[Congressional Record Volume 148, Number 124 (Thursday, September 26, 2002)]
[Senate]
[Pages S9432-S9433]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. KYL (for himself, Mr. McCain, Mr. Domenici, and Mr. 
        Bingaman):
  S. 3013. A bill to amend the Balanced Budget Act of 1997 to extend 
and modify the reimbursement of State and local funds expended for 
emergency health services furnished to undocumented aliens; to the 
Committee on Health, Education, Labor, and Pensions.
  Mr. McCAIN. Mr. President, I am pleased to once again join my good 
friend from Arizona, Senator Kyl, in introducing a bill to address a 
critical issue affecting our State, and other border States. Today we 
are introducing the Local Emergency Health Services Reimbursement Act 
of 2002 in order to provide appropriate Federal reimbursement to States 
and localities whose budgets are disproportionately affected by the 
emergency health costs associated with illegal immigration.
  Arizona and other border States now face a medical and financial 
crisis. A report released today by the U.S./Mexico Border Counties 
Coalition found that our Nation's border hospitals spent close to $190 
million in 2000 to provide health care to illegal immigrants--$31 
million of which was spent by hospitals in Arizona alone. Clearly, the 
staggering cost of providing medical care to illegal immigrants further 
burdens an already challenged medical system.
  The Federal Government maintains the sole authority to control 
immigration in this country. Despite that fact, the Federal Government 
often fails to take financial responsibility for the costs associated 
with immigration. Much of the financial burden has shifted to State and 
local governments.
  Compounding the problem, Federal law requires hospital emergency 
rooms to accept and treat all patients in need of medical care, 
regardless of immigration status. Unfortunately, this mandate does not 
ensure that these hospitals receive adequate compensation for the care 
they provide. Recently, this growing problem in the Southwest has been 
exacerbated by the increasingly desperate measures taken by 
undocumented aliens to cross our border with Mexico.
  The Local Emergency Health Services Reimbursement Act of 2002 would 
modify and extend federal funding to the States, local governments, and 
health care providers for medical costs that arise from the 
uncompensated treatment of illegal immigrants. Such funding previously 
flowed to all 50 States, the District of Columbia, and several U.S. 
territories. In fiscal year 2000 alone, approximately 360 local 
jurisdictions across the United States applied for these Federal 
monies. However these funds expired in 2001, and States and local 
governments are now suffering as a result.
  I have long worked to bolster enforcement against illegal immigration 
along our Southwest border, and I will continue to do so. However, I 
believe that States and local communities should not be left to foot 
the bill for what is a Federal responsibility. Although our bill gives 
special consideration to States with unusually high concentrations of 
illegal aliens and States with high concentrations of apprehended 
undocumented aliens, it would benefit communities across the Nation. As 
my colleagues know, illegal immigrants who successfully transit our 
Southwest border rapidly disperse throughout the United States. 
Although this situation is most critical in our border regions, if left 
unaddressed, it will surely become a national emergency. I hope the 
Senate will act expeditiously on this important legislation to 
alleviate those pressures by compensating State and local governments 
and health care providers for the costs they incur as unwitting hosts 
to undocumented aliens.
  Mr. KYL. Mr. President, I ask unanimous consent that the text of the 
bill be printed in the Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                S. 3013

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Local Emergency Health 
     Services Reimbursement Act of 2002''.

     SEC. 2. FEDERAL REIMBURSEMENT OF EMERGENCY HEALTH SERVICES 
                   FURNISHED TO UNDOCUMENTED ALIENS.

       Section 4723 of the Balanced Budget Act of 1997 (8 U.S.C. 
     1611 note) is amended to read as follows:

     ``SEC. 4723. FEDERAL REIMBURSEMENT OF EMERGENCY HEALTH 
                   SERVICES FURNISHED TO UNDOCUMENTED ALIENS.

