Florida Targets Undocumented Immigrants, Jeopardizing Public Health

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The emergency departments of public hospitals across the country have long been a place of refuge for undocumented immigrants to get healthcare and connect to other social safety nets. However, a 2023 Florida law requiring hospitals receiving federal Medicaid funds to ask about patients’ immigration status is causing many to fear the consequences of disclosing undocumented status.

Florida Only State to Require Immigration Status Probe

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Florida is the only state with the requirement that Medicaid-funded facilities inquire about immigration status. In the wake of this policy, care providers in Florida have sounded the alarm that many Florida residents may be avoiding necessary healthcare services such as mammograms and prenatal care. Immigration advocates, lawmakers, and healthcare officials have observed a marked decline in medical care use within this community.

Hesitation to Access Medical Care for Fear of Deportation

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Even in urgent cases, according to Florida’s Healthy Start Coalition, there has been hesitation, with one notable instance of a pregnant woman in severe pain almost avoiding an emergency room visit due to deportation fears. Clinic staff had to personally ensure the woman received the medical attention she needed.

Impact Extends Beyond Medicaid-Funded Facilities

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The new legislation to inquire about immigration status has not only affected individuals directly seeking Medicaid-funded hospital care but also extended its impact to clinics and organizations that do not receive federal funding. The concern of being exposed permeates to all healthcare facilities, as those seeking care may not know what networks of hospitals and clinics are bound by the mandate, so they avoid all medical care. 

Mexican Consulate Healthcare Provider Sees Reductions in Those Seeking Care

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The Mexican consulate in Orlando, which runs a program offering free healthcare to migrants, has seen a downturn in the number of women coming in for medical check-ups and prenatal care since the law was enforced in May 2023. Specifically, there has been an 18% reduction in the use of free mammogram services, underscoring the chilling effect of the law on healthcare access for migrants.

DeSantis Immigration and Border Reform Agenda

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The law is part of a broader immigration crackdown initiated by Florida Governor Ron DeSantis and supported by Florida Republicans, aimed at sending a strong message against the perceived lax immigration policies of the Biden administration. The legislation includes provisions that could lead to charges of human trafficking for transporting migrants across state lines and prohibits undocumented immigrants from driving in Florida.

Critics Fear Could Lead to Arrests and Impair Lifesaving Services

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The law’s enactment has sparked an immediate backlash, with several immigration advocacy groups and legal organizations challenging its validity in court. Critics argue that it could lead to unwarranted arrests and deter Florida’s undocumented population from accessing crucial health services.

Florida Law Makes It Less Likely Immigrants Seek Healthcare

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Despite these challenges, Florida remains a state that values family unity and support. The contradiction between this value and the barriers created by the new law has sparked a debate about the state’s commitment to ensuring healthcare access for all its residents.

Aim of Legislation to Deter Illegal Immigration 

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The legislation, championed by Republican State Senator Blaise Ingoglia, a DeSantis ally, aims to deter illegal immigration by removing the incentives that draw people to Florida. According to Ingoglia, the decrease in undocumented immigrants seeking healthcare services is a sign that the law is working as intended.

Florida Legislator Moves to Shield Nonprofit Clinics, Unlikely to Succeed

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Amidst the controversy, Florida Rep. Johanna López introduced legislation to protect nonprofit clinics from the law’s ramifications, ensuring they are not required to inquire about patients’ immigration status. However, the future of this bill remains uncertain in the GOP-dominated legislature.

At Odds with Nation’s Commitment to Access Emergency Services

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The Florida law, alone among states, could potentially be construed as at odds with Americans’ historical commitment to dignified access to emergency healthcare for all individuals. Since 1986, the law of the land has been to ensure public access to emergency services regardless of a patient’s ability to pay. 

COBRA and Emergency Medical Treatment and Active Labor Act of 1986

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For 40 years, the Emergency Medical Treatment and Active Labor Act (EMTALA), part of the COBRA omnibus bill, has required hospitals that accept payments from Medicare to provide emergency healthcare treatment to anyone needing it, including individuals who are not covered by Medicare, without consideration of insurance status, ability to pay, nationality, race, creed, or color.

EMTALA Covers Nearly All Hospitals in the U.S. 

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EMTALA mandates that any patient coming to an emergency department must be stabilized and treated, regardless of their financial situation or insurance coverage. This includes treatment and delivery for active labor. The law applies to all hospitals in the U.S. that participate in the Medicare program, effectively covering nearly all hospitals. 

Florida’s Punishing Medicaid Requirement Likely to Be Challenged in Courts

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Over the years, EMTALA has offered high-quality healthcare to anyone who enters a U.S. hospital for emergency care, but it also has led to financial woes for hospitals as more patients seek care who cannot pay and do not have access to insurance due to their immigration status. Seeking help in the emergency department is known to be the least cost-effective way to receive medical care, but it remains one of the only avenues available to many.

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