Health Care for Illegal Aliens: Why It Is a Necessity

Fallek, Shari B., Houston Journal of International Law

I. INTRODUCTION

The United States is presently experiencing growing restrictionist attitudes toward immigration and illegal aliens.(1) American citizens are becoming furious over what they perceive as a drainage of public funds being used to provide health care and other services to illegal aliens.(2) Because of this fury, measures are being considered that will actually end up being counterproductive in the long run.(3) Denying health benefits and other prevent those immigrants infected with contagious diseases from entering the country.

II. BACKGROUND ON IMMIGRATION

America began as a land open to all, but has since struggled to remain open and preserve the national bounty for those already here.(9) Since 1875, Congress has been placing restrictions on immigration.(10)

Despite this history, the Clinton administration has recently attempted a more moderate immigration policy.(11) In 1993, a new commissioner was appointed to the Immigration and Naturalization Service (INS) who advocated "control with compassion."(12) Recently, the administration passed measures to increase border themselves, rather than waiting to apprehend illegal aliens after they have already entered the country.(18)

Illegal immigrants enter the country in many different ways, including entering without inspection or entering fraudulently or through misrepresentation.(19) There are many different opinions on the actual number of illegal aliens in this country. One study based on the 1980 census and INS records concluded that approximately two million illegal aliens were included in the 1980 census count.(20) Some reports propose that as many as three to eight million illegal aliens currently reside in this country.(21)

Immigrants come to the United States for various reasons. Reasons for immigration have been termed "push-pull" factors.(27) The "push" factors encourage immigratnts to depart their countries of origin, while the "pull" factors attract illegal aliens to the United States.(28) Past public policies, national migrant communities within the United States, and U.S. foreign policy during the Cold War are some factors which played a role in encouraging immigration to the United States.(29) However, as one commentator explains, "there is no broad, or simple, explanation for ... migration."30

The federal government constantly struggles to protect national interests by proposing stricter immigration laws.(31) States may, and do, propose economic regulations which limit aid to immigrants to protect welfare interests.(32) States reserved the police power to protect property and the public's health and welfare.(33)

California's Proposition 187 is one example of such state legislation. Proposition 187 reflects the growing anti-immigrant sentiment across the country.(34) These anti-immigrant attitudes appear to arise mostly from economic factors.(35)

Opinions range from the view that immigrants assist the economy by creating jobs to the opposing views that assert immigrants steal jobs from citizens and soak up social services.(36) For example, in California, a significant portion of the public blames illegal immigrants for state ills such as unemployment, high taxes, urban decay, and crime.(37)

In a speech to the House of Representatives, Representative Barbara Vucanovich of Nevada pleaded for stricter immigration measures with this same anti-immigrant attitude:

Whereas, The United States government social

budget increased from over $778 billion in 1991 to more

than $859 billion in 1992, due largely to the increase in

the number of illegal aliens, thus over-burdening our

national, state and local health, welfare and educational

systems; and

Whereas, Some immigrants, including illegal

aliens, unlike those of the past, now decline to assimilate,

and demand the right to vote and to have ballots

written in their own language; and

Whereas, our nation, which is experiencing an

increase in terrorism, lacks adequate safeguards insuring

immediate hearings and deportation of immigrants

without proper credentials or documentation, and few

facilities for detention where appropriate or for the

monitoring of undocumented aliens seeking political

asylum; and

Whereas, Admission of immigrants with

communicable diseases, such as tuberculosis and AIDS, result

in health problems of epidemic proportions and the care

of the infected and contagious aliens adds to our disease

control problems and strains the health care

systems . . . .(38)

In 1990 it was estimated that illegal aliens cost taxpayers $5.4 billion in public assistance.(39) Dr. Donald Huddle, an economist from Rice University, completed a study on the costs of immigration.(40) Dr. Huddle concluded that 19.3 million legal and illegal immigrants have settled here since 1970 and have cost $42.5 billion in public assistance in 1992, while only paying $20.2 billion in taxes.(41) Dr. Huddle also estimated that the number of immigrants that have arrived in this country since 1970 will increase to 30.4 million by the year 2002.(42) This increase will cost the public $668.5 billion in 1993 dollars, with an average of $67 billion each year.(43) Dr. Huddle estimated that the 1992 illegal immigrant population of 4.8 million carried public assistance and displacement costs of $11.9 billion net of the taxes they paid.(44) For the decade from 1993 to 2002, he estimated that the net cost for illegal immigrants would be $186.4 billion.(45) Between 1993 and 2002, illegal immigrants will cost $221.5 billion in public assistance and displacement costs.(46) Regarding jobs, Dr. Huddle suggested that in 1992, 2.07 million U.S. workers were displaced from jobs by immigrants, which cost $11.9 billion.(47) He estimated the cost of job displacement for the 1993-2002 decade to be $171.5 billion.(48)

