[Congressional Record Volume 150, Number 69 (Monday, May 17, 2004)]
[House]
[Pages H3033-H3044]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
UNDOCUMENTED ALIEN EMERGENCY MEDICAL ASSISTANCE AMENDMENTS OF 2004
Mr. BARTON of Texas. Mr. Speaker, I move to suspend the rules and
pass the bill (H.R. 3722) to amend section 1011 of the Medicare
Prescription Drug, Improvement, and Modernization Act of 2003 to impose
conditions on Federal reimbursement of emergency health services
furnished to undocumented aliens.
The Clerk read as follows:
H.R. 3722
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 ``Undocumented Alien Emergency
Medical Assistance Amendments of 2004''.
SEC. 2. FINDINGS.
Congress finds the following:
(1) The provision of medical care by public or private
health care providers to undocumented aliens is appropriate
only--
(A) to protect the health and safety of United States
citizens;
(B) to save the life of an undocumented alien in a life-
threatening medical emergency; and
(C) to stabilize an emergency medical condition so that an
undocumented alien can be repatriated for medical treatment
in the alien's own country.
(2) Federal reimbursement of emergency hospital services
furnished to undocumented aliens should be conditioned upon
obtaining sufficient information to promptly remove the
aliens.
(3) Employers who employ undocumented aliens without
completing employment authorization verification procedures
should be held liable for uncompensated emergency services
furnished to such aliens.
SEC. 3. CONDITIONS FOR RECEIPT OF FEDERAL ASSISTANCE FOR
EMERGENCY SERVICES FOR UNDOCUMENTED ALIENS.
(a) In General.--Section 1011 of the Medicare Prescription
Drug, Improvement, and Modernization Act of 2003 (Public Law
108-173) is amended--
(1) in subsection (d)(1), by adding at the end the
following new subparagraph:
``(C) Application of requirement.--Under such process, the
Secretary shall not provide payment under subsection (c) to
an eligible provider that is a hospital for eligible services
for an alien described in subsection (c)(5)(A) unless the
requirements of subsection (f) are met by that provider with
respect to such alien.'';
(2) in subsection (e)(2), by adding at the end the
following new sentence: ``Such term also includes, with
respect to an undocumented alien described in subsection
(c)(5)(A), costs for emergency medical transportation and
evacuation incurred by a hospital in transferring and
removing the alien to a foreign country for receipt of
appropriate health care services.''; and
(3) by adding at the end the following new subsection:
``(f) Requirement for Collection of Immigration-Related
Information for Undocumented Aliens.--
``(1) In general.--No payment may be made under subsection
(c) to a hospital with respect to the provision of eligible
services to an undocumented alien described in subsection
(c)(5)(A) unless the following requirements are met:
``(A) The hospital has obtained in good faith from the
alien (or a legal guardian or other representative on behalf
of the alien) the following information in a document that is
signed by the alien (or such guardian or representative)
under oath or affirmation and that is in a form that includes
a notice that fraudulent or false statements constitute a
criminal act punishable under Federal law:
``(i) The citizenship of the alien.
``(ii) The immigration status of the alien.
``(iii) The address of the alien in the United States.
``(iv) Such personal or financial data regarding the alien
as the hospital routinely requires of non-indigent patients,
including information regarding health insurance.
``(v) Information on the identity of any current employer
of the alien for whom the alien has executed an Internal
Revenue Service Form W-4.
A hospital is not liable for the accuracy of the information
provided under this subparagraph so long as it exercises
reasonable care and good faith in obtaining the information.
``(B) The hospital obtains one or more identifiers for the
alien and records such identifiers in a digital, electronic
format specified by the Secretary in consultation with the
Secretary of Homeland Security. Such format shall be
compatible with at least one interoperable database
maintained by the Secretary of Homeland Security for the
purpose of verifying the identity and immigration status of
aliens.
``(C) The hospital transmits to the Secretary of Homeland
Security, in a digital, electronic format and manner
specified by such Secretary, the information provided under
subparagraph (A) and the identifier (or identifiers) obtained
under subparagraph (B).
``(2) Maintenance of hospital records.--For a period of at
least 5 years, a hospital referred to in paragraph (1) shall
maintain the original documents described in paragraph (1)(A)
on file and makes such documents available for examination by
the Secretary and the Secretary of Homeland Security or their
designees.
``(3) Provision of technical support.--The Secretary of
Homeland Security shall provide hospitals under this section
with software, training, and technical support services, at
no cost to the hospital, to assist and enable hospitals to
comply with the requirements of paragraph (1).
``(4) Prompt action by dhs.--The Secretary of Homeland
Security shall take steps as may be necessary--
``(A) to obtain, process, and promptly review information
transmitted under paragraph (1)(C);
``(B) to determine whether an alien for whom such
information is transmitted is removable under any provision
of Federal immigration law; and
``(C) to initiate removal proceedings under the relevant
provisions of the Immigration and Nationality Act in the case
of any such alien who is identified as being removable.
``(5) Removability.--An undocumented alien who obtains
eligible services through a hospital and does not provide for
payment for such services and who fails to provide accurate
information described in paragraph (1)(A) or an identifier
(as defined in paragraph (6)) shall be treated as removable
on the ground described in section 237(a)(5) of the
Immigration and Nationality Act (8 U.S.C. 1227(a)(5)).
``(6) Definition of identifier.--In this section, the term
`identifier' means a fingerprint or other biometric
identifier as the Secretary of Homeland Security may require.
``(g) Responsibility of Certain Employers.--
``(1) In general.--In the case of an employer of an
undocumented alien worker described in paragraph (2) for whom
payments are made to a hospital for eligible services under
this section, subject to paragraph (3), the employer shall be
liable to the Secretary for the amount of the payments so
made.
``(2) Undocumented alien worker defined.--
``(A) In general.--For purposes of this subsection, the
term `undocumented alien worker' means, with respect to an
employer, an undocumented alien described in subsection
(c)(5)(A)--
``(i) who is an unauthorized alien (as defined in section
274A(h)(3) of the Immigration and Nationality Act (8 U.S.C.
1324a(h)(3));
``(ii) who has provided the employer with an Internal
Revenue Service Form W-4; and
``(iii) with respect to whom neither the conditions
described in subparagraph (B)(i) or the condition described
in subparagraph (B)(ii) have been met.
``(B) Conditions for exemption.--For purposes of
subparagraph (A)(iii)--
``(i) First set of conditions.--The conditions described in
this clause for an employer and alien are the following:
``(I) The employer and alien have fully complied with all
requirements of the employment verification system prescribed
in section 274A(b) of the Immigration and Nationality Act (8
U.S.C. 1324a(b)).
``(II) The employer has enrolled the alien in a State
workmen's compensation plan.
``(III) The alien is enrolled under a health benefits plan
or health insurance coverage that provides such level of
coverage with respect to emergency medical and
hospitalization benefits as the Secretary shall specify, in
consultation with the Secretary of Homeland Security.
``(IV) The employer has assumed responsibility for any
cost-sharing (including applicable deductibles and
coinsurance) that applies to the alien.
``(ii) Alternative condition.--The condition described in
this clause for an employer and alien are that the employer
has verified the employment authorization of the alien
through the voluntary basic employment verification pilot
program under section 403(a) of the Immigration Reform and
Immigrant Responsibility Act of 1996 (division C of Public
Law 104-208), where available, or by any other means made
available for such verification purposes by the Secretary of
Homeland Security.
``(3) Limitation on liability.--The liability of an
employer under this subsection shall be limited to an
employer that employs an undocumented alien worker at the
time (as specified under rules of the Secretary of Homeland
Security) the eligible services are provided for which
payment may be made by the Secretary under this section.
[[Page H3034]]
``(h) Limitation on Care Required.--Notwithstanding any
other provision of law (including section 1867 of the Social
Security Act, 42 U.S.C. 1395dd), a hospital is not required
to make available to an undocumented alien described in
subsection (c)(5)(A) care or services if--
``(1) the alien may be transported to the alien's country
of origin (as determined in accordance with rules of the
Secretary of Homeland Security) without a significant
likelihood of material deterioration of medical condition of
the alien (or, in the case of an alien in active labor, of
the child), within reasonable medical probability, resulting
from the transfer of the alien from the hospital; or
``(2) the care--
``(A) involves organ transplantation or other extraordinary
medical treatment (or other treatment the estimated cost of
which exceeds $50,000); and
``(B) is for treatment of a condition that existed before
the alien entered the United States or is not required as a
direct and immediate result of an accident in the United
States.''.
(b) Effective Date.--The amendments made by subsection (a)
shall be effective as if included in the enactment of the
Medicare Prescription Drug, Improvement, and Modernization
Act of 2003.
(c) Regulations.--
(1) In general.--The Secretary of Homeland Security, in
consultation with the Secretary of Health and Human Services,
shall issue interim regulations implementing the amendments
made by subsection (a) no later than 60 days after the date
of the enactment of this Act and shall permit a period of
public notice and comment of at least 90 days.
(2) Final regulations.--The Secretary of Homeland Security,
in consultation with the Secretary of Health and Human
Services, shall issue final regulations implementing such
amendments not later than one year after the date of
publication of such interim regulations.
(d) Annual Report on Implementation.--
(1) In general.--The Secretary of Homeland Security, in
consultation with the Secretary of Health and Human Services,
shall submit to the chairman and ranking minority member of
the Judiciary and Appropriations Committees of the House of
Representatives and the Senate, the Select Committee on
Homeland Security of the House of Representatives, and the
Senate Committee on Governmental Affairs an annual report on
the implementation of section 1011 of the Medicare
Prescription Drug, Improvement, and Modernization Act of
2003, as amended by this section.
(2) Items to be included.--Each annual report under
paragraph (1) shall include--
(A) a cost analysis of Federal expenditures under such
section 1011;
(B) a description of the assistance provided to hospitals
under subsection (f)(2) of such section;
(C) the number of undocumented aliens removed under
subsection (f)(3) of such section; and
(D) amounts recovered from employers under subsection (g)
of such section.
