Undocumented immigrants to strain safety-net hospitals (C-HIT.org)

Undocumented immigrants are expected to make up a larger share of Connecticut’s uninsured population next year, putting new financial pressures on safety-net hospitals that provide emergency care to everyone, state and national health experts predict.

The Affordable Care Act (ACA) provides coverage options for legal immigrants, but those in the U.S. illegally cannot apply for Medicaid, even if they are poor, or buy coverage at Access Health CT (the new insurance marketplace), even if they have cash. That means illegal residents without coverage will continue turning to local emergency departments for care at a time when Connecticut hospitals face the loss of millions of dollars in federal and state subsidies to help defray the cost of uncompensated care.

“This is a global problem that isn’t going away. This population (of undocumented residents) is not being addressed by any state or federal initiatives. It’s operating under the radar screen,” said William Gedge, senior vice president for payor relations for Yale New Haven Health System, the state’s largest provider of uncompensated care. The system includes Yale-New Haven Hospital, Bridgeport Hospital and Greenwich Hospital.

The dilemma sheds light on the uncertain future of the so-called safety-net hospitals in Connecticut and the nation as health care reform unfolds. Often located in urban areas, safety-net hospitals treat a disproportionate number of low-income, uninsured, and otherwise vulnerable populations, including undocumented residents. Federal law requires hospitals to provide emergency care, regardless of a patient’s ability to pay or immigration status.

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