KHN Morning Briefing

Summaries of health policy coverage from major news organizations

California Officials Question Cost-Effectiveness Of Immigrant Screening Rules

Los Angeles County officials are questioning the "cost-effectiveness of rules aimed at screening those trying to get public health services," The Los Angeles Times reports. The county began implementing tougher federal standards in 2008, receiving "nearly $28 million in state and federal funds to cover the cost of the program and posted 81 people in 27 social service department offices to check documents." But "they have not found one illegal immigrant who posed as a legal resident to get benefits, according to Deborah Walker, the county's Medi-Cal program director. Fewer than 1% of applicants between July 2008 and February 2009 lacked the proper documents, and many of those applicants eventually produced them, she said."

The county found "a relative handful of cheaters" among new Medi-Cal applicants. "In the El Monte office, for instance, supervisor Alma Young said that five to eight undocumented immigrants were discovered among about 7,000 applicants in her unit over the last year -- about 0.1% of the total." The Los Angeles experience comes as federal officials weigh how to prevent illegal immigrants from accessing benefits if health care reform legislation is passed. "Members of Congress have proposed a range of new verification requirements, including presentation of photo identification and checks with the U.S. Department of Homeland Security's immigration database. Sen. Charles Schumer (D-New York), has proposed requiring biometric ID cards -- using fingerprints, for instance -- to prove citizenship." But immigrant advocates say extra verification rules, like those in Los Angeles County, "have proven costly, ineffective and ultimately harmful to U.S. citizens who may be deprived of healthcare because they lack the required documents."

The tougher rules implemented in Los Angeles "were passed as part of a 2005 federal Deficit Reduction Act and require applicants for Medi-Cal to present documents proving citizenship or legal status." But "two federal studies have raised questions about the cost-effectiveness of the rules. One congressional oversight committee found that the regulations cost the federal government and six of nine states surveyed this year $16.6 million in new administrative costs but resulted in snagging only eight illegal immigrants" (Watanabe, 10/6).

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