TALLAHASSEE – An appeals court decision could affect
how hospitals handle emergency care of immigrants, a law professor
told The Florida Record.
In July, News Service of Florida
reported that the 1st District Court of Appeal in June
upheld an administrative law judge's decision in favor of the Florida
Agency for Health Care Administration's recently changed position on
duration of emergency care for undocumented immigrants through
Medicaid. After hospitals in the state won a case against the AHCA in
2012 concerning the standard for length of care, the agency decided
that Medicaid should pay for services until any emergency was
The article states that more than 24
hospitals challenged the agency under the argument that a new care
standard was made without going through the required process. Any
patient who comes to a hospital in need of emergency care is required
to receive it, the article also says. It's all part of the bigger
dispute of how much Medicaid should cover care for undocumented
Art Rios, an adjunct professor at Stetson University
College of Law, told The Florida Record that the decision could put
hospitals on edge.
“I don't see it as being positive
because hospitals, at the end of the day, have their own concerns and
they have to pay their own bills,” he said.
Rios said immigrant care is a national
issue and that most of these matters are left to the states on how
to use their Medicaid funds.
“This is really a national debate
because what has happened is, there are certain areas where the
federal government has said, 'OK, we understand that we have certain
powers and certain rights where we can legislate on this.' But to be
honest with you, they kind of punted,” he said.
States can be liberal with Medicaid
funds, Rios said, but there are also federal prerogatives that come
into play. He cited, as an example, a green-card recipient, who can't
start receiving federal benefits until he or she has been here for
five years. That can be overridden by a state mandate but, he said,
states have pretty much split down the middle on that issue.
Other aspects can add confusion to the
system. There's the issue of what to do when parents who are in the
United States illegally but their children were born in the U.S.,
giving those children benefits the parents wouldn't have. Also,
asylum-seeking immigrants, particularly those from Cuba, can get a
lot of benefits, Rios said. Meanwhile, those here illegally can be
pretty limited as to what they can get, depending on what the state
says – even though they pay into the system.
“One of biggest fallacies about
immigrants is that they don't pay into the system. They actually do,"
he said. “The vast majority of immigrants that are here illegally
are paying tax and they're paying into Medicare and Medicaid. The
reality is that if they're never able to legalize their status, it's
kind of a windfall for the government because they're getting all
these deductions that they'll never have to pay out.”
Rios wonders how other states will
react based on the appeals court decision.
“Morally and ethically, how at the
end of the day that will change the level of care,” he said.