[Congressional Record (Bound Edition), Volume 149 (2003), Part 13]
[House]
[Pages 17829-17830]
[From the U.S. Government Publishing Office, www.gpo.gov]




 PAY UP ACT WILL HELP HEALTHCARE PROVIDERS RECOUP SOME OF THEIR LOSSES

  Mr. FILNER. Mr. Speaker, I represent a district that borders Mexico. 
In fact, I have the entire California-Mexico border in my district of 
South San Diego. I want today to address a problem that affects all 
border districts, that is, emergency healthcare for undocumented 
immigrants.
  In my district, hospitals, ambulance services and other health care 
providers are suffering huge losses every year due to the uncompensated 
care given to undocumented immigrants.
  When Congress passed the Emergency Medical Treatment and Active Labor 
Act, it required hospitals and other health care providers to give 
emergency care to anyone who comes through the emergency room doors, 
regardless of their ability to pay or their immigration status. I think 
this is a proper policy, and it is the only humane thing to do. We 
cannot leave people who need emergency care just out in the cold. 
However, since it is the Federal Government that instituted this law, 
then the Federal Government should cover the expenses of the medical 
care. What we have now is what is called an unfunded mandate. We 
mandate it, but we do not fund it.
  Here is what happens in a border district such as mine, and 
constituents who are in emergency rooms and paramedics come to me all 
the time with this kind of situation. A border patrolman in the normal 
course of his or her duties will come across a person who is trying to 
enter the country illegally, but who got injured in that process. 
Often, due to the emergency nature of the injury or illness, the Border 
Patrol does not have time to officially take the person into custody, 
and, more, than likely, they do not want to take that person into 
custody because they know there will be money involved that will be 
charged against the Border Patrol account. So we have built in an 
institutional mechanism not to take that undocumented person into 
custody.
  Then they will drive the injured person to the hospital, or call for 
an ambulance, and the hospital and the ambulance service will provide 
the necessary care and the person may be released and sent on his way.
  Now, what is wrong with this picture? One, the hospitals and the 
ambulance services are out every single penny that it costs to give 
that person medical care; and, two, the undocumented person is not 
released into anyone's custody and has successfully entered the country 
illegally, courtesy of the Border Patrol and the emergency room.
  What a great country. Apparently the best way to come in illegally is 
to injure yourself in the process. You will get top quality medical 
care for free, and then you will be released out into the community.
  Now, I know the Border Patrol is stretched to its limits. What is 
more, in emergency situations they do not have time to check someone's 
documentation and officially take them into custody. However, it seems 
like a very big security breach that would put such a huge burden on 
our health care system and then, on top of it, let that person into our 
country without documentation.

[[Page 17830]]

  I intend to introduce a bill to try to take care of this problem. It 
is called the Pay Up Act, ``pay up'' meaning ``pay for all your 
undocumented procedures.''
  This will ensure that the Federal Government reimburses the hospitals 
and other health care providers for the care that they provided for 
people who are brought in by the Border Patrol or other Federal 
agencies, and that they are then released into the custody of that 
Border Patrol person after the care has been given. This will allow 
both for the emergency care to be given in a timely manner and ensure 
that the health care providers are paid, and gives the Border Patrol 
time to do the procedures necessary to take that person into custody.
  Of course, we must authorize and provide the necessary funds to make 
sure that the Border Patrol and other Federal agencies involved are 
reimbursed properly. So I provide in this bill double security; 
security for our hospitals financially, and security for our Nation.
  Mr. Speaker, I urge my colleagues to support this bill and to support 
our health care providers.

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