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The Medicare Bill's Illegal Alien Payoff By: Steve Brown and Chris Coon
FrontPageMagazine.com | Monday, December 01, 2003


Inside the much-celebrated Christmas present to seniors from President Bush and Congress—the $395 billion Medicare package—another stocking stuffer went largely unnoticed, one that gouges the taxpayer yet again to benefit lawbreakers. Hidden within the sweeping reforms to Medicare is a provision that would provide $1 billion in federal funds for illegal immigrant health care. The Medicare bill, which swept through Congress , promises to be a centerpiece in President Bush's  re-election plans.

"Modernizing Medicare will make the system better and enable us to say to seniors, 'We kept our promise, '" Bush said. Absent from his self-congratulatory remarks was any mention of earlier campaign promises to keep government spending under control. Moreover, not a hint was made  regarding the lighthouse beacon the bill represents,  beckoning an even greater  invasion of illegal aliens to this country. Bill supporters and the president who signed it have collectively turned a blind eye to this invasion. Far greater than our present border authorities can hope to control, this politically motivated indifference is made even more troubling in a post-9/11 world. The burgeoning flood additionally threatens to overwhelm the strides the nation has made over the past two quarters toward recovering from Bill Clinton's recession.

Sen. John Kyl, R-AZ, a key member of the House/Senate conference committee that produced the final Medicare bill, sponsored an amendment reimbursing hospitals for federally mandated treatment of illegal aliens. The provision provides $1 billion over four years in payments to border area hospitals, including $150 million to Arizona facilities struggling under the strain of caring for illegal aliens.

Citing the financial difficulties hospitals in his home state have faced because of the mandate to treat any patient seeking  medical treatment, Kyl noted that the situation has forced many area hospitals into insolvency, even closing some trauma centers in the area. Kyl made keeping this provision key to his supporting the compromise bill.

One of the undisputed primary incentives to illegal immigration has been the bounty of services provided to the aliens invading our nation. The billion dollar giveaway to those in our country illegally brought an immediate outcry from immigration reform proponents.

"It’s ironic that this amendment was introduced by Kyl," David Ray, spokesperson for the Federation of Americans for Immigration Reform (FAIR) told Frontpagemag.com.  "They’ve enacted laws in Arizona that virtually roll out the   welcome wagon to illegal aliens. They have sanctuary policies barring cooperation between local police and immigration agents and they accept the Matricula card for services intended for legal residents.  Arizona is finally realizing that if you build it, hey will come, but now they’re looking to the rest of us to bail them out on the costs."

Rep. Tom Tancredo, R-CO, chairman of the House Immigration Reform Caucus, agreed wholeheartedly. Blaming the states themselves for encouraging illegals by providing them with services, he expressed outrage at the federal move to subsidize illegals' behavior.

"I find it troubling that this Congress is potentially providing such a considerable amount of money to states that are responsible for creating their own poor state of affairs. Some states have enacted laws -- such as those permitting illegal aliens to obtain driver's licenses, higher education subsidies, and federal and state public services through the use of the Matricula Consular IDs -- that create incentives for illegal immigration, which subsequently results in the need for emergency health care reimbursements. This exacerbates the already serious problem of illegal immigration by creating yet one more social service magnet."

But while Tancredo is correct that some recent actions taken by the states encourage illegal immigration, the unfunded federal mandate requiring hospitals to treat illegals, the Emergency Medical Treatment and Active Labor Act (EMTALA), has been in place since 1986.

The hospital community greeted the new Medicare bill with open arms, and why shouldn’t they? EMTALA forces hospitals to admit aliens regardless of ability to pay and has led to the financial problems in border states such as Arizona.

"The legislation offers needed relief for hospitals treating…large numbers of undocumented immigrants in their emergency departments, such as facilities in border states," an American Hospital Association spokesperson told Frontpagemag.com.

