Re: Opinion could limit care for immigrants

[Guest guest]

Here's a piece out of Texas today with national ramifications on a topic I

know a lot of you are closely monitoring.

Mimi

--

Mimi ez McKay

msfwhealth@...

Opinion could limit care for

immigrants

By Gaiutra Bahadur

American-Statesman Staff

Friday, July 13, 2001

Undocumented immigrants throughout Texas could lose

access to care at publicly financed hospitals and clinics,

except in emergencies, in the wake of an opinion by Attorney

General Cornyn.

In the opinion, the state's top lawyer said the

County Hospital District would violate a federal welfare reform law

if it provided free or discounted preventive care to undocumented

immigrants.

The Personal Responsibility and Work Opportunity

Reconciliation Act, passed by Congress and signed by former President

Clinton in 1996, bars immigrants living in the

United States illegally from receiving public benefits, except for the

treatment of communicable diseases or emergencies.

But many clinics and hospitals that provide

subsidized care for the poor nationwide have

abided by a " don't ask, don't tell " policy and attended to the health needs

of everyone,regardless of immigration status.

Cornyn cited a section of the federal welfare law

that allows states to make undocumented immigrants eligible for certain

public benefits only by passing legislation explicitly stating that

immigration status is moot. Texas, according to his opinion, has passed no

such law. Neither have most other states, although some -- such as

California in the cases of prenatal care for pregnant immigrants -- have

codified other exceptions to the federal law.

Cornyn's opinion, issued this week, could close

doors for undocumented immigrants in Texas,but it is not an official ruling.

County or local hospitals could continue serving immigrants without penalty,

but they run the risk of being taken to court, in which case Cornyn's

opinion would carry great weight.

Clinics and hospitals in Austin and throughout the

state that receive public money are now grappling with how to respond to the

opinion.

A. , president of the Seton

Healthcare Network, said it is unclear how the opinion

will affect its providers, including Brackenridge Hospital.

" Whether or not (the opinion) has broader

implications remains to be seen, " said Roseanna Szilak, executive director

of the nonprofit People's Clinic, which receives some money from the city

and the Texas Department of Health to provide charity care, such as checkups

and immunizations.

Even in County, officials are not sure

whether they will stop providing care to undocumented immigrants, who

account for about 23 percent of the visits to public clinics and

hospitals. " We're not changing anything we're doing right now, " said Dinah

Massie, a spokeswoman for the district.

The district's board of managers might discuss the

issue at its regular meeting later this month,she said. The district has

long asked for proof of permanent U.S. residency or citizenship but has

abided by an unofficial policy of providing care to those who had the

documents and those who didn't. Allegations by clients that some clinics

handled the cases differently than others,

with some alerting the Immigration and Naturalization Service, led to a move

to simply not ask about immigration status.

Before the board could set that as policy, however,

the county attorney asked for an opinion from Cornyn.

Although what happens now in Texas is murky,

advocates said the implications for public health are clear if

government-paid preventive care for undocumented immigrants stops.

More immigrants will allow their ordinary illnesses

to blossom into severe problems requiring attention in emergency rooms,

where it costs more to care for them, advocates and health policy analysts

say.

" That creates severe fiscal consequences in the

long term, " said Cadena, an analyst with the Texas Immigrant and

Refugee Coalition, an umbrella organization for immigrant groups.

" What that means is, you take a fairly common,

serious problem in the Latino community like

diabetes, " said Leighton Ku, an analyst with the Center on Budget and Policy

Priorities, a Washington, D.C.-based group. " Instead of paying for a

diabetes drug, you may instead find someone going into a diabetic coma, and

that's a cruel and extremely expensive way to

provide care. " Plascencia, a member of the Austin Commission on

Immigrant Affairs, a group appointed by the City Council, said ignoring the

early symptoms of some diseases could have " devastating effects on

community. "

The commission successfully campaigned for Austin

to offer medical aid to undocumented immigrants in the same way that it did

permanent residents. The city has been offering limited

financial assistance to poor undocumented immigrants for primary health care

since December.

Rep. Garnet , D-Houston, said he plans to

sponsor legislation that would explicitly allow publicly financed clinics

and hospitals throughout the state to provide indigent care to

undocumented immigrants. Until then, he urges publicly financed clinics and

hospitals to continue serving them. He also said he would ask Gov. Rick

to call a one-day special session to resolve the issue, if it becomes

necessary.

" It's bad public policy for counties to stop

preventative and primary health care for individuals .

.. . because those same counties are going to pay more money in the end, " he

said. " It's penny-wise and pound foolish. "

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