(e) Feasibility of Effecting Treaties for International
Medical Evacuation.--
(1) Study.--The Secretary of State shall conduct an
analysis of the feasibility and appropriateness of the
following:
(A) Negotiating with foreign states treaties under which
such states provide payment for the cost of international
medical evacuation for their nationals who require emergency
health care in the United States and who do not otherwise
have insurance or other coverage for the costs of such care.
(B) In the case of nationals of a foreign state for whom
significant costs are incurred under section 1011 of the
Medicare Prescription Drug, Improvement, and Modernization
Act of 2003 and for which state a treaty described in
subparagraph (A) is not in effect, imposing a visa, port of
entry, or similar surcharge the proceeds of which may be used
towards such costs and towards the cost of international
medical evacuation described in such clause.
(2) Report.--The Secretary of State shall submit to the
committees described in subsection (d)(1) a report on the
analysis under paragraph (1).
The SPEAKER pro tempore. Pursuant to the rule, the gentleman from
Texas (Mr. Barton) and the gentlewoman from California (Ms. Solis) each
will control 20 minutes.
The Chair recognizes the gentleman from Texas (Mr. Barton).
General Leave
Mr. BARTON of Texas. Mr. Speaker, I ask unanimous consent that all
Members may have 5 legislative days within which to revise and extend
their remarks and include extraneous material on H.R. 3722.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from Texas?
There was no objection.
Mr. BARTON of Texas. Mr. Speaker, I ask unanimous consent that the
gentleman from California (Mr. Rohrabacher), the author of the pending
legislation, be allowed to control debate on this bill on the majority
side.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from Texas?
There was no objection.
Mr. ROHRABACHER. Mr. Speaker, I yield myself such time as I may
consume.
Today, Congress has the opportunity to reassure the American people
that there are elected representatives on their sides. No vote could be
more indicative as to the priorities of a Member of Congress.
Is America to have a policy of unrestricted health care for illegal
immigrants at the expense of American citizens and legal residents?
That is the issue we are discussing today. Voting for H.R. 3722 means
that my colleagues are not in favor of spending our limited health care
dollars in an unrestricted way to give illegal aliens all the health
care that they need in terms of today's standards.
Those Members of Congress voting against H.R. 3722 are draining
limited health care dollars that should be going to our own citizens
and legal residents.
H.R. 3722 would put some common-sense controls over the $1 billion
fund that was created by a rider that was added onto the Medicare bill
that passed just a few months ago.
What does H.R. 3722 do? One thing it does not do is add a burden of
paperwork to the hospital emergency rooms, and that is a bogus
argument. I would warn my fellow constituents that that lie has been
spread around this body in order to get people to vote in the wrong
way. It is a bogus argument.
To be reimbursed, the hospitals will be asking questions. To get part
of that $1 billion fund they will be asking questions anyway. This
legislation does not add considerably to any major degree to those
questions. It simply adds a following question: Who was the immigrant's
last employer or his current employer? Plus, the hospital must then
take a photo or a fingerprint, which may be required to get that fund
money in the first place. This information would then be available to
the Department of Homeland Security and the INS.
This legislation does not require any reporting by the hospitals or
the doctors or anyone else to the Department of Homeland Security.
That, too, is a bogus argument that is going around, only we will hear
it in the debate, I am sure. The hospitals do no investigating, no
reporting; they simply have the information that is given to them when
the patient is put into the system and that is made available to
government agencies. It is the government agencies, the Department of
Homeland Security and INS, that do the investigating, that do the rest
of the work. Do not fall for bogus arguments.
Our hospitals today feel compelled to provide extensive and even
long-term treatment to illegal aliens. That is what our bill, H.R.
3722, does second. It makes sure that our hospitals are relieved of
this enormous burden of trying to provide unlimited health care to any
illegal that comes into an emergency room.
We have been giving heart bypasses, even transplants. A young girl
from Mexico had $5 million worth of expenditures in heart transplants
just a few months ago, and then when the transplant did not work, her
family, who were here illegally and actually had emigrated here with a
$5,000 fee to a coyote, then sued the hospital because the transplant
did not work. Well, this cost us billions of dollars a year.
If someone has a genetic disease or something like that, our
emergency rooms should not be treating this in the first place; and the
fact is, this bill will alleviate that burden by saying that only if a
person's life is imminently threatened by that malady do the hospitals
have to focus on that and treat someone whose life is immediately being
threatened rather than provide hundreds of thousands of dollars of
long-term cancer care, genetic problems, et cetera.
{time} 1500
This alone will save billions of dollars that should be going to the
American people. The doctor will only determine how much treatment is
necessary to get this person to a transportation source that will get
them back to their home country so their home country can pay for the
health care costs, rather than our senior citizens and our young people
being deprived of the resources for their health care.
[[Page H3035]]
Number three. If it is a life-threatening emergency, the illegal
alien will be treated. There is no doubt about that. This bill does not
change that. But if he has no insurance, the alien's employer or former
employer will be given the bill. Businessmen will be given the bill if
they hire illegal immigrants who end up draining away our health care
dollars. This makes all the sense in the world.
Now, the businessmen are coming out against this, saying how can we
judge? In 2005, there is a system already being worked on and being
established that with one phone call they will be able to determine if
they are hiring an illegal immigrant. If a businessman has not made
that phone call and has hired someone without checking it out, then he
will pay for the health care costs rather than having the taxpayer pay
for it.
We will hear a lot of people trying to tell us there are a lot of
other things in this bill that are not. But it comes down to this:
Whose side are we on? Do we care about our own senior citizens more
than we care about strangers from overseas? Do we care more about our
own people than we care about strangers from overseas?
If we keep trying to provide everything for everybody, our system is
going to break down, and it is doing so right now in California. I
would urge my colleagues to support 3722 and prove to their
constituents just whose side they are on. We could have corrected this
a long time ago, but we hear people all the time, and we will hear it
today, with every excuse for not doing something. But the fact is some
people in our country are benefiting from illegal immigration. They are
very powerful. But it is hurting American citizens, and this bill tries
to put a stop to that, or at least turn that situation around today
with H.R. 3722.
Mr. Speaker, I reserve the balance of my time.
Ms. SOLIS. Mr. Speaker, I yield such time as he may consume to the
gentleman from Arizona (Mr. Kolbe).
Mr. KOLBE. Mr. Speaker, I thank the gentlewoman from California for
yielding me this time, and I rise in opposition to H.R. 3722.
Mr. Speaker, if enacted, The Undocumented Alien Emergency Medical
Assistance Amendments will turn our hospital caregivers into ``de
facto'' border patrol agents for the Federal government. The measure
would require hospitals to take biometric ``identifiers''--fingerprints
or digital photographs--of any patient whom they suspect of being an
illegal immigrant and send that information to the Department of
Homeland Security (DHS), in order to receive funding for the
uncompensated costs of providing emergency care to undocumented
immigrants. Hospitals are already understaffed and they do not have the
resources needed to collect this information while trying to administer
emergency care.
This bill would discourage illegal aliens from seeking treatment for
possibly contagious diseases for fear of being deported. In close-knit
communities, such as many border areas, disease can spread quickly.
This would lead to a potential health crisis in areas throughout the
country--especially the southwest.
Illegal immigrants are in the United States as a direct result of the
government's inability to control our borders, and our hospitals are
bearing the brunt by not being reimbursed. Controlling immigration is a
Federal responsibility--not the responsibility of doctors and nurses
trying to administer care. Border Patrol agents are not taking illegal
immigrants into custody who need medical treatment to avoid paying for
the care. Federal agencies should be responsible for what is a Federal
problem.
The Emergency Medical Treatment and Active Labor Act (EMTALA)
requires hospitals to provide emergency care to anyone who comes to
their emergency rooms, without regard to race, creed, color, financial
ability to pay, citizenship, or immigration status. H.R. 3722 goes
directly against EMTALA by forcing hospitals to guess which patients
they believe are illegal immigrants, take down information about their
immigration status, employer and address, and report to the Department
of Homeland Security. It would burden hospital workers with a
staggering amount of administrative work and subject them to charges of
discrimination for singling out certain individuals for identification.
The Centers for Medicare and Medicaid Services is creating
regulations to keep hospitals accountable for how they are reimbursed
for treating illegal aliens. Those regulations are due in September.
Passing this legislation would directly preclude CMS--the agency that
knows best how to handle this situation. If it is deemed these
regulations are not adequate, we should revisit this debate.
Do not turn doctors and nurses into police officers. Oppose H.R.
3722.
Ms. SOLIS. Mr. Speaker, I yield myself 3\1/2\ minutes.
Mr. Speaker, I rise in strong opposition to H.R. 3722. I think this
is one of the most outrageous pieces of legislation I have seen this
year, and unfortunately I believe it is a misguided bill. I believe
that this bill does not stand for all of those that we represent in our
districts.
I understand that through the census count we account for everyone in
our districts, and that goes for the gentleman from Orange County,
California (Mr. Rohrabacher), where I know he has an undisclosed number
of people who may not be registered or accounted for; but he gets
credit for that. Those numbers are put into place because we represent
every single person, whether they are accounted for or not legally.
This bill goes in the wrong direction because it asks for our
hospitals to become enforcers of immigration law. I cannot underscore
how important it is to discuss this matter. Because as it is now, in
California, we have already gone through the battle of 187 and trying
to keep health care services and English educational services for
children. The courts found that unconstitutional. Do we have to go to
battle again?
Why does this bill have to direct our resources that right now are
so, so important for every single person in our districts and be used
to ask our hospital administrators, doctors, nurses, aides, to now
require to have 5 years' worth of records that they must maintain
giving some kind of evidence that they serve people who may be
undocumented? That, in and of itself, I would say is a waste of time
and money, money that should be afforded to sick people.
What happens in a classroom when you have a sick child who may, under
no fault of their own, be there and not be a U.S. citizen? When they go
to kindergarten, there is nothing that says that the child next to them
will not be infected by maybe a contagious disease that they have.
