LOS ANGELES (AP) Proponents of stricter immigration controls
are trying to use the courts to make public health officials
collect medical fees from the sponsors of legal immigrants who
can't pay their bills.
Years ago Los Angeles County reached the same conclusion as many
other local governments nationwide: The cost of tracking down the
people who sponsor immigrants, usually their family members, would
exceed the money the county could recoup.
A lawsuit filed in state court here could change that by forcing
public agencies to go after the money and in the process prompt
local governments to tackle immigration law, which is usually
federal domain.
The lawsuit, sponsored by the Friends of Immigration Law
Enforcement in Washington, D.C., asserts that the county is
violating federal law by not collecting from immigrant sponsors.
The group estimates that policy means taxpayers foot as much as $20
million a year in unpaid bills, said Craig Nelsen, director of the
group sponsoring the lawsuit.
The county says the money at stake is dramatically less than
that and insists tracking down sponsors would cost more than what
the county could recoup. Immigrant rights advocates who support the
county's position say the lawsuit, if successful, would keep legal
immigrants from seeking medical care for fear of burdening their
sponsors.
A Los Angeles judge is expected to decide Thursday whether the
case can proceed. Both sides of the immigration debate are watching
closely.
Under a 1996 federal law, sponsors of legal immigrants must sign
an ``affidavit of support'' promising to pay for public services
before the immigrant can enter the country. The law was intended to
prevent immigrants from moving to the United States solely to go on
the dole.
The case follows several similar federal proposals that target
undocumented immigrants. Yet those on both sides of the debate say
this lawsuit could set a precedent by using the issue of
sponsorship in the health care system to tighten immigration
policy.
Los Angeles County isn't alone in its failure to track and bill
immigrant sponsors but California counties are more vulnerable to
litigation because state law lets residents sue the government if
they feel their tax dollars are misappropriated.
Immigration advocates have attacked the lawsuit as a thinly
veiled attempt to manipulate immigration law under cover of fiscal
responsibility in health care. They say what the plaintiffs really
want is to get at undocumented immigrants; by making legal
immigrants name their sponsors, hospitals inevitably would identify
some illegal immigrants.
``The plaintiffs are affiliated with an anti-immigrant
organization, so they have an agenda,'' said Gabrielle Lessard,
health policy attorney for the National Immigration Law Center.
``Collecting a few dollars from a few lawfully present immigrants
is not going to solve the problems for the county.''
The lawsuit could discourage legal immigrants from seeking
preventive health care because they don't want to burden their
sponsors, said Barbara Frankel, supervising attorney at the Health
Consumer Center of Los Angeles, which has filed a brief against the
lawsuit. That would cost the county much more in expensive
emergency room services, which it can't refuse anyone and which
can't be billed to sponsors under federal law, she said.
Sharon Reichman, the lead county attorney defending the current
policy, said the amount of money in question is negligible not
the millions the plaintiffs estimate. Immigrants with billable
sponsors represent a small portion of the approximately 28,000
inpatients the county treats each year who aren't covered by
private insurance or a state or federal program, said John Wallace,
spokesman for the county health department.
What's more, opponents of the lawsuit point out, sponsors may
themselves be too poor to pay even part of the bill. A family
member must only earn 125 percent above the federal poverty line to
sponsor someone, Frankel said, a requirement they must meet without
including government welfare programs.
``We're probably talking about a lot of effort to recoup very
little money,'' Reichman said. ``And with the health care crisis in
Los Angeles County we don't have the money to chase that right
now.''
The county, which treats 600,000 uninsured patients annually,
faces a shortfall of $265.1 million by fiscal year 2006-2007 and
has been forced to close hospitals and consolidate services.
The plaintiffs counter that immigrants and their sponsors
who don't pay are part of that budget crisis.
The lawsuit echoes previous attempts to manage immigration
through the health care system, although those instances targeted
undocumented immigrants.
A recent bill sponsored by Rep. Dana Rohrabacher, R-Calif.,
would have require hospitals to report a patient's immigration
status before they could be reimbursed for treatment. Patients
found to be in the United States illegally could be deported. The
House overwhelmingly defeated Rohrabacher's proposal in May.
Regulations being written by the U.S. Department of Health and
Human Services' Centers for Medicare and Medicaid Studies could
require hospitals to ask emergency room patients their immigration
status if they want reimbursement from a $1 billion package
Congress set aside to defray the cost of treating undocumented
immigrants.
Immigration rights advocates say that while the Los Angeles
County lawsuit is milder than those examples and deals only with
legal immigrants, it is still too invasive.
But officials at Friends of Immigration Law Enforcement,
encouraged by overwhelming feedback from those who heard about the
lawsuit on talk radio, say they plan to file similar lawsuits in
other California counties. Nelsen said the group has received about
1,000 calls and e-mails from Californians willing to be listed as
plaintiffs.
``I'm hoping that the court will order the county to do the
public-minded,'' said Nelsen, ``responsible thing and begin asking
people who they are and whether they're legally entitled to the
services.''
(Copyright 2004 by The Associated Press. All Rights Reserved.)