Will Solving Immigration Reform Derail the Healthcare Revenue Cycle?

Momentum is building in Congress toward a resolution to America’s illegal immigration problem, but will the solutions to those ills create more problems for an already over-burdened healthcare system?

The California Healthline website assembled a sample of opinions on the impacts of immigration reform on the healthcare system, and while it is illuminating reading, one group that is not represented in the article is healthcare providers.

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It is a myth to suggest that illegal immigrants rush to the emergency room for every and any ailment. Studies have demonstrated that those who are illegally in the United States visit emergency rooms far less frequently than legal residents.

Even still, illegal immigration strains the resources of healthcare providers. undocumented immigrants, when in need of medical care,  often seek it from free or low-cost clinics and from hospital emergency rooms. In the latter case, because many undocumented workers do not have the resources to pay for medical care, nor do they qualify for Medicaid or other low-income aid programs, the healthcare services provided eventually are written off as bad debt. But what will happen should immigration reform win passage and undocumented immigrants receive provisional status?

While the immigration reform proposals do not specifically address access to healthcare, the current law prevents legal immigrants from receiving Medicaid assistance or access to subsidized health insurance for five years. Unless there are specific healthcare reforms for this population, the burden of serving them will fall to providers. Currently in the United States there are an estimated 11-15 million undocumented immigrants.

Legal immigrants who come into this country at a rate of 1 million per year  use emergency room services far more frequently than those in the country illegally (though still less than full citizens). It would be reasonable to assume that once illegal immigrants receive provisional status to remain in the United States, they will seek medical care more often.

If Congress intends to provide undocumented immigrants with a path to legal residency, it must also address the impact on the healthcare system, which already is undergoing dramatic change as a result of the Patient Protection and Affordable Care Act.