Hopefully, that never happens; but the fact that they would be
prevented from health care services, and just knowing the fear that
that family would have to go through to enter into the doors of a
hospital knowing somehow they may not come back; that somehow Homeland
Security is going to be there to pick them up and ship them back. And
what about a woman going through active labor? She will be deported,
because under the gentleman's bill that is what it says. The bill goes
in the wrong direction.
I am standing with people in my district. And, in fact, there are
several hospitals in the gentleman's own district who are against the
bill. Some of the hospitals in Orange County: Garden Grove Hospital
Medical Center, Loma Linda University, Queen of Angels Hollywood
Presbyterian Hospital, Scripps Mercy Hospital, Suburban Medical Center,
Sutter Medical Center in Santa Rosa, and Western Medical Center in
Santa Ana.
Throughout the State of California we are finding many of our
friends, both in public and private sector hospitals, are against this
bill. So I do not think we are standing alone here. I think we are
standing very united that we see a very misguided bill, unfortunately,
that is being presented to us today.
The Federation of American Hospitals, the American Hospital
Association, the Catholic Health Association of the United States, and
the National Association of Children's Hospitals are all in agreement
that this bill goes in the wrong direction.
I would ask for Members to consider the people who are joining us
today that are saying this is the wrong message. We all have an
obligation, I believe, to provide under our own laws service to people
who come to our hospitals. That is a given. We do that. And maybe it is
an unfunded mandate, but it is one we all abide by. I do not think we
are in a position to turn people away.
Mr. Speaker, I reserve the balance of my time.
Mr. ROHRABACHER. Mr. Speaker, how much time remains on each side?
The SPEAKER pro tempore (Mr. Culberson). The gentleman from
California (Mr. Rohrabacher) has 14 minutes remaining, and the
gentlewoman
[[Page H3036]]
from California (Ms. Solis) has 16\1/2\ minutes remaining.
Mr. ROHRABACHER. Mr. Speaker, I yield myself 30 seconds and just note
that this fund of a billion dollars that was created that we now have
to put some controls on, and that is what 3722 is trying to do, creates
a perverse incentive. If we let this go through as it stands, what is
going to happen is this: people who come to the emergency rooms who are
American citizens or legal residents who have no insurance will be put
behind and at the end of the line and the illegal immigrants will be
put to the front of the line because the Federal Government is picking
up the tab.
This is a perverse priority. We should be taking care of our own
citizens before we take care of illegal aliens.
Mr. Speaker, I yield 1\1/2\ minutes to the gentleman from Iowa (Mr.
King).
Mr. KING of Iowa. Mr. Speaker, I thank the gentleman from California
for bringing H.R. 3722 here before us and before the floor.
We have already a jobs magnet. The jobs magnet that is there is what
draws so much illegal immigration into this country. The disincentive
has not been put in place. This is not the first administration that
has not aggressively enforced our immigration laws. This jobs magnet
exists, and we have added to that a new magnet. The new magnet is
called free health care for illegals, and then we tap into the American
taxpayers.
Now, I hear my Democrat colleagues over on this side continually
railing about overspending, overspending. This is overspending. And it
is not just a billion dollars. That responsibility comes to $9 billion
a year, and it is growing. So we add to the jobs magnet the free health
care magnet.
And by the way, I want to point out that the system the gentleman
from California (Mr. Rohrabacher) addressed, where an employer has an
ability now, and will have by December 31 everywhere in the country, to
verify the hiring and the legal status of a prospective employee, is
called the SAFE Act. It has been in six States now. I have run that
system myself. It is Web-based, as well as a phone call, but Web-based,
and it is as close to infallible as anything we can put out, and it is
going to get better. Employers can guarantee that they are hiring legal
employees.
We do not need to be subsidizing the health care for illegals. That
is another way of subsidizing employers who are taking advantage of the
cheaper labor that sets our hardworking Americans back and puts them in
the unemployment lines. This is a national security issue, it is a
national budget issue, it is a cultural continuity issue, and it is a
commonsense issue.
I thank the gentleman from California for bringing the bill, and I
enthusiastically support H.R. 3722.
Ms. SOLIS. Mr. Speaker, I yield 3 minutes and 20 seconds to the
distinguished gentleman from New Jersey (Mr. Menendez).
(Mr. MENENDEZ asked and was given permission to revise and extend his
remarks.)
Mr. MENENDEZ. Mr. Speaker, I rise in strong opposition to a fiscally
irresponsible, unsafe, and discriminatory bill that is only on the
House floor due to a back-room deal that was reached late at night to
gain passage of the Republican Medicare prescription drug bill. That
deal was reached at the expense of Americans of Hispanic descent and of
other immigrant groups that are now legal and also U.S. citizens, as
well as our Nation's health is disgraceful. We continue to see elements
of the xenophobic face of the Republican Party.
What does this bill do? If you are rolled into an emergency room and
you do not have insurance, then you are to be asked whether or not you
are here legally in the United States. Now, I get rolled into an
emergency room, Mr. Menendez, or maybe someone who might even be
described as more characteristically Hispanic, or maybe Asian, or some
other group, and I do not happen to have insurance, as unfortunately 40
million Americans who are here as U.S. citizens do not have, and I get
asked whether or not I am a citizen of the United States. That is
shameful. You would not ask any other citizen that. But because I
happen to have the misfortune of not having health insurance, you ask
me. And of course those of us who look a certain way will for sure be
asked.
And then what else do you do? While I am suffering, not only do you
want that information, but then we are going to go through an Orwellian
process of getting some type of digital electronic identifier of this
U.S. citizen who does not have insurance but cannot prove that he is or
is not a U.S. citizen lying there in that emergency room. That is what
the bill of the gentleman from California (Mr. Rohrabacher) does. Do
not be deceived.
Now, I know he says there are a lot of lies going on about his bill.
I guess the hospitals of the Nation are lying as well. Let me tell you
what they say. Here is what the American Hospital Association said. It
says,
America's hospitals treat everyone who walks through their
doors, and we are opposed to Mr. Rohrabacher's bill because
it is bad policy, bad policy for hospitals, nurses, doctors,
and other health care personnel who work in hospitals, but
most importantly it is bad policy for patients.
Rohrabacher's legislation is bad policy because it takes
hospitals away from what we do best, caring for and healing
our patients. The requirements for reimbursement under the
legislation would turn hospital workers into border patrol
agents. That is not our jobs. We are caregivers, not cops.
And hospital caregivers are already burdened with paperwork
which requires at least 30 minutes, often an hour for every
patient. The additional burden of policing suspected
undocumented immigrants would take health care workers away
from their primary mission of healing and caring.
And not only that, it hurts everyone else waiting in that emergency
room for care. Because as we are trying to get all this documentation,
for which we give these hospitals no funding to do it, we are also
taking away from the care of everyone else there, and we are allowing
communicable diseases to spread in communities like that. That is
outrageous.
This bill should be defeated. It is shameful that it is even on the
House floor.
Mr. ROHRABACHER. Mr. Speaker, I yield myself such time as I may
consume.
What is shameful is how shameful some of my colleagues are getting
the facts totally wrong and do not know what they are talking about.
Someone must have briefed them with the wrong information.
This bill does not require our hospitals to gather any significant
more information. The information that is being gathered that my
colleague is complaining about, what we just heard, the great
condemnation of all the questions that must be asked and all the
information that must be gathered from this U.S. citizen, who might be
an illegal, is already required of the hospital in order to get the
funding, the billion dollars, that was set aside for them. It is not
required by my bill. It is required in order to get reimbursement.
My bill simply says that if they are going to ask those questions,
and they are going to expect to get reimbursed, they also have to ask
who the employer is and get a fingerprint or a picture, which they are
probably going to have to get in order to be reimbursed in the first
place. So the gentleman's complaints are not against 3722. His
complaints are that the Federal Government is now going to have an
unlimited reimbursement for illegal immigrants and they are going to
ask some questions for it. Do not blame 3722.
And let me note this also: we have had an example given to us of an
American citizen who is there, and he is being threatened because he
has to answer whether or not he is an illegal immigrant or not. The
greatest threat to the treatment of American citizens and legal
residents is that we are going to spend all of our available health
care dollars taking care of illegals who should not be getting that
money. The greatest threat to our senior citizens, to our young people
is that we have a limited amount of health care dollars and my
colleagues want to spend it on people who have come here illegally.
{time} 1515
My colleague pointed out this will bring tens of millions of more
people here and even a greater drain until the system breaks down.
The bottom line is the people who are in favor of spending our
limited dollars on American citizens and a very doable system here that
is no more complicated than what the hospitals are
[[Page H3037]]
going to have to go through to get reimbursement in the first place
should be voting in favor of H.R. 3722. If they want to spend their
money on people who came here illegally, rather than our own citizens,
waste those dollars, make sure more illegals get in, go ahead and vote
against H.R. 3722.
Mr. Speaker, I reserve the balance of my time.
Ms. SOLIS. Mr. Speaker, I yield 1\1/2\ minutes to the gentleman from
California (Mr. Waxman).
Mr. WAXMAN. Mr. Speaker, I rise in opposition to this legislation.
Seldom has this House had before it a more ill-considered proposal.
This legislation purely and simply attempts to turn our frontline
medical care providers into Border Patrol police.
Unlike what was just told us by the gentleman from California (Mr.
Rohrabacher), this is not their mission. They do not ask these
questions now. It is not their professional responsibility. It is not
the appropriate role for those committed to saving lives and protecting
the health care of our communities.
What does society gain by forcing undocumented aliens to forgo
emergency care because, as a practical matter, that will be the result
if they are asked these questions on their immigration status? What
benefit does it make for a woman in labor not to come in for medical
care because she is fearing that she will be deported? And what does
society gain by discouraging people with contagious conditions, who may
put us all at risk, from going in and getting the diagnosis and
treatment they need? Do we want someone who might have SARS to be
afraid to go in for treatment?
We need to help our hospitals and emergency systems have the
resources to treat all people who are eligible for those services. What
we do not need to do is to stretch their resources further on a mission
that is not theirs to fill. This is not an appropriate action for
Americans or appropriate policy on health care for those in need. That
is why all of the hospitals oppose this legislation.