The Arizona Hospital and Healthcare Association (AHHA) has been working for years with coalitions in other border states to get funding reimbursements for services they are forced to provide under the EMTALA mandate.

"This represents an opportunity to recoup the huge uncompensated care losses that hospitals assume taking care of the foreign national population," Barbara Felix, AHHA senior policy director told Frontpagemag.com. Felix estimated that Arizona hospitals spent more than $150 million over the last year alone providing services for illegal aliens.

The hemorrhaging in the state’s health care -- which includes hospital closures and service reductions -- was deepened by the Arizona State Supreme Court ruling in August finding that Arizona's Medicaid program (Arizona Health Care Cost Containment System) was required to provide health care for illegals beyond the emergency room. Lawyers for the Medicaid program, AHCCCS, argued that the only obligation Arizona's hospitals bore was to reimburse emergency services. However, the court's unanimous ruling, based in part on EMTALA requirements, stated that AHCCCS could not dictate what type of care could be covered. The attendant rise in state Medicaid costs now threatens to bankrupt the entire system.

Arizona is not alone in facing these problems. Hospitals and public health providers from California to Colorado are feeling the pinch of providing unlimited services to illegal immigrants, who have neither citizenship nor insurance. The Border Counties Coalition, an organization made up of elected officials representing the 24 U.S. counties that directly border Mexico, commissioned a report that estimated the cost of illegal alien medical expenses at more than $832 million for FY 2000. This includes more than $200 million for emergency health care ($79 million in California, $74 million in Texas, $31 million in Arizona, and $6 million in New Mexico, as well as $13 million in EMS transportation costs.) Sen. Kyl  noted that current estimates for total care run between $1.5 and  2 billion.

Kyl has stated, "One of my top priorities in the Senate has been to provide reimbursements to local health care providers for the costs of federally mandated emergency care of illegal immigrants." Apparently lawmakers have not considered that the answer to the problem of unfunded mandates is not public subsidies but repealing the mandate themselves.

The Medicare bill amendment's passage crossed ideological lines, as well. Kyl's fellow Arizona Senator Republican John McCain, who does not support the prescription plan, pledged to include the hospital funding in other appropriations bills if it had been stripped from the Medicare legislation. With passage of the bill the point is now moot.

The funding will also serve to undercut the political necessity of the Protect Arizona Now (PAN) initiative currently being sought for the 2004 referendum in their state. Both Senators oppose the voter referendum, which would eliminate the ability of illegals to avail themselves of any state services. One of the key selling points of the initiative is the burden such services place on Arizona health care facilities.

"The federal government has been doing this for years," Kathy McKee, PAN spokeswoman, told Frontpagemag.com. "They’ve been taking millions and millions of dollars and pouring it into illegal alien health care, education and everything else, putting it in different bills and the public is just now finding out about it. It’s not a small thing. It is a lot of money and it’s outrageous."

While the proposed PAN measure wouldn't prevent illegals from receiving immediate emergency care, opponents feel that the restrictions it would put in place would lessen the numbers of illegals who come to the state to avail themselves of free government services.

"Arizona has spent hundreds of millions of dollars on illegal alien health care. I’m glad the public is finally getting it, but apparently the federal government isn’t," an exasperated McKee explained.  "These people should not get one centavo."

Ultimately, the government is placing the illegal aliens' needs above those of its own citizens, the taxpayers who are footing the bill for illegals receiving better medical care then many insured Americans.

The federal government has created a no-win situation for the taxpayer: either create additional subsidies to foot the bill incurred by illegal aliens, strip coverage from Medicare and Medicaid recipients to budget the resources needed to cover these invaders, or continue the unfunded mandate, gutting Americans' access to health care facilities, as hospitals close their doors due to the lack of funding. There is a fourth option that they refuse to consider -- and, not surprisingly, one that makes the most sense: preventing illegal aliens from taking advantage of America's misplaced generosity and prioritizing the needs of our own citizens above those who invade and exploit our nation.



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