By Howard Fischer
Capitol Media Services
PHOENIX -- State lawmakers voted Monday to require hospitals to inquire whether patients are here illegally despite concerns that it would deter some people from seeking care.
But the sponsor of SB 1268 says she doesn't care.
"They should stay in their own country if they want to have care,'' Sen. Wendy Rogers said during a committee hearing on her legislation.
Strictly speaking, the proposal by the Flagstaff Republican which now goes to Gov. Katie Hobbs after Monday's 32-25 vote by the House does not link health care with legal status.
Instead, it would require any hospital that accepts Medicaid payments must ask patients whether they are citizens, are here lawfully, or there are not lawfully present. And the form tells would-be patients that their answers won't affect their ability to get care, and that their responses will not be reported to immigration authorities.
Rogers said it's simply designed to create a report for the governor and legislators of the cost of the care provided.
This generally speaking isn't for care paid for by AHCCCS, the state's Medicaid program. Those not here legally are not entitled to coverage except in narrow circumstances like emergency situations.
Instead, it would track uncompensated care provided by hospitals.
But Sen. Catherine Miranda said she was not reassured that this was simply a data-gathering operation.
"How can we be assured that this information won't be used for nefarious reasons?'' asked the Laveen Democrat.
Rogers took offense to the question.
"The word 'nefarious' is being applied to the consequences instead of the initial act of illegality,'' she said. "I would say that's kind of a specious premise.''
The legislation is not occurring in a vacuum.
Rogers said her measure is modeled after a similar law that Florida enacted in 2023.
Rep. Sarah Liguori said that law, whatever its intent, seems to be having an impact, with some residents lacking legal status moving out. But the flip side, the Phoenix Democrat said, is the state altered its child labor laws, something she said was done to make up for the number of people who disappeared from the state workforce.
Closer to home, the vote comes on the heels of a Mexican migrant living in Tucson being detained by immigration officers last week after visiting St. Joseph's Hospital where he had gone with a cousin who was requesting emergency care there.
In that case, an attorney for the man said his companion was questioned before being discharged about whether he had a Social Security number or legal status. That, the lawyer said, led to the family to suspect that someone at the hospital had contacted Immigration and Customs Enforcement.
During debate in the House, Rep. Selina Bliss, a supporter of the measure, insisted there would be no change in medical treatment.
The Prescott Republican who is a nurse, said those who provide direct health care don't know about -- and don't even ask -- questions unrelated to the medical issue. She said all patients get care, regardless of information they provide to intake clerks, like insurance or lack thereof.
"We don't have to worry about violating our oath because we are separated and protected from registration information,'' Bliss said.
She said, though, her experience convinces her there's a need for the information that SB 1268 would provide.
Bliss told colleagues there were incidents more than a decade ago where in her community, far from the border, women in labor crossed into the United States to have their babies.
"We weren't capturing that data,'' she said, saying there should be some accounting.
Opponents, however, said it's clear that there will be fallout simply in requiring the question to be asked.
"Unfortunately,using bills like this, that you're trying to sell as something that's not going to have any impact, is absolutely outrageous,'' said Sen. Alma Hernandez, D-Tucson. "We have people who are scared to go seek medical care.''
Nor is she convinced the legislation leaves medical providers out of the loop.
"If someone is seeking medical care, it is not your job as a medical professional to say, 'Show me your papers and then I will treat you,'' Hernandez said. "And I'm disappointed that, once again, we're putting the communities that are already struggling and already facing so many uncertainties in a situation where they have to decide, 'Do I want to go seek the medical care that I should be receiving? Or should I stay home and die, because if I do that I'll be deported?' ''
Rep. Nick Kupper said the plain language of the bill should reassure people that a visit to a hospital won't result in deportation. Aside from responding to the question apparently being optional, the Surprise Republican said the law spells out the data can't be reported to immigration officials.
But Rep. Mariana Sandoval said she's not buying that.
"History shows that such assurances can be easily undermined,'' said the Goodyear Democrat.
And she said people don't need to look hard -- or far -- for an example. She pointed to the decision last month by the IRS, whose records are normally confidential, to share tax information about some immigrants without legal status.
Rep. Nancy Gutierrez said this hurts families, including those with members who are here legally.
"I teach in a school that has many kids with mixed family status,'' the Tucson Democrat said.
"And they told me in the days of a prior bill, a lot like this one, their families would not go to the doctor,'' she said. "And they had family members get sicker and not get treated because they were afraid they would get deported.''
Rep. Lorena Austin said lawmakers need to understand the impact of their decision.
"Call me crazy,'' said the Mesa Democrat. "But I believe healthcare is a human right.''
And Marilyn Rodriguez, testifying on behalf of Planned Parenthood Advocates, told lawmakers the issue goes beyond the health of the person affected.
"As COVID 19 and the current flu epidemic make clear, your health and safety impacts my health and safety,'' she said. "If somebody has COVID, I want them to go to the hospital.''
Rogers, however, told colleagues this is simply about gathering data. And the fallout from all of that, she said, is irrelevant.
"It's not my job to determine if someone is dissuaded from care -- especially if someone is not a citizen,'' Rogers said. And she turned aside a question about how she feels about people possibly not getting care because of her legislation.
"This is not germane to the topic,'' Rogers said.
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