New York Times Highlights Dispute Between Texas Hospitals, Attorney General Over Care for Illegal Immigrants

Texas Attorney General John Cornyn's (R) written opinion that federal law prohibits public hospitals from using tax dollars to offer non-emergency services to undocumented immigrants is "eliciting conflicting responses from public hospital districts" statewide, the New York Times reports. Although the opinion is "non-binding and does not carry the rule of law," it "opens hospitals to legal challenges." While hospitals in Dallas and San Antonio will continue to offer services, in Montgomery County (a suburb of Houston) hospital administrators last week voted to "cut services to more than 400 illegal immigrants," and in Nueces County (which includes Corpus Christi) hospital officials are "cutting services to 311 people." The Times reports that the "biggest conflict" is in Houston where Harris County District Attorney Chuck Rosenthal, responding to "requests from residents and at least one county commissioner," is investigating whether hospitals "violated state laws against the misapplication of public money." Rosenthal said it is a "complex issue" and that he felt he was "obligat[ed]" to see if a law was violated. However, Rusty Hardin, an attorney for Harris County Hospital District, said that the investigation is not an "appropriate response." Hardin said, "It's one thing to have this policy argument. It's another to have somebody come in here from left field and say it's a criminal matter."

Difference in Interpretation
Cornyn's opinion was in response to a January request by hospital officials in Harris County who wanted a "legal assessment of changes in welfare laws, passed by Congress in 1996 before setting a policy on care for illegal immigrants." Cornyn said that federal law "required" that undocumented immigrants receive "emergency room care, immunizations and treatment of communicable diseases," but that the law "prohib[its]" all other types of care unless "states ena[ct] laws to provide it." However, the National Association of Public Hospitals and Health Systems "contends" that Texas did enact such a law in 1999. Also, Hardin says that the federal law states that undocumented immigrants are not "entitled" to other types of care -- not that hospital districts "are not permitted" to provide services. The Times reports that the subject is likely to become a major topic for the Texas Legislature when it convenes in 2003 (Yardley, New York Times, 8/12). For further information on state health policy in Texas, visit State Health Facts Online.