I urge that we oppose this bill.
May 7, 2004.
Dear Member of Congress: We understand that the House of
Representatives is expected to soon consider legislation
(H.R. 3722) proposed by Representative Rohrabacher (R-CA).
The undersigned organizations, representing America's
hospitals and health systems, health care providers, and
safety net systems, are united in our opposition to H.R.
3722, the ``Undocumented Alien Emergency Medical Assistance
Amendments of 2004,'' and urge you to oppose this
legislation. We believe it will severely undermine Section
1011 of the Medicare Prescription Drug, improvement, and
Modernization Act of 2003 (MMA) and create unnecessary
barriers to life saving treatments at hospitals nationwide.
After months of careful deliberation by the Medicare
conferees, the Congress and Administration included essential
resources for hospitals providing life saving emergency are
to undocumented aliens. The undersigned organizations deeply
appreciated the inclusion of Section 1011 in MMA.
We are deeply concerned that H.R. 3722 would weaken Section
1011 by imposing new burdensome requirements on hospitals in
order to receive any of the resources from Section 1011. In
addition, H.R. 3722 would virtually ensure that illegal
immigrants will avoid getting the appropriate and timely life
saving health care they need, when they need it. H.R. 3722
could pose a significant public health threat for entire
communities because the fear of deportation would inevitably
preclude undocumented immigrants from seeking care for
communicable disease until these individuals are extremely
ill.
Hospitals provide care to anyone who walks through their
doors,--regardless of race, ethnicity or citizenship
status,--twenty-four hours each day, seven days a week. That
is the role of community hospitals. Rep. Rohrabacher's
legislation, however, seeks to create a new role for
hospitals in their communities--that of border patrol agents.
In order to qualify for Section 1011 funding, the Rohrabacher
legislation would require that hospitals demand and upload
personal data--including such ``identifiers'' as fingerprints
and digital photographs--on undocumented aliens to an
electronic database set up by the Department of Homeland
Security (DHS) and the Department of Health and Human
Services (HHS) for deportation purposes. Furthermore, the
bill requires hospitals to retain original documents and data
for a period of at least 5 years, thus imposing additional
paperwork on an already overwhelmed system.
We do not believe this is in the best interest of the
patients we serve and the nurses and physicians that provide
emergency care. Today's health care delivery system in very
fast-paced and in an emergency situation, the urgency of
providing life-saving care takes precedence over anything
else. Requiring hospitals to collect these data diverts us
from doing our job of caring for patients. Hospitals do not
have the expertise or the resources to interrogate and
investigate patients in the pressured environment of an
emergency.
We respectfully ask that you oppose this legislation should
it come up for a vote.
Sincerely,
Federation of American Hospitals.
American Hospital Association.
National Association of Public Hospitals and Health
Systems.
Association of American Medical Colleges.
Catholic Health Association of the United States.
National Association of Children's Hospitals.
VHA Inc.
____
American Medical Association,
Chicago, IL, May 13, 2004.
Hon. J. Dennis Hastert,
U.S. Capitol,
House of Representatives,
Washington, DC.
Dear Speaker Hastert: On behalf of the American Medical
Association (AMA) and its physician and medical student
members, I am writing in strong opposition to H.R. 3722, the
``Undocumented Alien Emergency Medical Assistance Amendments
of 2004'' (Rohrabacher, R-CA). This bill would amend Section
1011 of the Medicare Prescription Drug, Improvement, and
Modernization Act of 2003 (MMA) to impose conditions on
Federal reimbursement of emergency health services furnished
to undocumented individuals and require physicians and other
health care providers to report undocumented patients to the
Department of Homeland Security so that they could be
deported.
This provision would effectively negate Section 1011 of the
MMA which will provide funds to reimburse physicians and
hospitals for treating undocumented individuals. The AMA has
been working with the U.S.-Mexico Border Health Commission
and state medical societies in Arizona, New Mexico, Texas,
and California, as well as the Centers for Medicare and
Medicaid Services, to determine the best way to implement
Section 1011. Physicians in these states believe these funds
are critically needed to provide necessary health services to
undocumented individuals who cannot afford to pay their
medical bills.
This bill would effectively turn physicians and other
health care providers into border patrol agents. By requiring
physicians to report patients and perhaps withhold necessary
care, this bill would in effect require physicians to violate
their Hippocratic Oath. Finally, by discouraging undocumented
individuals from seeking medical care for problems that might
cause harm to others, such as communicable diseases, this
bill could have very negative effects on existing public
health efforts.
The AMA urges you to oppose this bill when it is considered
on the House floor.
Sincerely,
Michael D. Maves, MD, MBA,
Executive Vice President, CEO.
____
FamiliesUSA,
Washington, DC, May 17, 2004.
Dear Member: On behalf of FamiliesUSA, the voice for
America's health care consumers, I am urging you to reject
the Undocumented Alien Emergency Medical Assistance
Amendments of 2004, H.R. 3722. This bill would require
hospitals to report to the Department of Homeland Security
the name of any undocumented immigrant who receives care
within two hours of their treatment. If adopted, this
provision would have damaging effects on the care of all
Americans, especially on the Hispanic population.
If they are faced with fear of deportation if they present
at a hospital, undocumented immigrants who are in need of
treatment may not seek it. As a result, health problems may
go untreated, endangering the health of the individual, and
also creating potentially serious public health problems.
Confusion about the applicability of this proposal may deter
even some legal immigrants from seeking treatment. What is
more, our nation's hospitals and health care providers will
be forced to divert their time and attention from saving
lives to acting as immigration officials, resulting in
diminished care in the hospitals.
We urge you to vote against this legislation which creates
a public health danger.
Sincerely,
Ron Pollack,
Executive Director.
Mr. ROHRABACHER. Mr. Speaker, I yield myself 30 seconds.
Mr. Speaker, again we hear this bogus argument that this bill is
going to create more paperwork. The paperwork and the questions that we
are talking about are required by hospitals who are going to be trying
to get reimbursement through this billion dollar fund, which was snuck
into the Medicare package with a back room deal, I might add. It is not
required by my legislation; it is required to get reimbursement. If a
hospital does not want to be reimbursed, they do not have to ask any
questions, they can do whatever they want.
Let me note, all contagious diseases have been exempted by this
legislation.
Ms. SOLIS. Mr. Speaker, I yield 20 seconds to the gentleman from
California (Mr. Waxman).
[[Page H3038]]
Mr. WAXMAN. Mr. Speaker, I want to repeat, my good friend from Long
Beach and Orange, California, is absolutely incorrect. The hospitals do
not have to ask this question of emergency care patients. We do not
know what the emergency is when they come in, if it is a communicable
disease that they are suffering from such as SARS. Hospitals do not ask
this question. They give care to the patients.
Ms. SOLIS. Mr. Speaker, I yield 1 minute to the gentleman from
California (Mr. Dreier).
Mr. DREIER. Mr. Speaker, it is painful for me to rise in opposition
to this legislation. The gentleman from California (Mr. Rohrabacher)
and I have worked together on immigration issues for years, and I will
take a back seat to no one when it comes to the issue of protecting our
borders. I have had legislation to dramatically increase the size of
the Border Patrol, and I believe it is very important for us to deal
with the issue of illegal immigration.
But I happen to have come to the conclusion, while I support the
right to offer this legislation, I believe it is wrong. My concern is
that it will send a message to many people who may not know that they
have a contagious disease that the threat of deportation is on the
horizon. Safety and security for the American people is our number one
priority.
I strongly support anything that we are going to do to ensure that
the American people are safe and secure, that we are able to protect
our families. My concern is that someone who could conceivably see the
threat of deportation as they go through this process, and when I think
about the process of State and local governments shouldering the
responsibility of having to deal with possible incarceration of these
people, the cost is tremendous and the possibility of the spread of
disease is very great.
I appreciate the fact that there is an exemption, but people may not
know whether or not they have a contagious disease, and it is for that
reason I think the right thing for us to do now is to oppose this
legislation and work in a broad way to deal with the challenge of
illegal immigration, which is a very serious and important one for us.
Mr. ROHRABACHER. Mr. Speaker, I yield myself 30 seconds.
Let me note that if we really want to have the spread of disease in
this country, let us set ourselves up as the HMO for the whole world.
Let us make sure that everybody in the world knows that if they can get
their kids to the United States, we will take care of them, and see how
many diseases we are going to get.
That is what is happening in California right now. Diseases are
beginning to materialize because people have brought their children and
brought their seniors as well to come to the United States to be
treated. We have got to end that syndrome because the money is coming
directly from the health care dollars that should go to our own
citizens, and it is luring more people with disease into our country.
This is a catastrophe. The best way to prevent it is to vote yes on
H.R. 3722.
Mr. Speaker, I yield 3\1/2\ minutes to the gentleman from Georgia
(Mr. Norwood).
Mr. NORWOOD. Mr. Speaker, I rise to support H.R. 3722, and I would
note if safety and security is the main concern of our country, then
perhaps we ought to start at the borders and enforce the laws that we
have on the books. Were we doing that, this legislation would not be
needed.
Between 1990 and 2000, the number of illegal aliens in Georgia rose
300 percent. That was from 33,000 to 226,000 according to the U.S.
Citizenship and Immigration Services. Nationwide, the estimates of how
many illegal aliens live in our country range from 8 to 11 million, it
sort of depends on who one talks to. Those that do work do not have
health insurance, and technically the law forbids them access to
Medicaid.
However, document fraud led many to question how many illegal aliens
are fraudulently obtaining Medicaid today where we have a problem for
our own citizens in every State having enough money to take care of
Americans.
Last month, the Atlanta Business Chronicle reported that Grady
Memorial Hospital in Atlanta is on the verge of closing its doors.
Grady treats more illegal aliens than any other hospital in the State
of Georgia. It only gets 7 percent of its revenues from patients with
private insurance.
