Jul 19, 2023 - News

Florida's immigration law has chilling effect on undocumented immigrants seeking health care

Illustration of a three dimensional health plus surrounded on all sides by barbed wire.

Illustration: Aïda Amer/Axios

An undocumented Tampa woman remembers the look on her father's face when food grazed his rotten molar, how he cradled his jaw afterward. He couldn't afford a dentist. So, eventually, he did what he could: remove it with pliers and over-the-counter oral anesthetic.

  • "It was bad then," said the undocumented woman, who asked that Axios not use her name for fear of deportation."It's worse now."

What's happening: Florida's immigration reform law — which tightens restrictions on undocumented immigrants and imposes harsher penalties for those who aid them — took effect this month.

  • It requires Medicaid-accepting hospitals to include a question on their admission and registration forms asking patients whether they're "lawfully present in the U.S." The legislation clarifies the question is voluntary, and responses will not impact their care.

Why it matters: Health care experts said simply asking the question could worsen health outcomes for the estimated 81,000 undocumented people living in Tampa Bay, a group that already faces obstacles receiving care.

State of play: Johns Hopkins All Children's Hospital and BayCare — which operate over a dozen hospitals in Tampa Bay — told Axios they've added the question to their intake forms. But the hospitals said it shouldn't deter undocumented patients from seeking care.

Reality check: Federal law requires hospitals that accept Medicaid to provide emergency medical care for anyone, regardless of their legal status. Gov. Ron DeSantis argued — in speeches and in court — that treating undocumented patients poses a financial burden to the state.

  • Emergency services provided to undocumented people are assigned a code in the Medicaid Management Information System — where claims information is logged — and that data can already be singled out, court records show.
  • The Florida Agency for Health Care Administration (AHCA) found that the state's emergency rooms provided about $111 million in care to undocumented immigrants between January 2020 and April 2022.

Between the lines: Hospitals must now submit a report of how many undocumented patients they treated to AHCA each quarter. The law doesn't apply to other health care providers, urgent care centers or abortion clinics.

Zoom in: Yared Vazquez, a physician who owns a clinic in Lutz and isn't required to submit a report to the state, told Axios he's seen fewer undocumented patients seeking treatment at his office since the law took effect.

  • "I haven't seen a single undocumented patient this month," he said. "Immigrants are still around. They're still doing their jobs. But they see getting health care as a danger to their American Dream."
  • Diego Alonso Dulanto Falcon Gutierrez Tanaka, an undocumented Tampa Bay resident, said he'd visited a hospital twice in five years. He told Axios in April he doesn't think he will seek health care again in Florida.

The bottom line: "The law states individual data will not be shared with the state, but that may not be enough to quell Floridians' fears," Alexis Tsoukalas, a policy analyst at Florida Policy Institute, told Axios.

  • Roxey Nelson, executive vice president of Florida's largest health care worker's union, said confusion about the law can lead to increased health care costs for taxpayers if "people put off preventative care out of fear and later show up to emergency rooms with critical health care needs."
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