Some see Dr. Huddle's study as radical, but many others come to similar conclusions on the economics of illegal immigrants.(49) Illegal immigrants cost San Diego County $206 million in services, while contributing only $60 million in taxes.(50) In 1997, the state of California asserted that it spent over $2.4 billion providing education and health care to illegal aliens, and on incarcerating illegal aliens who committed crimes within the state.(51)

Many defenders of immigration argue that because illegal immigrants are not qualified to receive many of the social services, they contribute more in taxes than they consume.(52) In facts, some argue that immigrants use less social services than native-born citizen.(53) Some see immigrants as a positive social and economic contribution to this country.(54)

Despite these claims, there remain very strong anti-immigrants attitudes throughout this country. As the late Texas Congresswoman Barbara Jordan observed in April 1994, the "heightened anti-immigrant sentiment . . . is so discernible and identifiable that you can almost smell it."(55) A national survey in 1993 reflected anti-immigrant sentiment by finding that sixty percent of those interviewed perceived immigration negatively while only twenty percent viewed immigration favorably.(56)

III. Legislation Against Providing Health Care

Economic and social hardships in the United States have caused some U.S. citizens to blame immigrants.(57) These anti-immigrant attitudes have in turn led to recent legislation which attempts to eliminate social services to immigrants.(58) This legislation is common ground for immigration advocates and reformists who agree that the federal government is not fulfilling its responsibility of paying for the services being provided.(59)

For example, at common law, in non-emergency situations, patients do not have rights to receive health care.(60) In emergency situations, however, health care provides are required to provide care.(61) Hospitals are also bound by the Hill-Burton Act(62) to treat indigent patients if the hospital receives funding through the Act. (63) More than one-half of the hospitals in the United States received construction funds under the Hill-Burton Act, and therefore are required to provide some care to indigents.(64)

Many states and counties voluntarily elect to provide free health care. States are free to provide these benefits pursuant to Maher v. Roe,(65) but the manner in which the states provide in the benefits remains subject to constitutional limitations.(66) Many states specifically exclude illegal aliens from their free non-emergency health care.(67) However, in the opinion of at least one court of appeals,(68) pregnant low-income illegal aliens are entitled to Medicaid benefits for the prenatal care of their future citizen children.

Providing this health care has put a drain on many states' finances, and several of these states have sued the federal government for reimbursement for services provided to illegal aliens. In 1980, San Diego County sued for the previous three and one-half years.(69) In 1986, El Paso billed the federal government ten million dollars for medical care provided to illegal aliens by its country hospital.(70) Recently Arizona,(71) California,(72) Florida,(73) New Jersey,(74) New York,(75) and Texas(76) sued to force the federal government to pay for the cost of providing health care and other services to illegal aliens. On April 11, 1994, Florida filed a suit against the federal government for reimbursement for providing social services to illegal aliens over the past decade.(77) Governor Lawton Chiles said that "[t]he federal government should bear the financial responsibility for its actions and should pay for the cost of refusing to protect Florida's borders,"(78) San Diego County Supervisor Brian Billbray went so far as to say that the federal government is "the biggest deadbeat dad in the nation when it comes to paying for this problem."(79)

One story epitomizes the reason for the anger that many feel due to the growing problem of illegal immigrants taking advantage of state-provided social services:

An ambulance pulled up outside Sharp Memorial

Hospital in San Diego on Sept. 4, 1991, with a

42-year-old Hispanic man named Hermillo Meave inside.

Despite that he was being transferred with a

chronic heart problem from a hospital in Tijuana,

Mexico, Mr. Meave gave the hospital a San Diego address

and …

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Publication information: Article title: Health Care for Illegal Aliens: Why It Is a Necessity. Contributors: Fallek, Shari B. - Author. Journal title: Houston Journal of International Law. Volume: 19. Issue: 3 Publication date: Spring 1997. Page number: 951+. © 2009 Houston Journal of International Law. COPYRIGHT 1997 Gale Group.

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