In 2002, the State of Georgia paid $58 million in emergency Medicaid
reimbursements to hospitals that treated more than 15,200 illegal
aliens, according to the Georgia Department of Community Health. About
75 percent of the funds went to pregnant women delivering babies. The
total was a 33 percent increase from 2001 when the State paid $43.4
million for the care of 12,000 people.
Mr. Speaker, I will have to say, if we do not pass this bill, it is
absolutely going to break our hospitals. We do have a billion dollars
that was put into the Medicare bill for reimbursement to our hospitals
for illegal alien care. That means, to obtain those dollars, and all
hospitals, particularly rural, desperately need those dollars,
hospitals have to ask the question: Are you or are you not a citizen?
It is that simple.
I do not happen to think that we have a pot full of money that is so
big that everybody can get everything that they want. We do not. I see
it in Medicaid today for U.S. citizens. There is not enough money in
there now. We have to be particular about how we spend that money. And
first and foremost, it must be spent on the American citizen, not
someone who started out the day breaking Federal law.
Mr. Speaker, we ought to be talking about that more than anything
else. This Congress is responsible for that. We passed a law saying
that people cannot sneak across our borders. If Members do not believe
that ought to be the law, if they think that is not important, then
stand up and repeal that and we will look at this whole scenario,
including health care, in a different vein.
Ms. SOLIS. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, I submit for the Record letters from various hospitals
and organizations in opposition to this bill.
May 13, 2004.
RE: H.R. 3722 (Rohrabacher)--Oppose
Dear Congresswoman Solis: On behalf of Private Essential
Access Community Hospitals, Inc. (PEACH, Inc.), representing
37 private safety net hospitals across California, I am
writing to express our strong opposition to H.R. 3722
(Rohrabacher), which would require hospitals to document the
immigration status of those seeking emergency care. We ask
for your NO vote when this measure comes before the House
this month.
In California and throughout the nation, private safety net
hospitals are a vital segment of the safety net, providing
critical health care services to diverse populations within
their communities, including undocumented immigrants. PEACH
hospitals consider it part of their mission to provide
essential services to all who seek care regardless of any
barrier, including ability to pay or immigration status.
We have two primary concerns about H.R. 3722. First and
foremost, our hospitals are in the business, socially,
morally and economically, of saving lives and protecting the
health care of their communities. They are not in the
business of serving as immigration officers. This is neither
the role of hospitals nor an effective use of extremely
limited hospital funds and staff time--particularly in an
emergency department setting.
Second, we believe that H.R. 3722, rather than discouraging
the tide of illegal immigration, would instead have a
negative impact on public health care. Individuals who are in
need of emergency care, including those with contagious
conditions and/or who are seriously ill, would be forced to
avoid treatment in order to avoid the threat of deportation.
This would likely result in the spread of serious and
contagious conditions to the greater community creating a
health care epidemic as well as a secondary wave of patients
needing costly emergency care.
PEACH appreciates the desire to stem illegal immigration,
but H.R. 3722 sets a very dangerous precedent by using health
care providers as adjunct Border Patrol. We urge you to
defeat this ill-advised measure, and appreciate your
consideration of the views of those who are on the front
lines of health care every day.
Sincerely,
Catherine K. Douglas,
President and CEO, PEACH, Inc.
On behalf of:
California Hospital Medical Center, Central Valley
General Hospital, Citrus Valley Medical Center--Inter-
Community Campus, City of Hope National Medical Center,
College Hospital Cerritos, College Hospital Costa Mesa,
Community Hospital of San Bernardino, Community and
Mission Hospitals of Huntington Park, Daniel Freeman
Memorial Hospital, Fountain Valley Regional Hospital
and Medical Center.
[[Page H3039]]
____
May 7, 2004.
Dear Member of Congress: We understand that the House of
Representatives is expected to soon consider legislation
(H.R. 3722) proposed by Representative Rohrabacher (R-CA).
The undersigned organizations, representing America's
hospitals and health systems, health care providers, and
safety net systems, are united in our opposition to H.R.
3722, the ``Undocumented Alien Emergency Medical Assistance
Amendments of 2004,'' and urge you to oppose this
legislation. We believe it will severely undermine Section
1011 of the Medicare Prescription Drug, Improvement, and
Modernization Act of 2003 (MMA) and create unnecessary
barriers to life saving treatments at hospitals nationwide.
After months of careful deliberation by the Medicare
conferees, the Congress and Administration included essential
resources for hospitals providing life saving emergency care
to undocumented aliens. The undersigned organizations deeply
appreciated the inclusion of Section 1011 in MMA.
We are deeply concerned that H.R. 3722 would weaken Section
1011 by imposing new burdensome requirements on hospitals in
order to receive any of the resources from Section 1011. In
addition, H.R. 3722 would virtually ensure that illegal
immigrants will avoid getting the appropriate and timely life
saving health care they need, when they need it. H.R. 3722
could pose a significant public health threat for entire
communities because the fear of deportation would inevitably
preclude undocumented immigrants from seeking care for
communicable diseases until these individuals are extremely
ill.
Hospitals provide care to anyone who walks through their
doors, regardless of race, ethnicity or citizenship status--
twenty-four hours each day, seven days a week. That is the
role of community hospitals. Rep. Rohrabacher's legislation,
however, seeks to create a new role for hospitals in their
communities--that of border patrol agents. In order to
qualify for Section 1011 funding, the Rohrabacher legislation
would require that hospitals demand and upload personal
data--including such ``identifiers'' as fingerprints and
digital photographs--on undocumented aliens to an electronic
database set up by the Department of Homeland Security (DHS)
and the Department of Heath and Human Services (HHS) for
deportation purposes. Furthermore, the bill requires
hospitals to retain original documents and data for a period
of at least 5 years, thus imposing additional paperwork on an
already overwhelmed system.
We do not believe this is in the best interest of the
patients we serve and the nurses and physicians that provide
emergency care. Today's health care delivery system is very
fast-paced and in an emergency situation, the urgency of
providing life-saving care take precedence over anything
else. Requiring hospitals to collect these data diverts us
from doing our job of caring for patients. Hospitals do not
have the expertise or the resources to interrogate and
investigate patients in the pressured environment of an
emergency.
We respectfully ask that you oppose this legislation should
it come up for a vote.
Sincerely,
Federation of American Hospitals.
American Hospital Association.
National Association of Public Hospitals and Health
Systems.
Association of American Medical Colleges.
Catholic Health Association of the United States.
National Association of Children's Hospitals.
VHA Inc.
Ms. SOLIS. Mr. Speaker, I yield 1\1/3\ minutes to the gentlewoman
from Guam (Ms. Bordallo).
Ms. BORDALLO. Mr. Speaker, I rise today in strong opposition to H.R.
3722, a bill that presents more questions than answers about providing
efficient and effective health care treatment to undocumented
immigrants.
I share the concern about lapses in our country's immigration
program, and I support measures such as biometric visas and other
advanced technologies to more accurately control who enters our
country. However, I am very concerned about this particular
legislation, as I fear that it will serve only to undermine the
efficiency and effectiveness of our public health system with little
benefit to our Border Protection Services.
Mr. Speaker, we are talking about health here. The reason that I
hesitate to support H.R. 3722 is twofold. First, funding was included
in last year's Medicare reform act for the simple purpose of assisting
State and local health authorities to cover the cost of providing
health services to illegal immigrants.
This provision demonstrates both our Nation's compassion by ensuring
public health to all walks of life and also its commitment to providing
our medical community with the necessary resources to do their jobs.
Adding more regulatory and financial burdens, such as those outlined in
H.R. 3722, will increase costs.
Secondly, I am concerned that immigration paperwork will either
prevent or delay critical health care services to immigrants in
general. Documentation can be dealt with after immediate medical
procedures are rendered. Because of these concerns, I urge my
colleagues not to support H.R. 3722.
Ms. SOLIS. Mr. Speaker, I yield 1 minute to the gentlewoman from
Illinois (Ms. Schakowsky).
Ms. SCHAKOWSKY. Mr. Speaker, we have been asked to vote on a lot of
really bad ideas presented by the majority, but I have to say this is
clearly one of the worst.
This bill, regardless what the gentleman says, would require doctors
and nurses to be part of enforcing Federal immigration laws while
threatening the health and well-being of our communities.
But do not take my word for it. The American Medical Association says
``This bill would effectively turn physicians and other health care
providers into Border Patrol agents. By requiring physicians to report
patients and perhaps withhold necessary care, this bill would, in
effect, require physicians to violate the Hippocratic Oath. Finally, by
discouraging undocumented individuals from seeking medical care for
problems that might cause harm to others, such as communicable
diseases, this bill would have very negative effects on existing public
health efforts.''
I know the gentleman goes to great lengths to say what is not in his
bill is not in his bill, but these are the experts that are required to
actually carry out this law. This bill is so ill-advised, it could
allow for a woman in active labor to be deported. That is not America.
We should vote ``no'' on the legislation.
{time} 1530
Mr. ROHRABACHER. Mr. Speaker, I yield myself 1 minute.
We keep hearing the bogus arguments. This requires the doctors to ask
so many questions; we know now that is not true. Only the people who
are trying to get reimbursed from that billion-dollar fund are going to
ask the questions. This bill has minimal added questions. Two. Who is
your employer and then taking a picture or getting a fingerprint which
might be required in order to get reimbursed in the first place.
Do my colleagues on the other side of the aisle really believe in
unlimited treatment for illegal immigrants without asking any
questions? Is that what we are going to do? Who benefits from that?
Certainly the illegal immigrant does and the tens of millions of other
illegal immigrants who come into our country seeking health care, yes,
they are going to benefit.
Who else benefits? The employer who does not want to offer health
care to his employees. That is who benefits. That is who is being
subsidized here. Behind the scenes when you get to the Chamber of
Commerce and these other people opposing this, that is what their
motive is. They do not want to offer health care to their employees.
This gives the government the subsidy to subsidize them hiring people
at below minimum wage level and, in fact, off the books at times. If
you want to combat illegal immigration, this is the way to start; and
it does not add any new paperwork or any new questions for the doctors.
Ms. SOLIS. Mr. Speaker, I yield 1\1/2\ minutes to the gentlewoman
from California (Ms. Linda T. Sanchez).
