Will undocumented immigrants be covered under 'health care' or 'health coverage'?

Foundation for Health Coverage EducationSep 17 2009

Contending that President Barack Obama and U.S. Congressman Joe Wilson were both right and both wrong in their much noted confrontation during the President's address to Congress on Wednesday, the Foundation for Health Coverage Education (FHCE), www.coverageforall.org, points out that the issue is with the definition of health coverage versus health care for undocumented immigrants in HR3200, the House's version of healthcare reform legislation.

"At the center of the controversy over whether undocumented immigrants are currently or will be covered is the mistaken use and interchangeability of the terms 'health care' and 'health coverage,'" said Phil Lebherz, FHCE Founder and Executive Director.

Under the current infrastructure of the health care system, in every state undocumented immigrants have access to urgent health care services regardless of ability to pay because of the law surrounding requirements of hospital 24-hour emergency rooms to deliver emergency treatment to any person regardless of their immigration status.

The law is the Emergency Medical Treatment and Active Labor Act (EMTALA), which requires hospitals and ambulance services to provide care to anyone needing emergency treatment regardless of citizenship, legal status or ability to pay. If staff does not administer service, the hospital emergency room will be fined and at risk of losing its license.

According to the Centers for Medicare & Medicaid Services, 55% of U.S. emergency care now goes uncompensated. When medical bills go unpaid, health care providers must either shift the costs onto those who can pay, mainly those with health insurance or government programs, or go unpaid. In 2008, the total amount of uncompensated care in the US was an estimated 57.4 billion (Hadley, 2008)(1). In California, it's estimated that cost shifting amounted to $455 per individual or $1,186 per family each year (Peter Harbage and Len M. Nichols)(2). "Clearly in the health care reform debate, the cost of uncompensated care must be taken into consideration. No one should be deprived of emergency care, but the immigration issue needs to be considered in order to lower the general cost of health care," said Lebherz.