Tens of thousands of illegal immigrants are flooding into U.S. hospitals for treatment and leaving billions in uncompensated health care costs in their wake.
With the majority of the illegal immigrant population lacking any kind of medical insurance, hospitals and government welfare programs such as Medicaid are feeling the weight of these unanticipated costs.
Last year set new record for illegal border crossings, surpassing 3.2 million apprehensions.
And with that sea of humanity comes the need for health care and, in most cases, the inability to pay for it.
In January, CEO of Denver Health Donna Lynne told reporters that 8,000 illegal immigrants made roughly 20,000 visits to the city’s health system in 2023.
The total bill for uncompensated care costs last year to the system was $140 million, according to Dane Roper, public information officer for Denver Health. More than $10 million of it was attributed to “care for new immigrants,” he told The Epoch Times.
Though the amount of debt assigned to illegal immigrants is a fraction of the total, uncompensated care costs in the Denver Health system have risen dramatically over the past few years.
The total uncompensated costs in 2020 were $60 million, Mr. Roper said. In 2022, the number doubled, hitting $120 million.
He also said their city hospitals are treating issues such as respiratory illnesses, gastro-intestinal illnesses, dental disease, asthma, and diabetes.
“The perspective we’ve been trying to emphasize all along is that providing health care services for an influx of new immigrants who are unable to pay for their care is adding additional strain to an already significant uncompensated care burden,” Mr. Roper said.
He said that this is why a local, state, and federal response to the needs of the new illegal immigrant population is important.
Colorado is far from the only state struggling with a trail of unpaid hospital bills.
Dr. Robert Trenschel, CEO of the Yuma Regional Medical Center situated on the Arizona–Mexico border, said that it costs up to three times more in human resources to resolve an illegal immigrant’s case and provide a safe discharge than it does to do so for someone else.
“We’ve had migrant patients on dialysis, cardiac catheterization, and in need of heart surgery. Many are very sick.”
He said many illegal immigrants who enter the country and need medical assistance end up staying in the ICU ward for 60 days or more.
A large portion of the patients are pregnant women who’ve had little to no prenatal treatment. This has resulted in an increase in the number of newborns who require neonatal care for 30 days or longer.
ER Duty to Care
The Emergency Medical Treatment and Labor Act of 1986 requires that public hospitals participating in Medicare “must medically screen all persons seeking emergency care ... regardless of payment method or insurance status.”The numbers are difficult to gauge as the policy position of the Centers for Medicare and Medicaid Services (CMS) is that it “will not require hospital staff to ask patients directly about their citizenship or immigration status.”
American patients are enduring longer wait times for doctor appointments because of a nursing shortage in the state, two health care professionals told The Epoch Times in January.
A health care worker at a hospital in Southern California, who asked not to be named for fear of losing her job, told The Epoch Times that “the entire health care system is just being bombarded” by a steady stream of illegal immigrants.
“Our health care system is so overwhelmed, and then add on top of that tuberculosis, COVID-19, and other diseases from all over the world,” she said.
In New York, where the illegal immigration crisis has manifested more significantly than anywhere but the southern border, city and state officials have long been accommodating of illegal immigrants’ health care costs.
Since June 2014, when then-Mayor Bill de Blasio set up the Task Force on Immigrant Health Care Access, New York City has worked to expand avenues for illegal immigrants to get free health care.
The report notes that in 2013, nearly 64 percent of illegal immigrants were uninsured. Since then, tens of thousands of illegal immigrants have settled in the city.
“The uninsured rate for undocumented immigrants is more than three times that of other noncitizens in New York City (20 percent) and more than six times greater than the uninsured rate for the rest of the city (10 percent),” the report states.
The report states that because health care providers don’t ask patients about documentation status, the task force lacks “data specific to undocumented patients.”
Some health care providers have said that a big part of the issue is that without a clear path to insurance or payment for nonemergency services, illegal immigrants are going to the hospital because of a lack of options.
“It’s insane, and it has been for years at this point,” Dana, a Texas emergency room nurse who asked to have her full name omitted, told The Epoch Times.
Working for a major hospital system in the greater Houston area, Dana has seen many migrants pass through under her watch with “no end in sight.” She said many who are illegal immigrants arrive with treatable illnesses that require simple antibiotics.
“Not a lot of GPs [general practitioners] will see you if you can’t pay and don’t have insurance,” she said.
She said the “undocumented crowd” tends to arrive with a lot of the same conditions. Many find their way to Houston not long after crossing the southern border. Some of the common health issues Dana encounters are dehydration, unhealed fractures, respiratory illnesses, stomach ailments, and pregnancy-related concerns.
“This isn’t a new problem, it’s just worse now,” Dana said.
Medicaid Factor
One of the main government health care resources that illegal immigrants use is Medicaid.Yet the lion’s share of Medicaid usage by illegal immigrants still comes through state-level benefits and emergency medical treatment.
Both years represent a significant spike from the $3 billion in fiscal 2020.
An employee working with Medicaid who asked to be referred to only as Jennifer out of concern for her job told The Epoch Times that at the state level, it’s easy for an illegal immigrant to access the program benefits.
Jennifer said that when exceptions are sent from states to CMS for approval, “denial is actually super rare.”
Moreover, Jennifer said there are ways for states to get around CMS guidelines. “It’s not easy, but it can and has been done,” she said.
The first generation of illegal immigrants who arrive in the United States tend to be healthy enough to pass any pre-screenings, but Jennifer said that the subsequent generations tend to be sicker and require more access to care. If a family is in the country illegally, they usually use Emergency Medicaid or nothing at all.
Related Legislation
In Florida, a 2023 law requires hospitals that accept Medicaid to collect and submit to the state information on patients’ immigration status (although the person can decline to answer).The Epoch Times requested the most recent report detailing the total uncompensated care costs attributed to illegal immigrants from the Florida Agency for Health Care Administration but didn’t receive a response.
The Jackson Health System in Florida offers a discount on services to those without insurance, but it doesn’t make payment arrangements. A representative named Elsie told The Epoch Times: “We do offer a 70 percent discount to a patient that does not have insurance; however, they must have no insurance at all. The 70 percent discount is offered off the total charge of the bill.”
When asked what happens if a patient refuses to give an ID or provide any personal information at the hospital, Elsie said another department gets involved. “If they are refusing to give information and want to be seen [by a doctor], the escalation team goes ahead to review all that information to see the reason behind why they don’t want to provide information at the time of service,” she said.
Other state legislators have also decried the amount of taxpayer money going to illegal immigrant health care.
She said it’s a $768 million, or 346 percent, increase over fiscal 2023.
In Maryland, lawmakers are seeking to create private insurance options.
Some members of Congress have also been spurred into action.
“Liberal states, like California, have abused loopholes to provide Medicaid to illegal immigrants at the expense of hardworking taxpayers,” Mr. Hudson said. “Not only is this against the law, but it further incentivizes more illegal crossings at our border.”
