Hey, Democrats, don't be ashamed of supporting health care for immigrants

It's the law. Instead of scolding, Republicans should look at what hospitals are already required to do.

Published August 3, 2019 4:00AM (EDT)


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Both political parties have been making much ado in the weeks since the Democratic debates about candidates holding up their hands affirmatively to say that migrants entering the country even illegally should be able to get health treatment.

Donald Trump and Republican followers more generally have been vocal in ridiculing this thought, labeling these ideas as favoring “open borders” and running counter to all that is American traditions. To Trump, the idea of Democrats showing some sense of empathy is weakness of backbone and blindness to the major immigration disaster facing the United States from illegal crossings of the border.

That’s why he wants a Wall, military deployments, family separations, an end to asylum laws as we have known them, an increase in border patrols, and raids on homes where undocumented immigrants may be living in cities across the country.

Hospitals must medically screen all persons seeking emergency care and provide the treatment necessary, regardless of payment method or insurance status.

But something has sounded tinny here. Every hospital I have entered has signs that say that while they ask for proof of insurance, they will not turn anyone away.

So, I checked. We already provide this kind of emergency care, have done so for years – and the government reimburses hospitals for doing so.

Hey, Trump, raise your hand

Perhaps the president should join those on the Democratic stage raising his hand.

Here is the what the government already says is the law for “emergency health services for undocumented aliens,” part of the Medicare modernization act.

Undocumented aliens’ use of medical services has been a long-standing issue for hospitals, particularly among those located along the U.S.-Mexican border. As required by federal law (The Emergency Medical Treatment and Labor Act or EMTALA), hospitals participating in Medicare must medically screen all persons seeking emergency care and provide the treatment necessary to stabilize those who have an emergency condition, regardless of payment method or insurance status.

In an effort to assist hospitals and other providers with their uncompensated care costs, Congress included a provision in the Medicare Modernization Act (MMA)—Section 1011—to set aside $1 billion through 2008 to help hospitals and other emergency providers recoup some of the expenses of providing this critical care.”

Back in 2005, the government was paying states to underwrite estimated costs for doing so. For California, that was more than $70 million a year, for example.

According to the summary of the law from the folks who administer Medicare, “The Secretary must directly pay hospitals, certain physicians, and ambulance providers (including Indian Health Service and Tribal organizations) for their otherwise unreimbursed costs of providing services under EMTALA to undocumented immigrants.  This includes related hospital inpatient, outpatient, and ambulance services furnished to undocumented aliens, aliens paroled into the United States at a U.S. port of entry for the purpose of receiving such services, and Mexican citizens permitted temporary entry to the U.S.”

All necessary medical services

In addition, CMS (Center for Medicare Services) “has adopted an indirect approach to determine whether a provider can seek payment for an eligible patient. CMS will not require hospital staff to ask patients directly about their citizenship or immigration status.” Section 1011 coverage would continue until the individual is stabilized, notwithstanding any inpatient admission. To be considered stable, a patient’s emergency medical condition must be resolved, even though the underlying medical condition may persist.  In general, we believe that most patients will be stabilized within two calendar days.

According to the MMA, Section 1011 funds can be used to cover all medically necessary and appropriate services which physicians furnish to a hospital inpatient or outpatient patients who receive emergency services required by section 1867 (EMTALA) and related hospital inpatient and outpatient services and ambulance services.

Rather than paying for open-ended medical treatment at emergency rooms, it does seem financially responsible to say undocumented individuals can buy medical insurance at their own cost, doesn’t it?

Be careful whom you ridicule. You might be the ridiculed yourself in a half-second.

Let’s Make America Accurate.

By Terry H. Schwadron

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