County Acts to Cut Alien Medical Tab : Illegals Will Have to Apply for Medi-Cal to Receive Treatment

Although they would not be eligible for it, illegal immigrants will be required in many cases to apply for Medi-Cal coverage if they want to receive county health services, the Los Angeles County Board of Supervisors decided Tuesday.

County Health Director Robert Gates recommended the tighter rule, arguing that without the change, some clinics might have to be shut down. Gates said it costs the county an estimated $130 million a year to treat undocumented aliens and that the new procedure could help recover about $2.5 million of that total.

Although an undocumented alien may not qualify for Medi-Cal insurance, the county may receive Medi-Cal reimbursements during the period before an applicant’s eligibility is determined, Gates said.

Supervisor Ed Edelman, expressing concerns shared by poverty lawyers, said the new requirements might scare off some people worried about deportation. But Edelman supported the measure anyway, explaining later that he was convinced that deportations would not occur.

The procedure is similar to one adopted by the board five years ago. That, however, was stopped by an injunction that ended last year in an out-of-court settlement. As one of its terms, the county agreed that attorneys representing indigents would receive at least 60 days notice of any attempt to eventually require undocumented aliens to sign up for Medi-Cal. Gates said he will comply with the 60-day agreement.

Under current procedures, anyone seeking medical care in either a county hospital or a clinic is asked whether he can pay for the services. If unable to pay, he is asked to apply for Medi-Cal so the county will receive partial reimbursement.

Gates said that invariably, undocumented aliens have refused to apply for Medi-Cal out of apparent fear they will be turned over to immigration authorities. Indeed, welfare officials check with immigration officials to determine an applicant’s status.

When an undocumented alien has refused to apply for Medi-Cal, the county has merely decided in the past to grant the health services anyway. Under the procedure adopted Tuesday, an indigent applicant must either apply or be turned down for services.

Gates said that most undocumented aliens who have opted against applying for Medi-Cal have paid a cash fee, now about $20, for the services they receive. That system will continue, but the amount will soon increase to $25, Gates said.

Last year, the cash fee collections amounted to about $11 million.