WASHINGTON, March 3 (UPI) -- The approximately 11 million illegal immigrants in the United States have increasingly come under fire for straining the nation's healthcare safety net.
At a recent meeting In Washington, D.C., state governors cited healthcare costs in urging the Bush administration to crack down on illegal immigration.
But states have already started acting on their own behalf.
In 2005, 20 states introduced 80 bills to limit access to health services for non-citizens or require that providers inform authorities about patients who have violated immigration laws.
Over the next four years, the federal government has pledged to spend $1 billion to reimburse hospitals for the cost of caring for immigrants who are unable to pay, and the cost of social services has figured heavily in debates about tough new federal legislation to crack down on those who come to the United States illegally.
Proponents of limits say they are necessary to keep illegal immigrants from draining resources, while those opposed say they will impose burdens on people who are trying to live the American dream.
However, some research indicates that the laws may not even accomplish their goal of reducing the cost of illegal immigrant healthcare.
"We have an enormous illegal alien problem," said Jack Martin, spokesman for the Federation for American Immigration Reform, a group that calls for tougher measures to prevent illegal immigration.
In border areas, he told United Press Internatioanl, the cost to states of illegal immigrants is as high as $10 billion per year, and that spending is concentrated in the areas of education, incarceration--and emergency medical care.
Laws that impose limits on illegal immigrants, such as a bill passed recently by the Wisconsin Senate requiring social service beneficiaries to produce documentation, and other initiatives preventing illegal immigrants from getting drivers' licenses, can help hold down immigration, Martin said.
"The atmosphere that either encourages or discourages illegal aliens to settle in a state," he said, "can be affected by policies adopted by a state or city."
If anything, he added, such bills do not go far enough.
"Emergency care should not be denied to anyone, but information (on their illegal status) should be collected and made available to the federal government," he said.
Currently, federal law limits social services, like access to Medicaid, that can be extended to immigrants, but requires that hospitals provide them with emergency care.
But laws designed to decrease spending on illegal immigrants will do little more than increase the burden on all low-income people in need of healthcare, and states themselves, Jennifer Ng'andu, health policy analyst for National Council of La Raza, told UPI.
"These laws are largely a duplication of current law," Ng'andu said, "and what will end up happening is that many non-citizens and citizens will be denied healthcare."
Illegal immigrants will be forced to rely more on emergency rooms, where the bill will likely be picked up by taxpayers, and some hospitals could start turning all but the most dire cases away, she said.
Many legal immigrants live in mixed families, with some members who are illegal, and will be kept from seeking the medical care they are entitled to, due to their fear of being separated from their family members.
And all low-income families will be forced to produce documentation they may or may not have, she said. Getting birth certificates and passports costs time and money.
"Low income families don't have a lot of time on their hands to go through bureaucracy," Ng'andu said.
An analysis of a law requiring documentation that was recently defeated by the Colorado legislature found that in order for the law to be enforceable, the state would have to develop the capacity to process documentation for 446,000 people. Critics of the bill said the expense would probably cause the bill to actually cost taxpayers money instead of generating savings.
The long-term costs of denying healthcare to a large segment of the population could also be high. A recent study found that the children of immigrants, 77 percent of whom are citizens, are twice as likely to be in poor health than the children of citizens. Groups like the American Academy of Pediatrics generally oppose cuts to social services for immigrants for that reason.
But beyond cost, Ng'andu said, such bills -- and the negative sentiments that often surround them -- discourage immigrants from interacting with society.
"These laws produce anti-immigrant sentiment that is felt in the immigrant community," she said, "We fear people will be further pushed into the shadows and isolate themselves."
Part of the reason for the increased outcry, Leighton Ku of the Center of Budget and Policy Priorities told UPI, is that over the last decade there has been a diffusion of immigrants across the country. Once mainly concentrated in border states and a few other epicenters, immigrants can now be found working in the farm fields of South Carolina and the meat-packing plants of Nebraska.
But a common myth, Ku said, is that they use a disproportionate share of healthcare resources.
Immigrants in general actually go to emergency rooms less than citizens. They are often simply faced with the same problem as 46 million Americans--a lack of health insurance.
Immigrant workers are disproportionately concentrated in industries that do not traditionally provide health insurance to workers--like construction, agriculture and the service sector.
In addition, even across industries, immigrants are less likely to have insurance, which indicates the possibility of discrimination.
"Especially when it comes to undocumented workers, employers may feel free to exploit," Ku said.
Those without employer-provided health insurance are also barred from receiving public health benefits like Medicaid. The federal government does not require states to include legal immigrants in Medicaid for a number of years after they gain legal status, though some states have voluntarily extended public insurance coverage.
The result is that this sizable segment of the population is forced to forego treatment altogether, go to emergency rooms or seek out dangerous cut-rate care on the black market. And the health outcomes are often less than optimal.
"Many people whose medical problems could be solved with a relatively simple intervention suffer indefinitely," Ku said. "It's heartbreaking. The real losers here are the (illegal) immigrants themselves."
For Ku and Ng'andu, the solution is comprehensive reform that identifies realistic pathways for illegal immigrants to participate in American society.
"The immigration system is broken," Ng'andu said.
Reforms such as those included in the Secure America and Orderly Immigration Act, by Sens. John McCain, R-Ariz., and Edward Kennedy, D-Mass., would help she said. The bill would more strictly enforce some immigration laws, but provide more avenues for immigrants seeking work in the United States, such as temporary worker visas which could lead to permanent residence. It also would make it easier for families to stay together.
But such reforms are unlikely to gain the traction of bills limiting immigrants' access to healthcare, Ku said.
"There is not a single blanket solution that is at all politically realistic," he said.
Instead, the reality will likely continue that illegal immigrants will have access to healthcare in some localities, but not in others.
