Substantial numbers of illegal immigrants use the nation's health care system, particularly in Los Angeles County, home to the country's largest concentration of undocumented people. But no one knows exactly how many, for a good reason: Generally, no one asks.

Many pay out of pocket or are covered by private insurance. Others lack insurance--so, as with other low-income people, the government is left to pick up the tab.

The Medi-Cal program, funded jointly by state and federal funds, covers some treatment--emergency services (including child delivery) and prenatal care--for those who meet its eligibility guidelines. Costs for other illegal immigrant care often falls to individual counties.

GOV. PETE WILSON: The governor's office estimates that more than 300,000 illegal immigrants statewide used Medi-Cal services during 1994-95, a tenfold increase in seven years. About 95,000 undocumented women gave birth under Medi-Cal in 1992, the governor says. The total estimated cost to California taxpayers: almost $400 million. Even many immigrant advocates agree that Washington should pick up more of such health care costs, saying immigration is a federal responsibility.

LOS ANGELES COUNTY: A 1992 study estimated that one-quarter of the county patient caseload consisted of illegal immigrants, costing taxpayers about $159 million in unreimbursed costs. A survey conducted in 1990-91 indicated that 65% of births at county hospitals were to illegal immigrant mothers.

OTHER EXPERTS: Critics say both the state and county numbers are inflated, based on questionable assumptions that lump together lawful and illegal immigrants. Many health professionals maintain that denying health services to the undocumented is a foolhardy and hazardous approach that ultimately increases costs for emergency care and treatment of infectious ailments.

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