       ``(a) Total Amount Available for Allotment.--There is 
     appropriated, out of any funds in the Treasury not otherwise 
     appropriated, $200,000,000 for each of fiscal years 2003 
     through 2007, for the purpose of making allotments under this 
     section to States described in paragraph (1) or (2) of 
     subsection (b).
       ``(b) State Allotments.--
       ``(1) Based on highest number of undocumented aliens.--
       ``(A) Determination of allotments.--
       ``(i) In general.--Out of the amount appropriated under 
     subsection (a) for a fiscal year, the Secretary shall use 
     $134,000,000 of such amount to compute an allotment for each 
     such fiscal year for each of the 17 States with the highest 
     number of undocumented aliens.
       ``(ii) Formula.--The amount of such allotment for each such 
     State for a fiscal year shall bear the same ratio to the 
     total amount available for allotments under this paragraph 
     for the fiscal year as the ratio of the number of 
     undocumented aliens in the State in the fiscal year bears to 
     the total of such numbers for all such States for such fiscal 
     year.
       ``(iii) Availability of funds.--The amount of an allotment 
     provided to a State under this paragraph for a fiscal year 
     that is not paid out under subsection (c) shall be available 
     for payment during the subsequent fiscal year.
       ``(B) Data.--For purposes of subparagraph (A), the number 
     of undocumented aliens in a State shall be determined based 
     on estimates of the resident undocumented alien population 
     residing in each State prepared by the Statistics Division of 
     the Immigration and Naturalization Service as of October 1992 
     (or as of such later date if such date is at least 1 year 
     before the beginning of the fiscal year involved).
       ``(2) Based on number of undocumented alien apprehension 
     states.--
       ``(A) In general.--Out of the amount appropriated under 
     subsection (a) for a fiscal year, the Secretary shall use 
     $66,000,000 of such amount to compute an allotment for each 
     such fiscal year for each of the 6 States with the highest 
     number of undocumented alien apprehensions for such fiscal 
     year.
       ``(B) Determination of allotments.--The amount of such 
     allotment for each such State for a fiscal year shall bear 
     the same ratio to the total amount available for allotments 
     under this paragraph for the fiscal year as the ratio of the 
     number of undocumented alien apprehensions in the State in 
     the fiscal year bears to the total of such numbers for all 
     such States for such fiscal year.
       ``(C) Data.--For purposes of this paragraph, the highest 
     number of undocumented alien apprehensions for a fiscal year 
     shall be based on the 4 most recent quarterly apprehension 
     rates for undocumented aliens in such States, as reported by 
     the Immigration and Naturalization Service.
       ``(D) Availability of funds.--The amount of an allotment 
     provided to a State under this paragraph for a fiscal year 
     that is not paid out under subsection (c) shall be available 
     for payment during the subsequent fiscal year.
       ``(3) Rule of construction.--Nothing in this section shall 
     be construed as prohibiting a State that is described in both 
     of paragraphs (1) and (2) from receiving an allotment under 
     both such paragraphs for a fiscal year.
       ``(c) Use of Funds.--The Secretary shall pay, from the 
     allotments made for a State under paragraphs (1) and, if 
     applicable, (2) of subsection (b) for a fiscal year, to each 
     State and directly to local governments, hospitals, or other 
     providers located in the State (including providers of 
     services received through an Indian Health Service facility

[[Page S9433]]

     whether operated by the Indian Health Service or by an Indian 
     tribe or tribal organization (as defined in section 4 of the 
     Indian Health Care Improvement Act)) that provide 
     uncompensated emergency health services furnished to 
     undocumented aliens during that fiscal year, such amounts 
     (subject to the total amount available from such allotments) 
     as the State, local governments, hospitals, or providers 
     demonstrate were incurred for the provision of such services 
     during that fiscal year.
       ``(d) Definitions.--In this section:
       ``(1) Hospital.--The term `hospital' has the meaning given 
     such term in section 1861(e) of the Social Security Act (42 
     U.S.C. 1395x(e)).
       ``(2) Provider.--The term `provider' includes a physician, 
     any other health care professional licensed under State law, 
     and any other entity that furnishes emergency health 
     services, including ambulance services.
       ``(3) Secretary.--The term `Secretary' means the Secretary 
     of Health and Human Services.
       ``(4) State.--The term `State' means the 50 States and the 
     District of Columbia.
       ``(e) Entitlement.--This section constitutes budget 
     authority in advance of appropriations Acts and represents 
     the obligation of the Federal Government to provide for the 
     payment of amounts provided under this section.''.
                                 ______