State leaders and policy experts are at odds about the cost of undocumented immigrants using Florida healthcare facilities.
The disagreement stems from by the Florida Agency for Health Care Administration showing the number of undocumented people who went to Florida hospitals and responded to a state-mandated survey.
The legislation (SB 1718, also known as the Immigration Law) was signed into law in May by Gov. Ron DeSantis. It requires Medicaid-accepting hospitals to ask admitted and emergency patients about their immigration status. have suggested it does more harm than good creating a culture of fear in a health care environment.
The State鈥檚 report lists $566 million in expenses incurred by undocumented immigrants.
Republican Senator Blaise Ingoglia of Hernando County is the sponsor of the Immigration Law. His office did not respond for comment. However, co-sponsor of the bill Republican Rep. Randy Fine, of Brevard County, said the report successfully showed that Florida is unfairly supporting undocumented people.
鈥淭he fact of the matter is, we're spending a half a billion dollars to provide health care and hospitals, to people who should not be in the United States. That's half a billion dollars stolen from real Floridians,鈥� Fine said.
But policy analysts argue that鈥檚 not what the report details.
鈥淟ooking more closely reveals the opposite is true,鈥� said Alexis Tsoukalas, a policy analyst with the Florida Policy Institute. 鈥淣ot only are undocumented people not as significant of a strain on the cost of health care as the state is purporting, but the share that is responding to the question and saying that they're undocumented and the share that is seeking care is much lower than I think the state originally intended to prove.鈥�
According to AHCA, the report 鈥渋ncludes county-level data information relating to the costs of uncompensated care for patients who are not lawfully present in the United States.鈥�
In its cost analysis, AHCA states that the 鈥渃ost of care provided to illegal immigrants is greater than $566 million.鈥� However a closer look at the report shows the $566 million is not the cost of care, it is an 鈥渆xpense incurred,鈥� Tsoukalas said.
鈥淭he difference there is you have expenses, but then you get a certain amount of that reimbursed based on whether people have their own insurance, or they're paying for the services or Medicaid or Medicare coverage,鈥� Tsoukalas said.
When asked what 鈥渆xpenses incurred鈥� meant, Fine said it referred to 鈥渦ncompensated care,鈥� or health care services that have not been reimbursed.
鈥淕enerally. it gets paid back in one of two ways, either higher prices on Americans or reimbursement from the state,鈥� Fine said.
The AHCA report states that there were nearly 5 million emergency department visits. Less than 1% of those patients identified as an undocumented immigrant (0.82%). It should be noted that patients had the option of whether or not to respond to the citizenship question.
As far as the expenses incurred, the report doesn鈥檛 detail how hospital reimbursements occurred, whether it was through Medicaid or Medicare covering the expenses, or if the patient used insurance. The latter is possible. An undocumented immigrant could have coverage through a family member鈥檚 job-provided insurance.
鈥淧eople can self-pay, and also there is federal Medicaid,鈥� Tsoukalas said. 鈥淭he funding that comes down specifically for people to access emergency care, regardless of citizenship status. The dashboard doesn't break any of that detail out.鈥�
There鈥檚 also the issue of the report鈥檚 methodology.
鈥淚t's not precise,鈥� Tsoukalas said.
The report doesn鈥檛 break down which services were provided nor the actual costs of those services. Instead, AHCA took the overall 鈥渃osts鈥� (in this case expenses) reported from each Florida county and multiplied it by the percent of listed undocumented immigrants to determine the $566 million figure.
鈥淭his methodology is not very sound, or very clear,鈥� Tsoukalas said. 鈥淚t鈥檚 still likely to overestimate the cost because county cost can vary in the actual procedures that people get in the treatments. They can vary widely.鈥�
Despite any issues observed in the report鈥檚 first year, Fine said it accomplished its goal.
鈥淚 think the purpose of this whole exercise is to show that Biden's open border policy isn't free. It has real consequences for everyday Floridians in terms of funding that is not available for all of the other things that we want to do,鈥� he said.
As for what鈥檚 next, the law remains in effect, and hospitals will continue to ask patients鈥� citizenship status. As for what that information will be used for in the future, Fine said he鈥檚 not sure.
鈥淚 don't know what we can do, but what we can do is we can get angry. And we can say this is what happens when Joe Biden has a border where if you're just willing to swim across the Rio Grande, you're welcomed into America,鈥� he said. 鈥淲hen you have an open border, as we do in this country, this is what happens. And this is just a fraction of the cost of illegal immigration.鈥�
, Gov. Ron DeSantis recommended nearly $558,000 for AHCA鈥檚 budget for the continued collection of hospital immigration data.
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