Immigrant health care costs elusive

Filed under: News |

Colorado’s Medicaid program will spend more than $53 million this year on acute emergency needs for non-U.S. citizens, but the exact amount that will be spent caring for illegal immigrants isn’t known.
“We only track figures for emergency room care,” said Holly Stevenson, spokeswoman for the Colorado Department of Healthcare Policy and Financing. “Illegal immigrants aren’t eligible for any other kind of Medicaid help.”
State officials estimate that 5,746 non-citizens will visit the emergency rooms or other acute-care clinics during this fiscal year. The estimated per-capita cost: $9,240.20. However, Stevenson said, Medicaid doesn’t separate illegal aliens from non-citizens who are legally in the United States.
Officials estimate that Colorado is home to 2 percent of the 10.3 million illegal alien population.
Hospitals, clinics and the public health department don’t ask about immigration status – Healthcare Portability and Accountability Act requirements won’t allow it, they say.
“We just list people as indigent, if they don’t have insurance,” said Memorial Health Systems spokesman Bradd Hafer. “We can’t ask for green cards or visas. We just don’t have hard and fast information, unless it surfaces through the filtering process for people who can’t pay. It’s difficult to find clean answers; the questions are so vague there’s no way to attain accurate numbers.”
Hafer said the illegal immigration issue does not loom as large for El Paso County as it does in border states and cities.
“It’s a small percentage,” he said. “But we just don’t have an identifier in place. We have to be careful because of the Healthcare Portability and Accountability Act. … The number of immigrants we treat is nothing to the level of U.S. citizens we treat who are indigent. It’s just a very small minority – a gray area.”
El Paso County’s Department of Public Health and Education offers clinics for women’s health, childhood immunization and sexually transmitted diseases. But officials at the department say they also don’t know the number of illegal aliens receiving services.
“We do not capture or track immigration status,” said spokeswoman Margaret Radford. “It’s not something we do – we are mostly concerned with public health, and we just offer a few clinics.”
At Colorado Health Initiative, Sherry Walker said that no one knows how many illegal immigrants are in the country, or how much it costs to care for them.
“It’s a dicey thing,” she said. “These people don’t exactly stand up to be counted, and no one seems to be tracking the numbers when they’re treated. We did a study, not related to immigration, last fall and we asked about illegal immigrants as a side issue. We talked to clinics who deal with people without insurance; many of them will not collect the data because they are afraid it might hurt their patients.”
In Colorado, two groups are supporting a ballot initiative that would prevent illegal immigrants from receiving any local or state government funded health care – except in the case of emergencies, which is federally mandated.
The Colorado Alliance for Immigration Reform and Defend Colorado Now say that the cost of providing health care to undocumented immigrants is a burden to American taxpayers. The alliance says that 12 percent of illegal aliens use Medicaid. But even that figure is not precise.
“We get the figures from national studies, and then extrapolate them for Colorado,” said Mike McGarry, an alliance spokesman. “Our figures were put together by Donald Rice of the Defend Colorado Initiative. The health care costs are tremendous: 12 percent are on Medicaid, 70 percent of the people without health insurance are illegal. In Colorado, one in five people who don’t have insurance are illegal aliens.”
McGarry said that 24 percent of the births in metropolitan Denver are to illegal immigrants, creating what he called “anchor babies” for their parents. He said the burden of caring for illegal immigrants causes financial hardship for hospitals.
“In California – the epicenter of illegals – 64 hospitals and emergency rooms were closed because of the costs of caring for illegal immigrants,” he said. “A lot of that cost comes from federal requirements to have translation services available. Denver hospitals spend $1 million on translation services alone.”
State and local officials are unsure about the numbers, as is the General Accounting Office.
For a 2005 study, the office contacted hospitals in the seven states with the highest population of illegal immigrants. The conclusion: There isn’t enough information to determine how many undocumented people use the health care system, or how much it costs.
“The GAO could not determine the effect of undocumented aliens on hospitals’ uncompensated care costs,” the study said.
Despite the lack of concrete numbers from local and state health care officials, figures from the Center for Immigration Studies show that “the share (of illegal immigrant households) using Medicaid and foods assistance welfare programs is quite high and substantially more than the share of non-illegal households.”
The center is a private nonprofit organization headquartered in Washington, D.C.
About 17 percent of illegal immigrants nationwide use Medicaid, according to the CIS; while only 14 percent of the rest of the national population uses the program.
“It must be remembered that, for the most part, illegal households using programs like free school lunch or Medicaid are receiving these benefits on behalf of U.S.-born children, who under current law, are awarded citizenships at birth,” the CIS says. “In considering consequences for public coffers, counting the costs of these programs is necessary, otherwise one would gain a very false sense of illegal immigration’s present costs. … Barring illegals from using the program would not significantly reduce costs. Their citizen children would continue to receive them.”
The center also says that illegal immigrants contribute about 37 percent more of their income to Medicare and unemployment taxes than the rest of the population.
However, because fewer illegal immigrants pay federal taxes, and pay less than the rest of the population, CIS estimates that their presence costs the government an average of $2,735 for each household annually, or $10.4 billion.
“And for Social Security … illegals pay 40 percent of the average households contribution,” the CIS says. “Tax payments are based on the assumption that only 55 percent of illegals pay payroll taxes. In general illegal households use much less in almost every type of service. Moreover, it is also clear that illegals pay substantially more in Social Security and Medicare than they use, creating a net benefit for these two programs of over $1,800 a year per illegal alien household.”
Amy.Gillentine@csbj.com