohrabacher and his aides, House Speaker Dennis Hastert and other bill supporters needed the vote of the Orange County Republican, who often influences a handful of other conservative congressmen.

But Rohrabacher opposed giving money to hospitals for illegal immigrant care. So the speaker and the congressman struck a deal: Rohrabacher would vote for the Medicare bill, including the billion-dollar provision for immigrant care, and House leaders would allow Rohrabacher to bring his INS-reporting bill to legislators for a vote in January.

The fast track

Bills normally must make it through a number of subcommittees before heading to the House floor. Rohrabacher said he plans to bypass those committees if Hastert keeps his word.

As a regular bill, a proposal from a right-wing congressman from the corner of the country may die in committee before reaching the House floor, legislative analysts said. But even opponents of Rohrabacher's idea said it might have a chance if it goes straight to representatives.

"I don't know if this would have a chance normally, but it would be dangerous if it got to a vote," said Angela Hooton, a legislative attorney for the Mexican American Legal Defense and Education Fund in Washington, D.C. "After 9-11, there's a strong anti-immigration movement all over the country. That's subsiding a little, and I think there are strong enough arguments against this proposal. But when it comes down to a floor vote, who knows how people will vote?"

Lobbying groups, including the state health-care association and its counterparts in other border states, New York and Washington D.C., plan to fight Rohrabacher's proposal, Emerson said.

Taking sides

"Forces are mobilizing to come out strongly against this, and not just in California," she said. "Here at home, we have 53 members of the (U.S.) House and two senators ... we will be pressuring them hard, showing them that a bill like that would create huge problems for hospitals in their areas."

A group of Latino federal lawmakers known as the Congressional Hispanic Caucus also opposes the plan. In a letter to Hastert, the caucus, made up of 20 members of the U.S. House and Senate, said the proposal would "have a devastating effect on our nation's public health" and would "take health-care officials away from their work of caring for patients."

Officials from Tri-City Medical Center and Fallbrook Hospital had no comment on Rohrabacher's proposal.

A spokesman for Rep. Randy "Duke" Cunningham, R-Escondido, said he supports efforts to reduce illegal immigration but won't support Rohrabacher's bill if it adds to the workloads of hospitals.

"I believe that every hospital, like every American, has a responsibility to report illegal immigration," Cunningham said in a written statement. "However, I do not support the creation of any new regulatory burdens for hospitals when they are already overburdened with paperwork. ... Congressman Rohrabacher has been a true leader in the fight to reduce illegal immigration. I intend to examine his legislation closely as it is finalized."

Contact staff writer Erin Walsh at (760) 739-6644 or ewalsh@nctimes.com.