The Center for Medicare & Medicaid Services (CMS) Agency administers the government funded healthcare programs, including Section 1011 and Part A, B, D reimbursements; ongoing field studies and collaboration with branch offices; as well as other Federal agencies, striving for efficient and equitable healthcare and human community service (for more information go to http://www.cms.hhs.gov/ .) Congress effectively addressed the issue of emergency care and illegal activity by passing the Emergency Medical Treatment and Labor Act (EMTALA) earlier in 1985; providing a financial direction and screening procedures; hoping to reduce discrimination based on whether patients can pay or not.
„The Act imposes on hospitals … the following duties:
(1) To provide ‘an appropriate medical screening examination… within the of the hospital’s emergency department’ to ‘any individual [who] comes to the emergency department’ and seeks examination or treatment. 42 U.S.C. ? 1395dd (a).
(2) If the „hospital determines that the individual has an emergency medical condition,” to stabilize the medical condition before transferring (or discharging) a patient. 42 U.S.C. ? 1395dd (b) (1) and (c) (1).” Cleland v. Bronson Health Care Group. 917 F.2d 266; 1990 U.S. App. LEXIS 18863.
Section 1867(g) also provides any hospital with specialized capabilities…like burn, shock-trauma, and neonatal intensive care units shall not refuse to accept … an individual who requires these specialized facilities. Once an individual is stabilized, EMTALA no longer applies. Case law has defined terms such as „appropriate medical screening,” „stabilized,” „inpatient,” „specialized capabilities,” and „on-call physicians.” See Moses v. Providence Hospital. 573 F.3d 397; 2009 U.S. App. LEXIS 15748; 2009 FED App. 0252P (6th Cir.). Rosa-Rodriguez v. Centro San Cristobal. 2009 U.S. Dist. LEXIS 40078. Morales v. Sociadad Espanola. 524 F.3d 54; 2008 U.S. App. LEXIS 8390. With that said, EMTALA applies to every person entering the Emergency room for treatment, including illegal and legal aliens. Later, a 2003 brought the Medicare Modernization Act leading to a Federally supported program for Emergency Services provided to undocumented aliens; mostly due to the border physician groups pressuring Congress.
The EMTALA Section 1011 project involved a four-year annual $250 million disbursement (2005 -2008) in order to reimburse State Facilities who are overburdened by emergency care for patients unable to pay for those services. Section 1011 government funding was only to be used for undocumented aliens’ emergency care. States aligned at our US borders are heavily impacted by immigrants crossing over, only to receive emergency care our and hospitals are required to give. These bills start to mount, no one is paying for them; and without the program leads to the denial of treatment and sending patients away untreated. Fortunately advisors request this program extend through 2010 at 2006 rates. (see CMS at id.) This program seems to work well.
Today, given the results in Moses, undocumented immigrants are included under current EMTALA laws and therefore, will still be treated like any other person entering the emergency room. However, should the New Healthcare Reform (the Senate Finance Committee has begun its revisions; see http://baucus.senate.gov/newsroom/details.cfm?id=318124) exclude undocumented aliens, that treatment is lost. What will be the cost? Will it deter immigrants entering the country so they can have good healthcare and healthy baby deliveries – I am not convinced it will.
The legal immigrants with documents (Visas, Green Cards, Parolees) may have a more massive cross to bear. Documented immigrants pay taxes, like any other American citizen. If US residents pay taxes, immigrant or not, should have the healthcare choice. Max Baucus of Montana (D) presented a bill identifying the need to revoke the immigrant five-year wait period before extending healthcare benefits (full text of the bill http://finance.senate.gov/healthreform2009/finalwhitepaper.pdf .) In the bill, Baucus states „Monitoring health insurance coverage through the taxcode would take advantage of this existing relationship.” This statement advocates a direct link to the taxpayer. Legal immigrant pregnant women and currently receiving State Children’s Health Insurance Program (SCHIP); may lose their treatment under the five-year wait theory. These patients will still need attention. What will it cost then when these patients end up in our emergency rooms? I still yet wait for a plausible Anti-immigrant case. Opponents against healthcare reform work hard to discredit the bill, however, a credible reason should be articulated. Simply excluding classes of immigrants is not the answer and only fuels outside nations’ view that American only value is money.