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Monday, March 24th 2003

The Honorable Jon Kyl
United States Senate
730 Hart Senate Office Building
Washington, DC 20510

Dear Sen. Kyl:

On behalf of the American Hospital Association (AHA), I am writing to express our strong support for your bill, S.412 the “Local Emergency Health Reimbursement Act of 2003.” The bill provides direct reimbursement to hospitals, localities, states and other health care providers for the cost of federally-required, but uncompensated emergency health treatment of undocumented aliens.

The AHA represents nearly 5,000 hospitals, health systems, networks and other health care providers.

America's hospitals are open 24 hours a day, seven days a week, 365 days a year and must provide emergency treatment to all who walk through our doors, regardless of their citizenship status or ability to pay.  In today's uncertain environment, hospitals are faced with growing financial constraints that have made it difficult to maintain their mission.  At the same time, demand for health care services is soaring; over the past 10 years, hospitals have seen a marked increase in emergency department visits.  The most recent statistic shows that America's hospitals provided nearly $21 billion in uncompensated health care services in 2001.

The Immigration and Naturalization Service (now the Bureau of Citizenship and Immigration Services) has estimated that 275,000 undocumented immigrants enter into the U.S. each year.  Some of these individuals incur injuries while crossing the border or come to a hospital emergency room with life-threatening conditions.  Federal law mandates that hospitals and emergency medical personnel treat anyone who needs emergency care, including undocumented immigrants.  But the federal government only pays for the care of illegal immigrants who are in the custody of Immigration Services or other authorized federal agents.  Those individuals make up only a small portion of the illegal immigrants who receive emergency care at our nation's hospitals.  Most illegal immigrants are not in legal custody, and hospitals must bear the costs of caring for these people.  The costs of providing services to illegal immigrants impose an increasing financial burden on our hospitals.

The problem is not confined only to hospitals serving our border states.  Many hospitals across the nation have reported significant costs associated with providing health care services to undocumented immigrants.  That is why your legislation is so important.

It provides $1.45 billion in direct aid each year, for five years, to hospitals, localities, states and other health care providers to help cover the cost of providing emergency care to illegal aliens.

For these reasons, the AHA is pleased to support S.412, the “Local Emergency Health Reimbursement Act of 2003.”  We applaud your effort to address this important issue and pledge to work with you and your colleagues to achieve swift passage of the bill.


Rick Pollack
Executive Vice President

This letter was also sent to The Honorable Jim Kolbe, U. S. House of Representatives in support of H.R.819

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