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.

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Border Hospital Survival and Illegal 
Immigrant Care Act''.

SEC. 2. FINDINGS.

    The Congress finds as follows:
            (1) Immigration is a Federal responsibility.
            (2) The Immigration and Naturalization Service does not 
        take into custody all aliens who are unlawfully 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 hospital, for 
        such further medical examination and such treatment as may be 
        required to stabilize the medical 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 undocumented aliens 
        because it ranks last in the country in terms of per capita 
        income.
            (5) The Southwest border region has been designated 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 caring for 
        undocumented aliens are severely threatening the financial 
        stability of health care providers in Arizona.

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 following:
    ``(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 
Reconciliation Act of 1996 (8 U.S.C. 1621(b)(1)) provided in Arizona to 
aliens described in paragraph (3), and to reimburse 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 subsection (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 examination and treatment of the 
alien as the hospital determined was required to stabilize an emergency 
medical condition (within the meaning of section 1867(e)(1) of the 
Social Security Act (42 U.S.C. 1395dd(e)(1))), the Secretary 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 General to take 
        the alien into custody after such stabilization;
            ``(B) such request was denied within 24 hours after its 
        receipt, or the Attorney General gave no response 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 Nationality 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 assistance.
            ``(D) The total annual amount paid to each provider or 
        supplier of assistance.
            ``(E) The feasibility and estimated cost of expanding the 
        pilot program to items and services provided 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 subsection (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 Naturalization 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 Department 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.''.

Summary: Border Hospital Survival and Illegal Immigrant Care Act - Amends the Public Health Service Act to direct the Secretary of Health and Human Services to establish a five-year pilot program of health care provider reimbursement for the costs associated with providing emergency medical and ambulance services in Arizona to: (1) illegal aliens who are not detained by any Federal, State, or local law enforcement authority; or (2) aliens paroled into the United States for less than one year to receive emergency medical treatment.