IMMIGRANT advocates and health-care experts say it’s extremely unlikely that a bill like one recently introduced in Arizona requiring hospitals to ask about immigration status would ever be proposed in the city.
"I think it would be politically very difficult to do it in a city such as New York with such a large immigrant population, and that has such a progressive history of not letting them be alienated from hospitals," said Theo Oshiro, director of health advocacy for the nonprofit group Make the Road New York. "It would be a public-health disaster."
The Arizona bill, which would have required hospitals to report undocumented immigrants to authorities, was defeated in the state Senate, along with four other anti-immigration bills.
Rather than facing efforts to turn them in, undocumented immigrants in New York City are triply protected when they seek treatment at hospitals – by a federal law, a state law and a mayoral executive order.
In 2003, Mayor Bloomberg issued an executive order forbidding city employees, including public hospital workers, from asking for confidential information such as immigration status.
Manny’s Law, a state statute enacted in 2007, requires New York hospitals with 24-hour emergency departments to offer financial aid to uninsured patients – which characterizes most undocumented immigrants – and bars them from turning away people who can’t afford to pay for care.
The law came in response to the 2005 death of 24-year-old Manny Lanza, an uninsured Long Island man, after St. Luke’s-Roosevelt Hospital refused to treat him for a brain disorder and told him to apply for Medicaid.
In addition, the federal Emergency Medical Treatment and Active Labor Act (EMTALA), passed in 1986, forbids any hospital that participates in the Medicare program – meaning virtually every hospital in the U.S. – to refuse emergency-room care to anyone, regardless of their ability to pay.
Undocumented immigrants aren’t eligible for standard Medicaid coverage, but they can get Emergency Medicaid for an urgent condition and related follow-up care.
Still, many immigrants don’t know about these rules and are afraid to seek treatment.
"Unfortunately, many immigrants in New York believe that a trip to the hospital can also mean a trip back to their country of origin," Oshiro said. "In many cases, immigrants avoid hospitals and get sicker because they fear stepping foot in a hospital."
Brian Conway, a spokesman for the Greater New York Hospital Association, said hospitals aren’t interested in being law enforcers, which runs counter to their mission of providing care.
"The mission of public hospitals is to treat everyone and to turn away no one," said Evelyn Hernandez, a spokeswoman for the Health and Hospitals Corp.
Though the city executive order doesn’t apply to private hospitals, they are still bound by Manny’s Law and EMTALA.
"We never ask for immigration status, and we don’t turn anyone away from the emergency room," said Ann Silverman, director of public relations for the private Lenox Hill Hospital.
Oshiro said he hasn’t heard of anyone with a medical emergency rebuffed by a public or a private hospital. "We have seen community members turned away from hospitals in non-ER situations," he said. "This happens more often at private hospitals."
"There has been a tradition in New York where people’s immigration status is not asked about, but people still hear stories," Oshiro added. "If it happens, it’s usually because of a rogue employee who wants to give immigrants a hard time. We haven’t seen any hospitals that as a policy turn away immigrants, but if it happens to one person, it has a chilling effect."
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