Health Care Give and Take

At the same time President Bush is considering some form of legalization for Mexican workers illegally in the United States, his administration is pressing for budget cuts to public hospitals that treat the uninsured--many of whom are immigrants. Would someone in the administration please connect the dots?

To compensate for the losses of hospitals that treat poor people who lack any form of insurance, the federal government now lets some hospitals bill more than the set rate for patients covered by Medicaid--up to 150% of the standard. Some states required hospitals to hand over the extra cash and then used it for projects such as road or bridge building.

That’s quite a boondoggle, but one the Clinton administration already addressed. Under rules that went into effect in March, only public hospitals are now reimbursed using the so-called upper payment limit. The exception recognizes that these hospitals need extra reimbursement if they are to survive as safety nets, providing costly trauma care and serving the uninsured. Now the Bush administration wants to eliminate the additional funding even for public hospitals but offers no alternative to cover uncompensated care.

California, which has an overwhelmingly large uninsured population and which has never been accused of scamming the system, would lose $250 million a year. Half of that would come from already financially strapped Los Angeles County.

The planned cuts would hurt everyone, but their effect on immigrants is glaring given Bush’s recent overtures to that group. It is not too late for the Bush administration to recognize the incongruity of offering with one hand while taking away with the other.