I
107TH CONGRESS
1ST SESSION
H. R. 2256
To amend the Public Health Service Act to establish a 5-year pilot program
under which health care providers are reimbursed by the Secretary of
Health and Human Services for the costs associated with providing
emergency medical care to aliens who are not lawfully present in the
United States and are not detained by any law enforcement authority,
and for other purposes.
IN THE HOUSE OF REPRESENTATIVES
JUNE 20, 2001
Mr. KOLBE introduced the following bill; which was referred to the Committee
on Energy and Commerce, and in addition to the Committee on the Judi-
ciary, for a period to be subsequently determined by the Speaker, in each
case for consideration of such provisions as fall within the jurisdiction of
the committee concerned
A BILL
To amend the Public Health Service Act to establish a 5-
year pilot program under which health care providers
are reimbursed by the Secretary of Health and Human
Services for the costs associated with providing emer-
gency medical care to aliens who are not lawfully present
in the United States and are not detained by any law
enforcement authority, and for other purposes.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ‘‘Border Hospital Sur-
vival and Illegal Immigrant Care Act’’.
SEC. 2. FINDINGS.
The Congress finds as follows:
(1) Immigration is a Federal responsibility.
(2) The Immigration and Naturalization Serv-
ice does not take into custody all aliens who are un-
lawfully present in the United States.
(3) Section 1867 of the Social Security Act (42
U.S.C. 1395dd) and State laws require that, if any
individual (whether or not lawfully present in the
United States) comes to a hospital and the hospital
determines that the individual has an emergency
medical condition, the hospital must provide either,
within the staff and facilities available at the hos-
pital, for such further medical examination and such
treatment as may be required to stabilize the med-
ical condition, or, if appropriate, for transfer of the
individual to another medical facility.
(4) The Southwest border region is ill-equipped
to absorb the expense of providing health care to un-
documented aliens because it ranks last in the coun-
try in terms of per capita income.
(5) The Southwest border region has been des-
ignated as a health professional shortage area under
section 332 of the Public Health Service Act (42
U.S.C. 254e).
(6) The unreimbursed costs associated with car-
ing for undocumented aliens are severely threatening
the financial stability of health care providers in Ari-
zona.
SEC. 3. REIMBURSEMENT TO HEALTH CARE PROVIDERS
FOR EMERGENCY MEDICAL CARE RENDERED
TO CERTAIN ALIENS.
Section 322 of the Public Health Service Act (42
U.S.C. 249) is amended by adding at the end the fol-
lowing:
‘‘(d)(1) The Secretary shall establish and implement
a 5-year pilot program under which funds made available
under paragraph (6) are used to reimburse providers for
items and services described in section 411(b)(1) of the
Personal Responsibility and Work Opportunity Reconcili-
ation Act of 1996 (8 U.S.C. 1621(b)(1)) provided in Ari-
zona to aliens described in paragraph (3), and to reim-
burse suppliers of emergency ambulance services furnished
to such aliens for which the transportation originates in
Arizona (where the use of other methods of transportation
is contraindicated by the alien’s condition), if payment
may not be made to reimburse the provider or supplier
under any Federal program or law other than this sub-
section (such as title XIX of the Social Security Act), any
State or local program or law, any group or individual
health plan, or any insurance policy.
‘‘(2) As part of the pilot program, in a case in which
an alien described in paragraph (3) arrived at a hospital
in Arizona and the hospital provided for such medical ex-
amination and treatment of the alien as the hospital deter-
mined was required to stabilize an emergency medical con-
dition (within the meaning of section 1867(e)(1) of the
Social Security Act (42 U.S.C. 1395dd(e)(1))), the Sec-
retary shall use funds made available under paragraph (6)
to reimburse the hospital for any transportation costs paid
by the hospital to return the alien to the United States
border, if—
‘‘(A) the hospital requested the Attorney Gen-
eral to take the alien into custody after such sta-
bilization;
‘‘(B) such request was denied within 24 hours
after its receipt, or the Attorney General gave no re-
sponse to it within such period; and
‘‘(C) the hospital determined that discharging
the alien without providing for such transportation
might pose a threat to the health or safety of the
alien (or, with respect to a pregnant alien, the health
or safety of the alien or her unborn child).
‘‘(3) An alien is described in this paragraph if the
alien—
‘‘(A) is not lawfully present in the United
States and not detained by any Federal, State, or
local law enforcement authority; or
‘‘(B) is paroled into the United States under
section 212(d)(5) of the Immigration and Nation-
ality Act (8 U.S.C. 1182(d)(5)) for less than one
year in order to receive treatment for an emergency
medical condition.
‘‘(4) During the period in which the pilot program
is operating, the Secretary shall submit annual reports to
the Congress on its operation. Each report shall contain
at least the following information:
‘‘(A) The number of aliens to whom assistance
was rendered for which payment was made under
this subsection during the previous year.
‘‘(B) The nationality of such aliens.
‘‘(C) The average cost per alien of such assist-
ance.
‘‘(D) The total annual amount paid to each
provider or supplier of assistance.
‘‘(E) The feasibility and estimated cost of ex-
panding the pilot program to items and services pro-
vided anywhere in the Southwest border region of
the United States.
‘‘(5) Nothing in this subsection shall be construed to
authorize any reduction in the funds payable to any person
under any Federal program or law other than this sub-
section (such as title XIX of the Social Security Act), any
State or local program or law, any group or individual
health plan, or any insurance policy.
‘‘(6) To the extent provided in appropriations Acts,
from amounts made available to the Immigration and Nat-
uralization Service for enforcement and border affairs for
each of the 5 fiscal years following the fiscal year in which
the Border Hospital Survival and Illegal Immigrant Care
Act is enacted, the Attorney General may transfer to the
Health Resources and Services Administration of the De-
partment of Health and Human Services such amounts
as may be necessary to carry out this subsection, not to
exceed $50,000,000 for each such year.’’.
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