Immigration and L.A.'s Health Care System

By Craig Nelsen
Published in The Social Contract
Volume 14, Number 1 (Fall 2003)
Issue theme: "Mass immigration: the public health dimension"

It would be difficult to overestimate the negative impact of illegal immigration on California. For example, in Los Angeles County alone, illegal immigrants cost the health care system $340 million annually, according to a report from the county's Department of Health Services. The source of much of the cost is aliens who use the county's emergency rooms for routine health care -- essentially turning emergency rooms into free clinics and driving many hospitals into the red.

California officials note that the problem is epidemic in the state. In addition, since employers usually pay illegal aliens "off the books," neither the employer nor the workers pay payroll taxes.

Federal statutes, including Section 1621 of the Immigration and Naturalization Act, the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, and the Illegal Immigration Reform and Immigration Responsibility Act of 1996, severely restrict the kinds of public benefits, cash assistance, and non-emergency health care available to aliens. Yet a link from the Los Angeles County Department of Health Services' website takes one to a county Public Services department web page titled "Important Notice for Immigrants," which instructs "immigrants" (in ten languages) to access many of the public services forbidden to them by federal law. (According to county officials we spoke to, the county, in dispensing most services, does not distinguish between immigrants, illegal aliens, and foreign nationals.)

The department lists 20 welfare and social programs available to "immigrants." The programs include food stamps, housing assistance, energy assistance, transportation assistance, educational assistance, job training assis-tance, Medi-Cal, WIC, childcare, prenatal care, and county health programs. No wonder 40 percent of Medi-Cal patients are now non-English speaking foreigners demanding costly translator services at public expense, and no wonder an entire industry has sprung up in Asia advising sick Asians how to access U.S. health care.

One might wonder how the county and city of Los Angeles can openly urge immigrants to access prohibited public services and cash benefits. In a remarkable bit of Orwellian doublespeak, the "welfare-for-immigrants" web page assures immigrants they can access cash benefits to which they are not lawfully entitled because, well, the cash benefits aren't really cash benefits.

Just read carefully the following clarification from the department's website: "Some of the above programs may provide cash benefits," a disclaimer under the list of available welfare programs reads.

"The purpose of such benefits is not for income maintenance but rather to avoid the need for on-going cash assistance for income maintenance; therefore, they are not subject to public charge consideration."

Go ahead and read that again, if you need to. The gist of it is that the local government in Los Angeles County is providing cash assistance to aliens so that aliens won't need cash assistance.

It is time to buck up as a nation, put the adults back in charge, and end this kind of nonsense. In a world in which nearly five billion people live in countries poorer than Mexico, neither California nor the rest of the United States can afford to be the emergency room to the world.

A very good way to start getting serious about illegal immigration would be to decrease voter innumeracy -- and the best way to do that would be for the media and for those running in the California recall election to start connecting the dots between California's budget disaster and massive foreign immigration.

About the author

Craig Nelsen prepared this item for his newsletter at, Issue 163 Aug 19, 2003.

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