[Congressional Record Volume 148, Number 125 (Monday, September 30, 2002)]
[Extensions of Remarks]
[Page E1697]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




       IMPACTS OF UNCOMPENSATED CARE ON SOUTHWEST BORDER COUNTIES

                                 ______
                                 

                           HON. DUNCAN HUNTER

                             of california

                    in the house of representatives

                      Thursday, September 26, 2002

  Mr. HUNTER. Mr. Speaker, this morning, the United States/Mexico 
Border Counties Coalition released an important report detailing the 
increased healthcare burden incurred by our nation's twenty-four 
counties that share a border with our southern neighbor, Mexico. I am 
privileged to represent a congressional district that includes nearly 
all of the California/Mexico international border. As a result, I can 
tell this body firsthand what the study proves--border communities 
suffer a significant financial burden from providing unreimburseable 
healthcare services to undocumented aliens.
  The study, titled ``Medical Emergency: Costs of Uncompensated Care in 
Southwest Border Counties,'' estimates that at least 25 percent of the 
border county hospitals uncompensated care costs, or $190 million in 
2000, are incurred from providing services to undocumented aliens. In 
addition, emergency medical service providers lost about $13 million 
providing care and transportation for illegal aliens injured while 
crossing the border.
  In 1998, Imperial County alone incurred nearly $1.3 million in 
unreimbursed healthcare services provided to undocumented aliens. 
Unfortunately, Imperial County is already one of the poorest counties 
in the country and certainly in the State of California. As a result, 
this financial burden is particularly difficult for this community to 
sustain. While the cost of healthcare delivery is high, it is not the 
only cost incurred on behalf of illegal aliens. In total, Imperial 
County estimates that, in 1998, it spent more than $5.4 million 
providing services to undocumented aliens and that amount continues to 
increase.
  At the same time, San Diego County is also bearing a significant cost 
for unreimburseable services provided to illegal aliens. The County 
estimates that in 1998 they spent nearly $10.8 million for emergency 
medical care and over $50 million in total services provided. Clearly, 
this money would be better spent delivering services to needy county 
residents.
  The impacts of uncompensated emergency services does not stop at an 
affected hospitals' balance sheet. Healthcare costs and insurance 
premiums are on the rise, partially in order to cover the 
unreimburseable costs incurred by the healthcare institutions. Rising 
health insurance premiums are threatening employers' ability, 
particularly small businesses, to offer their employees affordable 
health care benefits. High liability costs and low levels of 
compensation are threatening the viability of emergency rooms and 
emergency transportation providers all along the border, and 
particularly in California where the healthcare system is already in 
crisis.
  Throughout my tenure in Congress, I have fought for additional border 
security, not only to address safety concerns, but also as a way of 
addressing the financial impacts of caring for the undocumented alien 
population. The fact is, securing our international borders is the 
responsibility of the federal government. So it logically follows that 
providing necessary medical care for individuals who penetrate our 
border is also a federal responsibility.
  To make matters worse, the federal border agencies, in order to avoid 
paying the costs associated with healthcare delivery to the injured 
alien, will report an emergency situation to local emergency personnel 
without officially taking control of the alien. As a result, when the 
ambulance picks up the undocumented alien for transport to the nearest 
hospital, they are also accepting total financial obligations for the 
immigrant. It is unacceptable for federal agencies to be passing on 
their responsibilities to our already financially-strapped local 
communities. This practice must come to an end.
  The study makes several important recommendations for addressing 
these problems, all of which appear to have merit. The primary 
solution, however, is clear: border communities must be compensated for 
the costs incurred from caring for undocumented aliens. I plan to work 
closely with my colleagues who represent affected counties to find a 
solution to this problem and I hope my colleagues throughout the 
Congress will join us in this effort. After all, it is a matter of 
fairness and accepting responsibility of our federal obligations.

                          ____________________