A battle between New York state and federal health officials has come to a head with the intervention of Governor Eliot Spitzer, who called the new federal ruling that limits coverage of emergency health care for illegal immigrants “morally and clinically and legally wrong”, said the New York Times today.
The row is about the new federal directive whereby the cost of chemotherapy for illegal immigrants with cancer will no longer qualify under Medicaid’s emergency programme.
State officials however said they would cover the costs, regardless of federal government, marking a reversal in their stance of two weeks ago when they said the state could not pay the costs. The cost is estimated to be in the region of 5 to 10 million dollars a year.
New York has more than half a million illegal immigrants. Under state law no person can be refused emergency medical care. If a person in need of emergency care is treated in a New York hospital, the hospital is entitled to be reimbursed from a state fund, but the state funds for covering such costs will not be enough, said health officials.
Under current federal rules for Medicaid (the health care programme for the poor), the cost of emergency treatment for illegal immigrants is split between state and federal funds. However, in November 2001, the debate got heated because a new federal ruling came out stating that dialysis and chemotherapy were classed as treatments for chronic, non emergency conditions, and would not be covered.
However, since that time, New York has continued to file claims for about 11 million dollars, which the federal government is refusing to match because of the disagreement about what constitutes an emergency.
Spitzer said at a news conference that the policy was “bad” and “wrong”, that they are “picking on the most vulnerable populations”, immigrants who need chemotherapy and children without health insurance.
The federal Centers for Medicare and Medicaid Services (CMS) carry out audits of emergency payments on a state by state basis. Audits carried out since the 2001 ruling, including one in New York State that took three and a half years to complete, have thrown up cases where the CMS says claims should not have been made for matching Medicaid costs because they do not constitute an emergency and thus reimbursements for chemotherapy for illegal immigrants will no longer be made.
New York State health department have registered their protest in a letter to federal health officials.
The debate is opening up political divides between those who think illegal immigrants should be entitled to have chemotherapy treatment subsidized by Medicaid and those who say that because so many Americans are already finding it difficult to pay for health care, the government should stop paying for healthcare for illegal immigrants.
The health commissioner of New York state, Richard F Daines, said this ruling takes the decision of what constitutes an emergency out of the hands of doctors. In an interview with MSNBC’s Chris Jansing he explained that:
“An emergency is something that’s acute and potentially life-threatening, and the position before has always been to let the patient’s physician define that it’s an emergency.”
Steven Camarota, director of research at the Center for Immigration Studies in Washington, told the New York Times the crux of the problem is there are large numbers of unskilled immigrants in the US with low paid jobs with no health insurance.
Click here for MSNBC report “Cancer ruling heats up immigration debate”.
Written by: Catharine Paddock