Ms. LINDA T. SANCHEZ of California. Mr. Speaker, envision this: an
undocumented immigrant or a legal permanent resident or even a U.S.
citizen suffers severe abdominal pain and finds himself in the
emergency room of a nearby hospital. The first order of business for
the emergency physician, nurse, or whoever is attending the patient is
not to ask them where it hurts and do a physical exam to see if their
life is in imminent danger, but to ask their immigration status and get
a sworn statement to that effect.
If that patient at that particular moment cannot prove their legal
status, that same doctor must make the choice not to provide care to
this person, or they must at least report them to the immigration
officials before providing lifesaving treatment. I ask you, what kind
of choice is that? What happens if that same immigrant decides not to
seek care because of the potential consequences and what could become a
burst appendix leads to infection, more expensive care or possibly
[[Page H3040]]
even death? There is no humanity in the choice you are asking health
care workers to make in this circumstance. They are no longer healers,
but immigration law enforcers.
What is even more appalling is that the Republican leadership chooses
to pursue this course of action to deal with this country's immigration
problem rather than look at the comprehensive immigration reform
measures that have been introduced in the House. If the Republicans are
serious about reforming immigration, then take a look at the bill the
Democrats introduced which would bring a sense of order and reason to
the influx of immigrants into this country.
Let us not jeopardize our entire public health system in this
misguided attempt to bring down health care costs and deport
undocumented workers. This bill is an affront to our health care
professionals and to the immigrant community in this country which
would no longer be able to get care without presenting their green card
first.
I urge a ``no'' vote on this legislation.
Mr. ROHRABACHER. Mr. Speaker, I yield myself 30 seconds. This bill
does not require the first order of business to ask questions. This
bill says if you want to be reimbursed from that billion dollar fund,
yes, you are going to have to ask some questions, anyway, and adds one
other question: Who is your employer? It does not require the doctors
to turn anybody into the INS, although we have heard that over and over
again in this debate. It does not require that. It requires their files
to be available to the INS and to the Department of Homeland Security.
It is those agencies that then follow through. The doctors do not have
to report anything. It just has to be available on a computer.
Communicable diseases, we keep talking about that, that also is
wrong. The bill exempts communicable diseases. Let us talk about the
real issue, illegal immigration. How many services are we going to give
people until we get tens of millions of more immigrating into our
country?
Ms. SOLIS. Mr. Speaker, I yield 1\1/2\ minutes to the gentleman from
Texas (Mr. Hinojosa).
Mr. HINOJOSA. Mr. Speaker, I rise in strong opposition to H.R. 3722.
I am appalled that the Republican majority would bring such a mean-
spirited and discriminatory bill to the floor of this House for a vote.
Under current law, hospitals can receive reimbursement for emergency
services they provide to uninsured people, including immigrants. Our
current law is a responsible public health and safety policy. It is
humane. In this country, we do not deny emergency medical treatment
because someone is poor, uninsured, or born in another country.
The proposed H.R. 3722 would turn hospital emergency rooms into
immigration processing facilities or, worse, detention facilities.
Hospitals would be required to collect sworn statements of citizenship
from individuals suffering medical emergencies. Hospitals would have to
collect fingerprints or other biometric identifiers of all emergency
patients. Under this proposed H.R. 3722, they would have to submit the
information to the Department of Homeland Security and store it for a
minimum of 5 years.
It seems to me there are a few Republicans who want to make people
afraid to go to the hospital. This legislation will have deadly results
in many of our congressional districts, especially in my district, a
border district. We have daily trade and commerce across the border.
Businesses depend on it. Fear will keep people from seeking lifesaving
medical treatment. I urge all my colleagues on both sides of the aisle
to send a message to those who would sow fear and hate, by strongly
opposing H.R. 3722.
Mr. ROHRABACHER. Mr. Speaker, I yield 1 minute to the gentleman from
Texas (Mr. Culberson).
Mr. CULBERSON. Mr. Speaker, we face a record national budget deficit
in this country. We face a record national debt of over $7 trillion,
which we cannot leave to our children. We face in Harris County, Texas,
spending over $100 million a year providing health care to illegal
aliens.
This bill that the gentleman from California has filed, which I
strongly support, only requires hospitals that are seeking
reimbursement from that billion dollars to identify whether the
individual in question is a citizen or not. A hospital is not eligible
to be reimbursed unless they are already treating somebody who is an
alien.
The gentleman from California's bill, and I have read it very
carefully, requires that this question be asked of everybody who is
presented to a hospital for medical treatment if they are an alien. The
gentleman from California's legislation is based on common sense. We
must make sure that we balance the budget in this country. The budget
deficit is now over $500 billion. Uncontrolled immigration is a
national security issue. We must control our borders. It is a financial
security issue for the sake of our kids and our grandchildren.
I think the gentleman from California has come forward with a
commonsense proposal that we can move forward on to the Senate and that
we could deal with in conference committee. If opponents of this bill
have better ideas, let them offer them as amendments. I strongly
support the legislation and encourage my colleagues to vote for this
bill in the interest of national security and the financial security of
the future of this Nation.
Ms. SOLIS. Mr. Speaker, I yield 2 minutes to the gentleman from Texas
(Mr. Doggett).
Mr. DOGGETT. Mr. Speaker, our border communities face some tremendous
health care challenges. This bill would simply add to their burdens. It
seems to confuse TV shows, trying to merge ``ER'' with ``NYPD Blue.''
It would involve our health care workers, our physicians, and instead
of being physicians, it would turn them into Homeland Security
deputies. When a doctor asks the nurse for a patient's vital signs, it
ought not to mean fingerprints and a visa entry number.
Think of it. A parent who is rushing a child to the emergency room
with an excessively high fever, with a rattlesnake bite, with an
accidental-fall injury is thinking, ``can I get my child to the doctor
on time?'', not ``did I bring my employment history, my immigration
status, my financial status?'' Some of our border physicians face such
immense burdens. That physician is thinking, ``how can I take care and
save the life and the future of this young person?'' Involving doctors
and nurses in the red tape of the federal bureaucracy jeopardizes all
of us, because these viruses and bacteria are equal opportunity
pathogens. Tuberculosis, typhus and hepatitis do not ask for your
immigration status. All of us could be adversely affected if fear
forces people not to seek treatment at a medical facility.
It is also important to consider that, finally, there is a small
amount of relief for our border communities. Starr County, one of the
poorest counties in the entire country, ought not to have to bear all
of the cost of our federal immigration policy, nor should physicians in
Mission or McAllen bear the entire cost of a policy that is federal in
nature. Finally, there is some assistance on the way under legislation
approved last year. Let us not destroy it with this bill. The Border
Health Caucus has been leading the way in trying to find solutions to
address the care of all the people in the border region.
As we discuss immigrants, some here see numbers, but these are real
live human beings that face crisis every bit as real as that of someone
like myself who has lived here forever. This is a chance for groups to
come together to stop bad legislation and start us on the way to
solving our health care problems along the border.
Ms. SOLIS. Mr. Speaker, I yield 1\1/2\ minutes to the gentleman from
New York (Mr. Crowley).
Mr. CROWLEY. I thank the gentlewoman for yielding me this time.
Mr. Speaker, I rise in strong opposition to H.R. 3722. Hospitals,
doctors, and nurses ought to be free to do the incredibly important
jobs we all depend on them to do, that is, to save human life. Sadly,
this bill would help prevent that. In turn, this bill will hurt
patients.
On a recent New Year's Eve in a hospital in my district, an
undocumented woman gave birth to a girl. That girl, by birth, is a U.S.
citizen but her mother remains not. If this bill had been law, that
mother would have likely faced deportation. If that mother were
deported, in all likelihood her baby
[[Page H3041]]
girl, a U.S. citizen, would have gone with her. In essence that baby
girl, a U.S. citizen, would have been deported.
If this bill had been law when this mother went into labor, there is
also a good chance that she would not have sought care at all. I ask
you, if a pregnant woman is afraid to seek out care to help herself and
her baby who, when born, will become a U.S. citizen, who suffers? If a
person with a communicable disease does not seek treatment, who
suffers? A communicable disease does not ask whether you are a U.S.
citizen or not. If a person with a chronic ailment does not seek
treatment until the condition worsens, requiring emergency care and
taking up a scarce bed in the ER, who suffers?
The reality is that this bill endangers the health of the
undocumented, and this bill endangers the health of the documented as
well. I would have thought that the sponsor of this bill would have
learned from the ill-fated proposition 187 in his home State of
California that led to scares and communicable disease outbreaks
throughout the entire population, especially school children, because
some people were denied care.
I urge my colleagues to vote ``no'' on this bill.
Ms. SOLIS. Mr. Speaker, I yield 1 minute to the gentlewoman from
California (Ms. Waters).
Ms. WATERS. Mr. Speaker, this is not the way to deal with immigration
problems. I rise in strong opposition to H.R. 3722. As a matter of
fact, I am surprised at the gentleman from California. Does he not
understand that this would transform our health care personnel into the
border patrol? This bill will have a disastrous impact on emergency
care and community hospitals throughout America.
Mr. Speaker, hospitals, doctors, nurses, and health care personnel
are trained to be caregivers, not adjuncts of immigration law
enforcement. Do our health care personnel not have enough to do already
without imposing this huge reporting burden on an already overextended
health care system?
Mr. Speaker, forcing health care personnel to start taking
fingerprints and snapping pictures of patients suspected of being
undocumented when perhaps they need a blood transfusion or something to
save their lives will cause people who urgently need medical care to
refrain from seeking such care because they fear that they may die
trying to get service or they will be deported. We all know that in
health care an ounce of prevention is worth a pound of cure. When any
persons delay their access to health care, their medical condition is
much worse.
I would urge a ``no'' vote on this bill. It is unsound public policy.
I am ashamed of it. Do not do it.
Ms. SOLIS. Mr. Speaker, I yield myself the balance of my time.
