Trump's shutdown fight over 'immigrant health care' could push hospitals to the brink

Based on the ongoing rhetoric surrounding the federal government shutdown, perhaps it is time to ask the question.

The question is, do we – the United States of America – really want undocumented immigrants receiving medical treatment in our hospital emergency rooms?

If a non-citizen falls off a roof of a house while doing carpentry work, do we want to transport him to the hospital or just leave him in the yard to fend for himself – broken legs and all? If a non-citizen child is sick, should she be provided emergency care?

Under current law signed in 1986 by President Ronald Reagan, the answer is yes to providing emergency care.

Hospitals, if they receive federal funds, are obligated to provide “stabilizing care” in their emergency rooms to all who show up, including undocumented immigrants.

The issue is worth discussing now because Republicans, led by U.S. House Speaker Mike Johnson, are complaining that Democrats are shutting down the federal government demanding federal funds to provide health care to undocumented immigrants.

U.S. Rep. Mike Ezell of Mississippi’s 4th District wrote on social media, “Senate Democrats failed America. They shut down the government because we refused to give free healthcare to people who broke our laws to get here.”

U.S. Sen. Cindy Hyde-Smith of Mississippi reposted the Senate Republicans proclaiming, “Senate Democrats are putting illegal aliens ahead of our troops and American families in need.”

In reality, the issue that led Democrats to oppose the continuing resolution to fund the federal government and thus leading to the shutdown has little to do with illegal immigrants. Instead, Democrats are trying to extend federal subsidies that make insurance policies purchased through the federal Affordable Care Act exchanges dramatically cheaper than they would otherwise be.

If the subsidies are not extended before the end of the year, the cost of insurance will go up on average $480 annually for the estimated 285,000 Mississippians on the exchange, according to KFF, a national nonprofit health care research organization. The premiums will go up much more for some Mississippians.

Some Republicans counter that they will discuss the subsidies once the government is funded. But the main talking point for many Republican lawmakers is that the Democrats want free health care for non-citizens.

Under federal law, undocumented immigrants are not eligible to receive coverage through federal health care plans, such as Medicare, Medicaid and the Children’s Health Insurance Program. Republicans had a chance to take up that issue when they passed what they called the “One Big Beautiful Bill Act” earlier this year at the urging of President Donald Trump. They did not.

Granted some states – yes, California _ do use their own state funds to provide health care for undocumented immigrants. Congressional Republicans considered trying to penalize those states for using their own money to provide health insurance for undocumented people, but opted not to in the big bill that President Trump signed into law in July.

While undocumented immigrants do not get health care through any federal program, hospitals do receive compensation for treating in their emergency rooms people, including non-citizens, without insurance and with limited ability to pay.

Trump’s big bill reduced the amount of compensation hospital emergency rooms receive for treating undocumented immigrants. That reduction hurts the hospitals, not the undocumented immigrants who the hospitals still must treat if they show up in emergency rooms.

Hospitals are partially reimbursed for the uncompensated care they give to help ensure their financial sustainability and help hold down the cost of health care for Americans. Without the federal assistance, hospitals could be forced to close or reduce services or increase costs for those with the ability to pay through private insurance or through other means.

So, if congressional Republicans and President Trump are complaining about Democrats trying to provide health care for undocumented immigrants, perhaps the options should be discussed.

One option was the big bill’s reduction of money going to the hospitals to treat undocumented people. This option penalizes hospitals and potentially those with insurance or the ability to pay. The alternative would be to provide adequate federal funds for the care that federal law mandates the hospitals provide.

Another option is to stop requiring hospital emergency rooms to treat undocumented immigrants. That could save a lot of money.

How does the United States of America, a country where a majority of people claim some type of religious views, want to address that issue?

Perhaps it is time to cut through the rhetoric and ask that question.