Brent Zell Aug. 23, 2016, 3:15pm


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 alleviated.

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 immigrants.

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.

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Florida First District Court of Appeal
2000 Drayton Drive
Tallahassee, FL 32311

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