In closing, I urge all my colleagues to join the hospitals, doctors,
nurses, business owners, women's groups, children advocates, civil
rights organizations, and, yes, the U.S. Chamber of Commerce to stand
strongly against this bill. We cannot let this bill be the message to
send to the American people about what the U.S. Congress thinks about
the role of hospitals. We cannot let this bill be the message we send
to the American people about what we think about immigrants,
hardworking, tax-paying immigrants who come to this country for a
better life, just as my parents did some 50 years ago. In fact, the
average immigrant contributes about $1,800 more in taxes annually than
he or she receives in any form of benefit, because they do not collect.
We can do better than this bill. I urge my colleagues to vote against
H.R. 3722.
Mr. Speaker, I yield back the balance of my time.
{time} 1545
Mr. ROHRABACHER. Mr. Speaker, I yield myself the balance of my time.
Mr. Speaker, I would ask my colleagues to seriously consider this
vote, and I would remind them that there are people all over the United
States, especially their constituents, who are looking at this vote as
a determinant as to whether or not we believe that illegal immigration
is something that should remain uncontrolled and should continue in the
years ahead, or whether we should start doing something about it.
There is a seething among the American people, among the working
class and middle-class people. They know that illegal immigration has
had a horrible impact on their lives. It has brought down wages. We
actually had a policy that permitted unlimited illegal immigration into
our country, and because of that, working class people do not make as
much money as they did before.
Now we have a situation where illegal immigrants who go for emergency
treatment, we are being told that we have to give them unrestricted and
unlimited treatment, health treatment, and it is going to be paid for
by the Federal Government. But that is not true of U.S. citizens. What
about those middle-class, working-class people? They are out of work;
they do not have insurance.
In this situation today, we have created the perverse priority that
our government is reimbursing hospitals and helping illegals, but we
will not do it for our own citizens.
We have a horrible problem in this country with illegal immigration.
It is hurting many people's lives. Yes, rich corporations in the
Chamber of Commerce, they get to hire people who are not even paying
taxes half the time. They do not have to provide health insurance
anymore because there are all these illegals willing to work anyway.
That is very damaging to the American people.
Also we are spending billions of dollars here already on cancer
treatments, organ transplants and genetic problems. We are spending
about $10 billion on this every year.
This legislation says the only free treatment that somebody gets at
an emergency center, illegal or not illegal, is if their life is under
a threatening situation. I think even that is very generous of us in
the United States. Interestingly enough, if someone goes through the
process of being a legal immigrant, they do not get their health care
covered, they do not get it reimbursed by the Federal Government.
Mr. Speaker, unless H.R. 3722 passes, we have set up the priority of
helping illegal immigrants. Do not think that will not attract tens of
millions more illegal immigrants to this country who have diseases that
need to be treated. That makes sense. Think about it. This is common
sense.
The American people are waiting to see whether or not we are going to
use our scarce health dollars to take care of our senior citizens, to
take care of our own people, to take care of our own little kids, or
whether we are going to attract tens of millions of new people here and
give that money away to strangers.
This is not mean-spirited. This is down-in-your-heart. We love
everyone in this country. We have a diverse country, every race and
religion. It is that love for each other that keeps us together. We
have to care more about our own people, and that is not mean spirited,
than we do about people that come here illegally.
Mr. Speaker, I would ask my friends and colleagues to support H.R.
3722.
Mr. BACA. Mr. Speaker, I rise in strong opposition to H.R. 3722, the
Undocumented Alien Medical Assistance Amendments of 2004.
The Medicare Prescription Drug Act that this Congress passed last
year includes $1 billion to reimburse hospitals for their uncompensated
care of undocumented immigrants. We included that funding because we
recognized the strain hospitals experience in providing uncompensated
emergency medical care to the uninsured. H.R. 3722 undoes this goodwill
by requiring hospitals to enforce immigration law, refuse emergency
medical treatment to immigrants, and have them deported.
Many American citizen and immigrant families who are living, working
and paying taxes in the United States are unable to obtain health care
coverage for themselves or their families. At a time when health care
has become a national crisis due to the large number of uninsured, we
need to take steps to heal more, not less.
Undocumented immigrants are not covered by employer health care
plans, and they are systemically excluded from public health insurance
programs such as Medicaid and SCHIP. We cannot encourage immigrants to
refuse to seek medical care due to fear of deportation. It makes no
sense. Do we want outbreaks of tuberculosis and other diseases and
epidemics common in the developing world right here in America? That is
likely to happen if immigrants are refused emergency medical care. This
is why hospitals nationwide, the
[[Page H3042]]
American Medical Association, and physicians of all types are urging
this Congress to reject this attempt to inject an anti-immigrant agenda
into the field of medicine. Besides public health, H.R. 3722 fails on a
number of fronts.
For instance, it would force hospitals to choose which law they will
violate--the one that requires them to provide medical assistance to
anyone that requires it, or H.R. 3722 and its requirement that we even
deport women while in labor.
The Emergency Medical Treatment and Active Labor Act requires that
any patient, without regard to race, sex, creed, immigration status, or
ability to pay, be given appropriate emergency care to stabilize his or
her condition. This law is consistent with the Hipprocratic Oath, and
is meant to ensure that no person in our country will be denied
emergency medical care.
I cannot support legislation that could punish employers that
unknowingly hire immigrants with fraudulent green cards by forcing them
to pay the medical bills. There is no precedent for holding employers
liable for injuries and illnesses that are not work-related. Also, I
fear that employers will discourage their employees from seeking
treatment for any illness.
Are we prepared to possibly read stories of immigrant laborers found
injured or dead on sidewalks? It is not difficult to imagine immigrants
being left behind by fearful employers trying to avoid the scrutiny of
federal immigration enforcement officials.
Mr. Speaker, H.R. 3722 is a Pandora's box that our Nation cannot
open. H.R. 3722 will endanger the health of everyone in America. It
will force doctors to violate their oaths and the law, require
hospitals to enforce immigration law, and it will encourage employers
to force their immigrant laborers to never seek medical treatment.
I urge my colleagues to please oppose this misguided proposal.
Mr. STARK. Mr. Speaker, I rise in opposition to H.R. 3722, the
Undocumented Alien Emergency Medical Assistance Amendments Act. This
draconian bill would convert our nation's hospitals from health care
providers to border patrol officers.
If enacted, it would seriously endanger the health and lives of
immigrants who need emergency care--and jeopardize our nation's entire
public health system in the process. This bill would deny critical
federal reimbursement to hospitals for the emergency care of
undocumented immigrants unless the hospital determined patients'
immigration status and obtained employer information for transmission
to the Department of Homeland Security for purposes of beginning
deportation procedures for undocumented workers.
Today, the House Republicans are proving that President George Bush's
promise to reform America's immigration system is not real and is
nothing more than an election year ploy to gain votes from immigrants.
If President Bush were concerned about the well-being of immigrants, he
would publicly denounce this bill and would have made clear to the
House Republican leadership that it did not deserve to see the light of
day. He's done no such thing.
This bill also clearly demonstrates the Republican Leadership's
willingness to sacrifice the health needs and safety of America's
immigrants to ensure their large donors--the pharmaceutical companies
and health insurance industry--get their billions of dollars in
subsidies from the Medicare bill. HR 3722 is on the floor today because
of a commitment the House Republican leadership made to the bill's
author in exchange for his vote for the Republican Medicare bill when
it narrowly passed the House last November. Its yet another example of
the dirty dealing it took to get their Medicare bill through Congress.
If enacted, this policy would create a chilling effect in which both
documented and undocumented workers would fear coming into hospitals
for critical medical services. The result would be immigrants suffering
from more serious health complications and eventually leading to the
unnecessary deaths of many immigrants.
This bill would also threaten the public health of this nation. Since
this bill would surely drive a significant proportion of this country's
population away from seeking needed medical care, it would undermine
our public health system's ability to track and prevent the spread of
contagious disease. Clearly, such a change would impact health care
beyond the immigrant community.
Instead of limiting health care, this Congress should be finding ways
to expand health care to the 44 million Americans without health
insurance. This bill would take us in the exact opposite direction. I
urge my colleagues to vote against this bill and to protect our
hospitals' abilities to continue to provide medical care to those who
need it. To do otherwise is to endanger the health of us all.
Ms. JACKSON-LEE of Texas. Mr. Speaker, I rise in opposition to H.R.
3722, the ``Undocumented Alien Emergency Medical Assistance Amendments
of 2004.'' This bill would amend Section 1011 of the Medicare
Prescription Drug, Improvement, and Modernization Act of 2003 MMA. The
purpose of Section 1011 of the MMA is to provide funds for reimbursing
physicians and hospitals for treating undocumented individuals who
cannot afford to pay their medical bills. H.R. 3722 would impose
conditions on the Federal reimbursement of emergency health services
furnished to these individuals, and it would require physicians and
other health care providers to report the undocumented patients to the
Department of Homeland Security so that they could be deported.
H.R. 3722 would require physicians and other health care providers to
be part time border patrol agents. According to the American Medical
Association AMA, by requiring physicians to report patients and perhaps
withhold necessary care, this bill would in effect require physicians
to violate their Hippocratic Oath. The AMA also has expressed concern
over the fact that by discouraging undocumented individuals from
seeking medical care for problems that might cause harm to others, such
as communicable diseases, H.R. 3722 could have very negative effects on
existing public health efforts.
I share the concerns of the AMA. The fear of deportation inevitably
would preclude undocumented immigrants from seeking care for
communicable diseases until they are extremely ill.
It is important to remember that community hospitals must provide
care to anyone who walks through their doors, regardless of race,
ethnicity or citizenship status, and they must do this twenty-four
hours each day, seven days a week. In order to qualify for Section 1011
funding, the Rohrabacher legislation would require the hospitals also
to demand and upload personal data. This would include the uploading of
fingerprints and digital photographs for undocumented aliens to an
electronic database set up by the Department of Homeland Security DHS
for deportation purposes. Furthermore, the bill would require hospitals
to retain original documents and data for a period of at least 5 years,
thus imposing additional paperwork on an already overburdened system.
