Health care reform may jeopardize service to undocumented immigrants

Rep. Joe Wilson (R-S.C.) created a stir when he accused President Barack Obama of lying that undocumented aliens would not benefit from his planned health care reform. The irate representative may have been uncivil, yet his outburst raised a touchy question. To what extent should they be part of health care reform.  As a matter of public health, the undocumented can lawfully receive care in the emergency. This is often more than what most people think of as an “emergency” – like patching up someone who had been wheeled in from an auto accident or delivering a baby for someone who walks through the clinic door. Benefits that the undocumented may receive include such elaborate and extended services as dialysis.

Even before the recent debate on health care and the undocumented, what care they do receive seems in jeopardy from the recession. The New York Times reports that Grady Memorial Hospital, a public health facility in Atlanta, intends to close its dialysis center because of costs. It generally treats the poor – those on Medicare, Medicaid, immigrants (legal and undocumented). Already the center has plunged Grady into serious deficit. With Congress contemplating large “savings” from Medicare and Medicaid, such services as the dialysis center will be cut back. Grady’s problems have to do more with the recession and previous reduction in Medicaid payments. The contemplated “savings” will only make things worse for Grady and similar hospitals and clinics. The congressional rationale is not directed at the undocumented, but rather arise from the assumption that with more poor insured there will be less need for Medicaid and Medicare.

The undocumented will, if that’s the case. be the most affected. The reforms likely will not include them and, if anything, makes it difficult to pay for insurance out of pocket. Nonetheless, U.S. Catholic bishops , following Pope John XXIII that health care is a human right, have met with legislators, advocating that minimal health care be provided to the undocumented in the reforms.