updated 8/31/2004 7:41:54 PM ET 2004-08-31T23:41:54

Proponents of stricter border controls complain that legal immigrants who cannot pay their hospital bills are a huge drain on the medical system, and they say it is time to force the patients’ immigration sponsors to pay up.

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A lawsuit, sponsored by the Friends of Immigration Law Enforcement in Washington, asserts that Los Angeles County is violating federal law by not collecting from immigration sponsors. The group estimates that as a result, taxpayers are being to forced to foot as much as $20 million a year in unpaid bills.

The county says the money at stake is far less than that. And like many local governments across the country, the county concluded years ago that the costs of tracking down sponsors would exceed the amount of money recouped.

Immigrant rights advocates also warn that the lawsuit, if successful, would discourage legal immigrants from seeking medical care for fear of burdening their sponsors.

A Los Angeles judge is expected to decide on Sept. 14 whether the case can proceed. Both sides of the immigration debate are watching closely.

“I’m hoping that the court will order the county to do the public-minded, “responsible thing and begin asking people who they are and whether they’re legally entitled to the services,” said Craig Nelsen, director of the group sponsoring the lawsuit.

Finding sponsors
Under a 1996 federal law, many would-be immigrants must find sponsors — almost always family members — who sign an “affidavit of support” promising to pay for any public services received by the immigrant if the immigrant cannot pay. The law was intended to prevent immigrants from moving to the United States solely to go on welfare.

About 75 percent of legal immigrants admitted to this country since 1996 were sponsored, said Jeff Passel, a researcher at the Washington-based Urban Institute. Immigrants can also become legal permanent residents if a U.S. employer petitions for them or if they are refugees.

Both sides of the debate say this lawsuit could set a precedent by using the issue of sponsorship in the health care system to tighten immigration policy.

California counties are more vulnerable than other places to such litigation because state law lets residents sue the government if they feel their tax dollars are misappropriated.

A hidden agenda?
Immigration advocates have attacked the lawsuit as a thinly veiled attempt to crack down on immigration under cover of fiscal responsibility. They say what the plaintiffs really want is to get at illegal immigrants; by making legal immigrants name their sponsors, hospitals inevitably would identify some illegal immigrants.

“The plaintiffs are affiliated with an anti-immigrant organization, so they have an agenda,” said Gabrielle Lessard, health policy attorney for the National Immigration Law Center. “Collecting a few dollars from a few lawfully present immigrants is not going to solve the problems for the county.”

The lawsuit could discourage legal immigrants from seeking preventive health care, said Barbara Frankel, an attorney at the Health Consumer Center of Los Angeles. That would cost the county much more in expensive emergency room services, which cannot be refused to anyone and cannot be billed to sponsors under federal law, she said.

Sharon Reichman, a county attorney in charge of defending the current policy, said the amount of money in question is negligible. Immigrants with billable sponsors represent a small portion of the approximately 28,000 inpatients the county treats each year who are uninsured, said John Wallace, spokesman for the county health department.

What’s more, opponents of the lawsuit point out, sponsors may themselves be too poor to pay even part of the bill.

“We’re probably talking about a lot of effort to recoup very little money,” Reichman said. “And with the health care crisis in Los Angeles County, we don’t have the money to chase that right now.”

The county, which treats 600,000 uninsured patients annually, faces a shortfall of $265.1 million by fiscal year 2006-07 and has been forced to close hospitals and consolidate services. The plaintiffs counter that immigrants contributed to the crisis.

© 2012 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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