Class 7 Unit 3 Assignment

November 6, 2017

The Honorable Bill Nelson

2555 Ponce de Leon Boulevard Suite 610,

Coral Gables, FL 33134

RE: Medical care for illegal immigrants.

Dear Senator Nelson,

My name is Jeannie Beaver along with Gabrielle Kulig, Stephanie Anderson and Liu Chuan. We are residents of your district and are writing to you today to address as issue that we feel is affecting healthcare in our state, illegal immigration. As registered nurses we are on the frontline of healthcare and are concerned about the financial impact illegal immigration is having on an already heavily strained system. We have researched the current policy structure regarding healthcare for illegal immigrants and feel changes need to be made. It is “estimated that taxpayers spend $4.3 billion a year providing health care to uninsured illegal immigrants.” (Edwards 2010) We have formulated suggestions for change to the present structure that would relieve a large portion of the financial burden our state is presently obligated with. We have also devised a framework that incorporates a larger role for nursing.

At present illegal immigrants can seek out care in clinics that offer basic health services and charge nominal fees regardless of immigration status. Medical and dental schools are also an avenue that they can utilize for free or low cost health care. Those here illegally who are attending college may also be eligible for healthcare that is offered through institutions of higher learning. In some cases, they may qualify for emergency Medicaid. The most uneconomical option is the use of hospital emergency rooms. Hospitals who are federally funded cannot refuse any patient because of immigration status or inability to pay for services rendered. Patients must be treated and stable prior to discharge. If a patient is an illegal immigrant and is admitted into the hospital, they are treated at the expense of the facility with little hope of financial reimbursement. The Affordable Care Act does not cover immigrants who have entered the country illegally. “Federal law already requires an individual to be a citizen or legal resident in order to enroll in a health plan through an exchange and receive premium assistance credits, which must be verified by the Department of Health and Human Services.” (Marcos 2017)

The role of the nurse in implementing this policy change is simple. Upon admission to the ED, the nurse will ask, "Do you have health insurance? If yes, present with ID. If not, ask about citizenship. If they are not a citizen ask if they are willing to start the process. If they agree to start the process, educate them on the Medicaid plan that they are eligible through. They can receive emergency medical services through Medicaid as undocumented immigrants. (Gusmano, 2012). The nurse would also be in charge of provided resources to be used by the patient in order to start the immigration process. In Florida, there is an immigration office in Orlando called USCIS. The nurse would be responsible for calling the local immigration office to facilitate the transition into citizenship to ensure that the patient follows through with the process. If the patient is unwilling to become a citizen, the nurse will have to contact the USCIS to begin this process. The nurse can also call the tip-line at 1-866-347-2423 to report an illegal alien. (USA.gov, 2017). The nurse can utilize other health care professions such as case managers, social workers, the legal department, and nurse managers to aid in this discussion and provided education and assistance.  Below is a flow chart depicting this conversation.

References

Edwards, J., 2010. The Medicaid Costs of Legalizing Illegal Aliens. Retrieved from https://cis.org/Medicaid-Costs-Legalizing-Illegal-Aliens

Gusmano, M. 2012. Undocumented immigrants and health care access in the United States.  Retrieved from http://undocumentedpatients.org/issuebrief/health-policy-and-access-to-care/ 

Marcos, C., 2017. House votes to bar undocumented immigrants from healthcare tax credits. Retrieved from http://thehill.com/blogs/floor-action/house/337684-house-votes-to-bar-undocumented-immigrants-from-healthcare-tax

USA.gov. 2017. Deportation. Retrieved from https://www.usa.gov/deportation 

(Tell your representative how you want her or him to vote on this issue and ask for a response. Be sure to include your name and address on both your letter and envelope.)

Sincerely,

Jeannie R. Beaver