Illegal, uninsured...but alive

By Mark Bixler, April 25, 2004; published in the Atlanta Contitution-Journal

A desperate mother and father smuggled their family from Mexico to the U.S. to find medical help for their son. What they did broke the law. But it has kept their boy alive as they ponder his uncertain future...

Georgia hospitals report spending nearly $1 billion a year to treat poor patients without insurance.

The state makes it a condition of getting a hospital license: Every institution agrees to spend at least 3 percent of its gross revenue treating patients who cannot pay. In return the state provides hospitals with tax money to cover some costs of treating the uninsured.

Hospitals in Georgia spent $819 million of their own money to treat poor patients last year, and were reimbursed with at least $192 million in mostly public money. Those figures were up from $581 million and $157 million, respectively, in 1999.

Experts cite several reasons.

More expensive prescription drugs increase the cost of treating all patients. More people lack health insurance. Some people in managed-care plans are frustrated by attempts to see a doctor. They go to the emergency room, the most expensive place for routine care. Their insurance plans do not cover the visits, and sometimes the patients don't pay.

The growing number of illegal immigrants is also a reason, but it's hard to quantify because hospitals don't ask patients their immigration status.

"It is really not something we've been able to measure, but we do know anecdotally that, absolutely, there are a lot of costs being absorbed by the system, by hospitals treating illegal immigrants," says Kevin Bloye, spokesman for the Georgia Hospital Association. "I wouldn't say that it's the dominant factor in rising health care costs. It's one of many factors."

In 2002, 37 of 43 hospitals responding to a survey from the National Association of Counties reported an increase in uncompensated health care costs. Sixty-seven percent of respondents cited immigrants as a reason.

Another study in 2002 estimated that hospitals near the U.S.-Mexican border spent $190 million a year treating illegal immigrants, about 25 percent of their total cost for uncompensated care.

In November, as an amendment to the Medicare prescription drug bill, Congress set aside $1 billion to help hospitals that treat large numbers of illegal immigrants. Hospitals in every state are eligible for money, but the funding formula favors hospitals in California, Texas and other border states.

The General Accounting Office, the research arm of Congress, is preparing its first report estimating the financial effect illegal immigrants have on hospitals around the United States...

The state and federal government paid $58.1 million in Emergency Medicaid benefits to 15,210 people in Georgia in the budget year that ended in August 2002, a 34 percent increase in cost from the year before, the Georgia Department of Community Health says.


For millions of illegal immigrants, the United States represents more than a land of opportunity. It's a land of accommodation.

The U.S. government spends more than $1 billion a year trying to keep illegal immigrants out. But once they're here, taxpayers spend billions more to provide immigrants with medical care, schooling and jobs.

The lure is strong. Even as the government considers reforming immigration policy, illegal immigrants continue to stream into the country, despite the danger and expense. One man working construction in Georgia says he tried 11 times to cross the border from Mexico before finally succeeding.

Eight million to 10 million illegal immigrants live in the United States, including 228,000 or more in Georgia.

What Americans say about illegal immigration and how they actually deal with it are usually two different things. We pass laws and then decline to enforce them. We rail about illegal immigrants and then hire them to work in our fields, build our homes and do our landscaping.

The people who deal with illegal immigrants every day --- police, farmers, business owners, teachers --- are on their own, making critical decisions about the lives of neighbors the law says shouldn't live here. Today, the @issue section examines the many contradictions that arise from America's ambivalence toward illegal immigration.


No one can say for certain how many illegal immigrants live in the United States. The INS put the number at 7 million in 2000, with an annual increase of 350,000. The U.S. Census Bureau put the number at between 7.7 million and 8.8 million in 2000, and the Center for Immigration Studies calculates an annual increase of 500,000. Based on those estimates, the number now could be 8 million to 10 million. Other estimates put the number at 11 million or more.


Legal immigrants

Source: U.S. Immigration and Naturalization Service

Illegal immigrants

Mexico......... 68.7%
El Salvador..... 2.7%
Guatemala....... 2.1%
Colombia........ 2.0%
Honduras*....... 2.0%
*Includes 105,000 Hondurans granted temporary protected status in December 1998. Source: U.S. Citizenship and Immigration Services


In granting permanent status, U.S. law gives preference to relatives of citizens, refugees and people with particular job skills. Here are the major categories for admission in 2002:

Employment-based................. 16.4%
Refugees given permanent status...10.9%
Diversity program....................4%
Cancellation of removal............2.2%
Source: U.S. Citizenship and Immigration Services


The U.S. census counted 8.2 million Georgians in 2000, including 577,273 born in other countries. Federal officials estimated 228,000 illegal immigrants lived in Georgia in 2000. Foreign-born.........577,273
Illegal immigrants...228,000

Here is where Georgias foreign-born are from:

Sources: U.S. census, INS

Read the complete article in the Atlanta Contitution-Journal.