Today's health care delivery system is very fast-paced, and, in an
emergency situation, the urgency of providing life-saving care takes
precedence over anything else. Requiring hospitals to collect
immigration data would divert time and attention from caring for
patients. Hospitals do not have the expertise or the resources to
interrogate and investigate patients in the pressured environment of an
emergency room.
It also would divert funds that could be used to provide health care
services for some of America's estimated 44 million uninsured patients.
A substantial portion of these funds would have to be used to establish
and implement an expensive new immigration enforcement program for our
already underfunded, overburdened community hospitals.
More than 200 organizations are opposed to this bill, including the
American Hospital Association, Federation of American Hospitals,
National Association of Children's Hospitals, National Association of
Public Hospitals and Health Systems, Catholic Health Association,
Association of American Medical Colleges, National Immigration Forum,
National Immigration Law Center, Leadership Conference on Civil Rights,
National Council of La Raza, League of United Latin American Citizens,
MALDEF, National Asian Pacific American Legal Consortium, Asian and
Pacific Islander American Health Forum, Families USA, AFL-CIO and
Catholic Charities.
This legislation would weaken federal Emergency Medical Treatment and
Active Labor Act EMTALA obligations by redefining the circumstances
under which hospitals are required to treat patients who are
undocumented immigrants. Such a policy would create a dangerous
situation for all patients because physicians would be required to
impose differing standards of care based on whether they determine a
patient to be in the country legally or not. By necessity, emergency
department professionals must be afforded the latitude necessary to
provide treatment based solely on which treatment is medically
appropriate for the patient and without regard for immigration status.
It is in the best interests of all patients, documented and
undocumented alike, that medical staff be permitted to focus their
attention on caring for patients and providing necessary medical
treatment rather than on assisting the federal government in enforcing
the immigration laws of this country. I urge you therefore to vote
against H.R. 3722, the ``Undocumented Alien Emergency Medical
Assistance Amendments of 2004.''
Mr. ISSA. Mr. Speaker, I rise today to oppose H.R. 3722, the
``Undocumented Alien Emergency Medical Assistance Amendments of 2004.''
I commend the gentleman from California for his intent in introducing
this legislation. It
[[Page H3043]]
attempts to address legitimate concerns that exist about widespread
illegal immigration and the cost of providing services to those aliens.
This legislation requires hospital emergency rooms to collect
citizenship, immigration status, financial data, and employer
information from aliens seeking emergency care and transmit that
information to the Department of Homeland Security in order to receive
reimbursement for services. H.R. 3722 also requires an employer who
knowingly employs an illegal alien to pay the cost of providing
emergency care to the alien. As a representative of the same state as
the gentleman from California, I understand the factors that led to him
draft this legislation.
However, I am disturbed that this legislation has come to the floor
of the House without proper consideration, that it has not been fully
vetted through the Committee process. I am a member of the committee of
jurisdiction, the Committee on Energy and Commerce, and this
legislation has not had a hearing or a mark up before our committee.
Before we make a change in the law, before we enact legislation that
will impact the operation of every emergency room in America, I think
we ought to have a thorough debate on the issue, hear from the doctors
and hospital administrators and others who will be impacted by this
legislation, and who will bear the burden of implementation.
I am opposing this legislation today, with the hopes that the
gentleman will continue to pursue solutions to a serious problem, and
that we would have an opportunity to hold hearings on this issue in the
committees of jurisdiction and address it through the normal committee
process. This will give us the opportunity to perfect legislation in
order to make it fair and practical for hospital emergency rooms and
the patients they serve.
I thank you for the opportunity to speak, applaud the good intentions
of the gentleman from California, and respectfully urge my colleagues
to vote ``no'' on this bill at this time.
Mr. FILNER. Mr. Speaker, our Nation is not healthy unless everyone
is. I rise in strong opposition to the Undocumented Alien Emergency
Medical Assistance Amendments.
It is true that hospitals in San Diego, Imperial County and
throughout the border region need Federal assistance to pay for the
uncompensated care they provide. Instead of debating H.R. 3722,
however, I would prefer to debate and vote on my Pay Up! Act, H.R.
2848, aimed at offering full Federal reimbursement to hospitals for the
service they provide to undocumented patents. My bill would not force
nurses and doctors and other medical professionals to suddenly become
de facto immigration officials.
Unfortunately, the dangerous legislation that we are considering
today would do exactly that: it would deny Federal reimbursement to
emergency health service providers unless they agree to also serve as
immigration agents.
As California's Border Congressman, I can tell you this legislation
would be a disaster for border communities. It would put an extra
burden on our already overworked health care professionals, as they
scramble to find the resources to collect and process patients'
immigration information, biometric identifiers and financial data. This
legislation will lead to fear and confusion among both documented and
undocumented immigrant families, discouraging them from getting
necessary medical attention for children, pregnant women, the elderly
and others. In fact, this legislation could put everyone's health at
risk. The University of California at San Diego Medical Center has
warned that this bill ``could undermine public health by deterring
those with contagious diseases from seeking care.''
This bill puts the lives of immigrants at risk. It puts our health
care services at risk. It puts our public health at risk.
On behalf of California's border communities, I urge my colleagues to
not force doctors to spend their time figuring out which patients are
in good standing with our complex immigration laws. I urge my
colleagues to not force immigrant families to skip treatment for life-
threatening medical problems because they fear deportation. I urge my
colleagues to vote ``no'' on the Undocumented Alien Emergency Medical
Assistance Amendments.
Mr. MORAN of Virginia. Mr. Speaker, I rise in strong opposition to
the Undocumented Alien Emergency Medical Assistance Amendments of 2004,
H.R. 3722, because it will place a new burden on already struggling
emergency health care systems nationwide and will deter immigrants and
their family members from seeking much needed health services.
It is interesting to note that this month, at medical school
graduations nationwide, a new community of physicians were called upon
to take the Hippocratic Oath, which remains a sacredly held principle
to the medical community today. Unfortunately H.R. 3722 would allow
hospitals which receive federal funding to decide whether or not they
would like to make emergency medical services available to certain
immigrants, even if they are suffering from an emergency medical
condition. This is a right that hospitals and other health care
organizations do not want, as evidenced by the strong opposition of the
American Hospital Association, the American Medical Association and
countless other public health organizations. This seems to be in direct
conflict of the Hippocratic Oath and will deny basic medical services
to some of the most vulnerable of our society.
In Northern Virginia, which encompasses my congressional district,
the INOVA Health System serves nearly 400,000 residents a year and has
about 240,000 visitors to its emergency rooms alone. The emergency room
personnel at INOVA hospitals are some of the same nurses and doctors
who serve as our First Responders and were certainly heroic on
September 11th in aiding the victims of the Pentagon attack.
Proponents of H.R. 3722 claim that this measure will help to lower
the cost of health care in our country, but in reality, will do little
to alleviate the growing cost of health care needs and will force
hospitals to expand staff and technological resources to implement the
reporting requirements such as obtaining signed statements relating to
citizenship, immigration status, address, financial data and current
employee status as well as purchase a digital electronic biometric
identifier.
I am greatly disappointed that the House Republican Leadership would
bring to the floor for a vote, a measure which strives to deny even
basic health services to some of the most vulnerable in our society,
while our military is working hard to establish health services for
citizens in some of the most war-torn and poverty-ridden countries in
the world. H.R. 3722 will do little to address the important issue of
rising health care costs and its intent seems to have been influenced
more by political considerations than sound policy. I urge all my
colleagues from both sides of the aisle to vote against the
Undocumented Alien Emergency Medical Assistance Amendments of 2004.
Mr. RUPPERSBERGER. Mr. Speaker, I rise in opposition to H.R. 3722
because this bill places an undue burden on our hospitals to be the
judge and law enforcement officer for our country's immigration
policies. I agree with the sponsor of this legislation that we need to
stop illegal immigration but we need to do that by giving immigration
officers more resources to find, detain, and deport illegal immigrants.
We need to redouble our efforts on our borders and aggressively prevent
illegal immigration, but should not shift the responsibility of
enforcing our immigration policy onto our health care professionals.
The problem with this bill is that it targets the reimbursement of
hospitals that provide care to injured or sick undocumented aliens.
This legislation withholds reimbursements from hospitals that do not
collect and share a person's immigration status, their citizenship,
address, employment information, personal and financial data, health
insurance information, and electronic version of their fingerprints
that meet DHS standards. If they do not comply they do not get
reimbursed. This means hospital personnel will have to spend time
collecting information as opposed to treating the sick. More
importantly, this places the burden on doctors to choose between
treating a person and looking out for the financial security of the
hospital. This is not a choice that a doctor should be forced to make.
Many businesses do their due diligence in determining and screening
workers but they do not have all the resources to fully verify
immigration status. This legislation forces those businesses to
reimburse hospitals for care if the company unknowingly employs a
worker without full immigration documentation or offer health insurance
to all of their workers. We should not punish businesses that have
tried and do not have the resources to verify the immigration status of
their workers. We also cannot require businesses to provide health
insurance. That is a business decision and should be left to them.
Government should not be forcing the hand of business.
This legislation is opposed by the American Hospital Association, the
American Medical Association, the U.S. Chamber of Commerce and the
National Association for Manufacturing because this legislation does
not address the real issue.
This legislation penalizes hospitals and businesses and is not a way
to stop illegal immigration. This is a law enforcement problem not a
medical problem. We need to step up our efforts to reduce illegal
immigration by increasing our resources in the law enforcement
community.
The SPEAKER pro tempore (Mr. Boozman). The question is on the motion
offered by the gentleman from California (Mr. Rohrabacher) that the
House suspend the rules and pass the bill, H.R. 3722.
The question was taken.
The SPEAKER pro tempore. In the opinion of the Chair, two-thirds of
[[Page H3044]]
those present have voted in the affirmative.
Ms. SOLIS. Mr. Speaker, on that I demand the yeas and nays.
The yeas and nays were ordered.
The SPEAKER pro tempore. Pursuant to clause 8 of rule XX and the
Chair's prior announcement, further proceedings on this motion will be
postponed.
____________________