US hospitals concerned about cuts in fund for illegal Caribbean ...

By CMC - Sunday, July 29th, 2012.

WASHINGTON, July 29, CMC ? An increasing number of hospitals in the United States say President Barack Obama?s health care law is putting tremendous burden on them by cutting aid they use to pay for emergency care for Caribbean and other illegal immigrants.

The hospitals ? which range from prominent public ones, like Bellevue Hospital Center?in Manhattan, New York, to neighborhood mainstays like Lutheran?Medical Center in Brooklyn, New York, and Scripps Mercy Hospital in San Diego, California ? say many of their uninsured patients are illegal immigrants.

The hospitals lament that their large pools of uninsured or poorly insured patients are not expected to be reduced significantly under Obama?s Affordable Care Act, even as US federal aid shrinks.

The federal government says it has been spending US $20 billion annually to reimburse these hospitals ? most in poor urban?and rural areas ? for treating more than their share of the uninsured, including illegal immigrants.

But hospital executives say the health care law will eventually cut that money in half, based on the premise that fewer people will lack insurance after the law takes effect.

Health experts say the estimated 11 million people?now living illegally in the United States are not covered by the health care law; and legislators, seeking to sidestep the contentious debate over immigration, say they excluded them from the law?s benefits.

As a result, so-called safety-net hospitals said the cuts would result in a severe blow to their finances.

All hospitals in the US are obligated under federal law to treat anyone who arrives at the emergency room, regardless of their immigration status.

?That?s the 800-pound gorilla in the room, and not just in New York ? in Texas, in California, in Florida,? said Lutheran?s chief executive, Wendy Z. Goldstein.

?I was told in Washington that they understand that this is a problem, but immigration is just too hot to touch,? she added.

The Affordable Care Act establishes state exchanges to reduce the cost of commercial health insurance, but people must prove citizenship or legal immigration status to take part.

In some states, including New York, hospitals caring for illegal immigrants in life-threatening situations can seek payment case by case, from a program known as emergency Medicaid.

But health executives and immigration advocates say the program has many restrictions and will not make up for the cuts in the US $20 billion pool.

?I kind of like living in a society where we don?t let people die on the steps of the emergency room,? said Mark Krikorian, the executive director of the Washington-based Center for Immigration Studies.

But the Obama administration said the Affordable Care Act supports safety-net hospitals in other ways, pointing to measures that raise payments for primary care and give bonuses for improvements in quality.

?We are taking important steps to make health care more affordable and accessible for millions of Americans,? said Erin Shields Britt, a spokeswoman for the Department of Health and Human Services. ?Health reform isn?t the place to fix our broken immigration system.?

Hospitals in New York State say they now receive US $2.84 billion of the nation?s US $20 billion in so-called disproportionate share hospital payments.

Hospital executives suggest those payments will begin to shrink in 2014 under the law, and drop to US $10 billion by 2019.

?It is a difficult time to really advocate around this issue, because there is so much antipathy against new immigrants,? said Alan Aviles, president and chief executive of New York?s Health and Hospitals Corporation, which runs New York City?s public hospitals and treats 480, 000 uninsured patients annually, an estimated 40 percent of them illegal Caribbean and other immigrants.

Source: http://www.antiguaobserver.com/?p=78667

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