Editor's note: Immigration 101 is a series of stories looking at immigration issues in the Fremont area. The series will cover a variety of topics and run occasionally throughout the next several weeks. Today we look at the cost of healthcare.
In emergency situations, hospitals across the nation must provide care.
Federal regulations prohibit hospitals such as Fremont Area Medical Center from withholding treatment from patients in an emergency condition - including childbirth - regardless of the patient’s financial status.
Across the nation, hospital emergency rooms have become the basic healthcare provider for those who do not have insurance and cannot afford visits to a family physician. Among those are immigrants to the United States - both legal and illegal.
How much do these emergency room visits cost Dodge County residents? And how much of that cost can be attributed to illegal immigrants?
There are no simple answers.
But FAMC officials, in a fact sheet provided to the Mayor’s Task Force on Immigration, tried to answer those questions.
Privacy regulations can make it difficult - if not impossible - to find the actual answer about illegal immigrants. While hospital personnel require identification during the registration process, they aren’t allowed to determine the legal status of patients.
Also, FAMC is required to gather racial information about its patients for various purposes, but the law prohibits the hospital from inquiring about resident status.
Over the past six years, as the Hispanic population in Dodge County grew by about 66 percent to 6.6 percent of the overall population, the percentage of Hispanic patients at FAMC remained relatively constant, officials said.
Hispanics, the ethnic group most often associated with illegal immigration, made up 6 percent of the emergency care patients, 14 percent of the obstetrical care patients and 5 percent of the inpatient care patients, the fact sheet said.
Another constant has been the percentage of Charity Care and bad debt expense - the two categories of unreimbursed care the hospital offers. Hispanics are responsible for about 10 percent of the Charity Care and bad debt expense, the fact sheet said.
During that same time, the hospital had seen its Charity Care expense increase from about $1 million in 2001 to $1.5 million in 2008 and its bad debt expense increase from $1 million to almost $4 million.
FAMC officials, in the fact sheet, attributed those increases to the growth in its service volumes, inflation and an increasing number of uninsured and underinsured patients.
Hospital officials said the Charity Care and bad debt expense attributable to all Hispanic patients is $300,000 to $500,000 per year. They cannot, however, break out how much of that might have benefited illegal immigrants because they are prohibited from asking a patient’s resident status.
That leaves about $4 million to $4.2 million in Charity Care and bad debt expense attributable to all other patients.
FAMC officials are not able to answer exactly the question: How much does healthcare for illegal immigrants cost the hospital? But they and task force members said it appears the use of the Charity Care and bad debt expense by Hispanic patients is proportional to their use of hospital services.
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