Hospitals blast immigration plan

Hospital groups are criticizing the new immigration plan this week from President Obama, which bars immigrants who could gain provisional legal status from buying health coverage from insurance exchanges and denies them Medicare and Medicaid benefits, Law360 reported.

The Affordable Care Act allows legal noncitizens to gain coverage but not unauthorized immigrants. The bipartisan immigration reform provides a path for immigrants toward citizenship, but Obama conceded to opponents by denying healthcare coverage to the 11 million newly legalized immigrants, msnbc reported.

Some providers say the proposed legislation denies basic health benefits. Still, hospitals are required to provide care to all patients, regardless of their ability to pay or immigration status, under EMTALA (the Emergency Medical Treatment and Active Labor Act). Providers, already experiencing strains on DSH (disproportionate share hospital) payments, argue that the immigration reform will further hurt hospitals that provide uncompensated care.

Msnbc columnist Geoffrey Cowley wrote, "Denying people insurance coverage doesn't magically eliminate the cost of their care. It just pushes them from primary care settings into hospital emergency departments that provide less consistent care at much higher prices." 

Meanwhile, a bill (HB 2293) introduced last week, if enacted, would compel hospitals to "reasonably confirm'' the legal status of uninsured patients in Arizona--a state with some of the strictest immigration laws, Capitol Media Services reported.

Patients from non-American counties (besides Canada) would have to prove their nation participates in the visa waiver program recognized by the United States or provide a non-immigrant U.S. visa, the Los Angeles Times reported. If patients can't provide proof they are in the country legally, hospital staff would have to call the authorities.

Rep. Steve Smith (R-Maricopa), who introduced the bill, said the bill isn't aimed at denying care to immigrants but intended to collect data on how much care is provided to illegal immigrants.

"They're (hospitals) not withholding care, they're not deporting, they're not throwing them out, they're not doing anything," Rep. Smith said, Digital Journal reported.

The Arizona Hospital and Healthcare Association blasted the bill, according to Capitol Media Services.

"When does this begin or end?'' Pete Wertheim, AzHHA vice president of strategic communication, said. "What other industry should be screening their customers for citizenship verification?''

Wertheim also noted hospital employees don't have the training to determine immigration status.

For instance, anyone with a driver's license might be presumed legal.

Critics argue the proposed legislation could not only deter immigrants from seeking care but also would essentially put hospitals in the position to play border patrol.

Immigration will be a key issue in Obama's second term, The Hill's Healthwatch reported.

For more information:
- read the Law360 article (subscription required)
- here's the msnbc column
- check out the bill HB 2293
- see the Capitol Media Services story
- read the Los Angeles Times article
- here's the Digital Journal article
­- see the the Hill's Healthwatch blog post

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