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Thursday, May 27, 2004

Immigrant care cost defies tally

Immigrant care cost defies tally

Immigrant care cost defies tally

By MARK BIXLER
The Atlanta Journal-Constitution
Published on: 05/27/04

A federal study to determine how much hospitals spend treating illegal immigrants has concluded that valid estimates are impossible to determine, frustrating the congressman who asked for the numbers.

The General Accounting Office surveyed hospitals in Georgia and nine other states that together contain an estimated 78 percent of illegal immigrants in the United States. The office determined that "the impact of undocumented aliens on hospitals' uncompensated care costs remains uncertain."

Rep. Mark Foley (R-Fla.) asked for the study after hearing from hospitals in South Florida that spent millions to treat illegal immigrants. He estimated that hospitals nationwide spend billions to care for people here without permission and was irritated by the study's inconclusive findings.

"They threw up their arms and said 'I'm sure there's a problem, but we can't quantify it,' " he said. "I was hoping we could get a tip-of-the-iceberg estimate."

The Atlanta Journal-Constitution obtained a copy of the report after the GAO delivered it last week to Foley and 14 other members of Congress who requested it. The report is to be made public next month.

Federal law requires hospitals to treat patients who show up in the emergency room, regardless of their immigration status or ability to pay. Several hospitals near the Mexican border have nearly closed because of soaring costs of treating illegal immigrants, and it is an emerging concern in Georgia and other states.

Since hospitals do not ask patients about their immigration status, the GAO tried to focus on costs of treating patients without a Social Security number. It reported a "low response rate to key questions" that made reliable estimates impractical.

One of the few firm numbers in the study is from Georgia, where the estimated population of illegal immigrants went from 34,000 in 1990 to 228,000 in 2000. It says the costs in Georgia went up 349% from 2000 to 2002 in a program using state and federal money to provide emergency services to illegal immigrants, mainly childbirths.

The rise, in the program known as Emergency Medicaid, compares with a 44 percent increase in overall Medicaid spending in Georgia but represents less than 3% of total Medicaid spending in the state, the study says.

Foley wants Congress to reimburse hospitals for treating illegal immigrants on the rationale that hospitals end up paying for the federal government's failure to secure its borders. Last year, Congress set aside $1 billion to reimburse hospitals for some of those costs, but Foley proposes more relief.

"I'm not saying we're going to reimburse every $50 hospital visit," he said.

He proposes assistance for hospitals that provide ongoing, expensive care, the kind of treatment that Children's Healthcare of Atlanta provides Edgar Gutierrez, 13.

Edgar's parents brought him to the United States illegally after he developed kidney problems in rural Mexico. Children's Healthcare has provided Edgar with $92,000 worth of dialysis, but he has not received a transplant, mainly because his family lacks insurance or any other way to pay.

After the Journal-Constitution highlighted the case last month, a top CNN executive, Eason Jordan, agreed to pay roughly $114,000 for a transplant. And Joseph Moss, an investment adviser and retired Delta Air Lines pilot, said he would pay at least $48,000 for drugs Edgar would have to take after surgery.

"I'll give it to them in cash up front," he said.

Edgar's mother, Consuelo Correa, said representatives of the Mexican government have visited the family to talk about whether they might qualify for assistance provided in Mexico to poor families with medical problems.

Meanwhile, a spokeswoman for Children's Healthcare, Alia Cory, said Edgar may receive a transplant after all.

"We're working on it real hard over here," she said. "The ball is definitely rolling."

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