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Budget-strapped counties across the country are looking for ways to save money. Some are apparently turning their sights on health care for illegal immigrants. From Capital Public Radio in Sacramento, Kelly Weiss reports.
KELLY WEISS: You might not know it, but counties can choose to expand medical services for the poor to illegal immigrants, and this can be more common in states with higher numbers of undocumented residents. But now with the economy tanking, some are pulling back on that policy, like California.
Dr. JOE ISER (Yolo County Health Department): I feel like the Grinch that stole Christmas.
WEISS: That's Dr. Joe Iser. He heads Yolo County's health department. He says the county faces a $24 million shortfall, and the move will save the county more than a million dollars. Iser estimates illegal immigrants make up about half of the people on the county's program for the poor. It's hard to tell though, because in the past providers didn't check legal status, but starting in July they will. Iser says this was a tough cut but it will protect other important programs.
Dr. ISER: Otherwise the rest of my department might have to give up funds to do the public health kinds of things that we do, including the swine flu response, including immunizations.
WEISS: Yolo County is the third Northern California county to do this. It's following the lead of nearby Sacramento and Contra Costa counties. Undocumented immigrants like Claudia Diaz are horrified. Diaz, her husband and their four children are here illegally from Mexico. Her husband works as a groundskeeper for about 1,500 dollars a month. He has a lung condition controlled with medicine, but she says with these cuts they won't be able to afford the prescription. And she's afraid he'll end up in the hospital, like he has in the past.
Ms. CLAUDIA DIAZ: (Through translator) He couldn't breathe. The time he went in, he was kept that night in the hospital. And then the next day he went home, rested for two days. If he doesn't get paid, how are we supposed to pay for our medical bills?
Mr. TAD DEHAVEN (Cato Institute): When it comes down to taking care of the health care needs of a regular citizen versus a undocumented immigrant, then nine out of 10 times it's the undocumented immigrant that gets cut.
WEISS: Tad DeHaven is a budget analyst at the nonprofit libertarian Cato Institute. He says it makes sense that people like Claudia would lose benefits when money's short.
Mr. DEHAVEN: There's not going to be a lot of broad-based sympathy from folks who are paying taxes to fund these services and might be unemployed right now, are facing their own personal problems.
WEISS: Still, many providers in the region say these cuts are a short-sighted policy that could hurt everyone. They worry that if thousands of undocumented immigrants cut back on doctor's visits, they might go untreated for communicable diseases like tuberculosis, measles, gonorrhea or HIV.
Robin Affrime is the CEO of CommuniCare Health Centers in Yolo County.
Ms. ROBIN AFFRIME (CEO, CommuniCare Health Centers): We're worried about any kind of epidemic we just saw with the swine flu. What if people aren't feeling well and they're afraid to come in until they're really, really sick. It can have some really unintended, really negative consequences on the health of the whole community.
WEISS: And, she warns, this policy will shift the cost to already overburdened emergency rooms and community health centers, which under federal rules must treat everyone regardless of legal status. Bottom line is that these cuts are a sign of the economic times.
Mr. ROBERT PESTRONK (National Association of County and City Health Officials): Waves of desperation are rolling across the country at the local level.
WEISS: Robert Pestronk is the executive director of the National Association of County and City Health Officials. He says already Texas counties are considering similar cuts.
Mr. PESTRONK: More elected officials are going to be facing this very challenging situation of figuring out what to do with the limited resources they have, and then to face the consequences, health and otherwise, as a result of the decisions that they have to make.
WEISS: As California debates how to fill it's more than $24 billion budget hole, the outlook gets even more grim for county and state programs. In fact, Governor Schwarzenegger is now proposing major cuts in health benefits for some of the state's poor legal immigrants.
For NPR News, I'm Kelly Weiss in Sacramento.