The cost of illegal immigration
GREELEY – Dr. Daphne Madden faces an agonizing dilemma at least once a month at the Sunrise Community Health Center in Greeley.A young pregnant woman arrives to the clinic without health insurance or a Social Security number. The woman is an illegal immigrant and doesn’t qualify for prenatal Medicaid assistance. When she arrives at the hospital in labor, emergency Medicaid will cover her expenses, but before that, she’s on her own. Most women who arrive in this situation find a way to pay for the prenatal care but some simply can’t afford it.The situation forces family physicians like Madden to choose between giving free medical care or putting a woman and her baby (who will become a U.S. citizen at birth) at risk. “We can’t give prenatal care for free because we have our own costs, which are some five to eight times more than that, particularly if they begin having complications,” said Dr. Madden, who has worked at the Sunrise clinic since 1995.Doctors aren’t the only ones who feel the strain of the estimated 200,000 – 250,000 illegal immigrants living in Colorado. Educators face the challenge of educating children who enter kindergarten unable to speak or understand English. Sheriffs and district attorneys struggle to shoulder the extra load of a growing population that – like any other – has members who commit crimes and crowd jails and court dockets. Some argue that the illegal immigrants lower wages in agriculture, construction and service jobs while others say their presence creates negative stereotyping of all Latinos. Half have insuranceMadden explains to patients that the prenatal care will consist of seven to 10 visits, multiple lab tests, a physical exam and will cost between $200 – $600 depending on where she falls on the clinic’s sliding pay scale.It would cost more at a clinic that didn’t serve the uninsured. At the Sunrise Community Health Center, they offer flexible payments plans, even if it’s $10 a month. Yet, some still can’t pay. Madden has seen women suffer from a number of illnesses due to a lack of prenatal care, including gestational diabetes, which causes complications in labor and force long stays at the hospital for both the mother and baby. “It’s an unfortunate consequence of how life is here as an immigrant; a poor, working-class immigrant,” Madden said.Dr. Masroor Kakakhel – known better as Dr. K at the Monfort Children’s Clinic in Greeley – doesn’t know which of his patients are illegal immigrants. Few doctors do.
It’s difficult to pinpoint the fiscal impact illegal immigrants have on the health care system, because most hospitals, community care centers, and doctor’s offices don’t track their patients’ immigration status. One thing health care professionals like Dr. Madden and Dr. Kakakhel agree on is that illegal immigrants without health insurance – even if they form a small part of a national problem – put a strain on resources. “Our challenges are how do you treat someone who can’t afford the medications?” said Kakakhel.Studies show that within the illegal immigrant population, people are less likely to have health insurance and more likely to have larger families than native U.S. citizens. According to a Pew Hispanic Center study, 59 percent of illegal immigrant adults and 53 percent of illegal immigrant children do not have health insurance. That compares to 25 percent of U.S. citizen children and 14 percent of U.S. citizen adults lacking health insurance. Many illegal immigrants work in low-paying jobs that either don’t offer health insurance or offer it with premiums they can’t afford, said Penny Gonzales-Soto, an immigration attorney with Catholic Charities Northern. High fertility rates play a significant role in the equation as well. Illegal immigrants who have been in the U.S. more than 10 years average 2.65 children per family, compared with 1.96 for native U.S. citizens. Mexican immigrants in the U.S. average 3.3 children per family, according to the Pew Hispanic Center. Of the 6.3 million illegal immigrant families in the U.S., an estimated 31 percent have at least one U.S. citizen child. Current law grants citizenship to any child born in the U.S., regardless of the parents’ status. Bill Horner, North Colorado Medical Center administrator, said illegal immigrants account for a small portion of uninsured patients that strain the hospital’s resources. Hospital administrators don’t track how many illegal immigrants use the emergency room, but said looking at how many adults failed to report Social Security numbers can offer a ballpark guess. Of the 44,000 adults who visited the ER in the 2004 fiscal year, 1,400 adults, or about 3 percent, did not report Social Security numbers. The Sunrise Community Health Center, which serves 25,000 of the 40,000 low-income, uninsured residents of northern Weld County for the medical and dental services the center offers, doesn’t track numbers of who is documented but estimates that between 15-25 percent of its patients are illegal immigrants. That accounts for about 5,000 of the 25,000 patients. Mike Bloom, president at the Sunrise Community Health Center, said even if it didn’t have to serve this population, the center would still have 10,000 eligible patients it couldn’t help. “We would be full and still wouldn’t be meeting the need,” Bloom said.Their estimation that illegal immigrants form a small subset of a larger problem would make sense considering that illegal immigrants account for about 4-5 percent of Colorado’s population and 3 percent of the nation’s population. “It’s not in any way, in my opinion, the cause of the problem,” said Dr. Mark Wallace president of the Health Alliance in Weld County.Judy Griego, director of Weld County Social Services, said the agency’s Fraud Investigation Unit reviews all Social Security and identification cards for validity. “We see a very minimal impact because of our responsibility as a governmental agency to only serve U.S. citizens or legal residents,” Griego said.
The majority of the services the department provides – food stamps, Medicaid, child care – are off limits by federal laws to anyone who isn’t a U.S. citizen or legal permanent resident. The department can provide child support assistance, child protection assistance and emergency Medicaid (like labor assistance to pregnant women or life-threatening illnesses) to illegal immigrants. Griego said her office has small case loads from illegal immigrants in these areas. In 2004, the Fraud Investigation Unit worked two cases and none so far in 2005. Griego stopped short of guaranteeing a 100 percent fool- proof rate but said they’re confident almost no one gets through the system. “It’s not if you’re going to get caught,” Griego said. “It’s when.”‘From square one_The Greeley-Evans School District 6 currently finds itself under the watchful eye of state and federal officials who are threatening to revoke the district’s accredidation because of low test scores. One factor in that complicated equation is the number of children who speak English as a second language. The number of Spanish-speaking students coming to the district continues to rise, said Anne Ramirez, the district’s English language acquisition coordinator. Since 2000, the number of English-language learners has doubled in the school district to about 4,100 students. Of those students, 9 percent were born outside the United States.Educators struggle to teach those students fast enough to score well on standardized tests. “We have to teach these kids from square one,” said Juan Verdugo, principal of East Memorial Elementary School in Greeley. “So, that already pushes us back.”Dr. Wallace, also a former school board president in Greeley, said children of illegal immigrants bring two challenges to the classroom. First, they’re English-language learners. Second, they often come from low-income, migratory families. Verdugo said many of those parents are incapable of supporting their children in their studies. “They can’t take homework home and get help from parents because they don’t have the education in either language,” he said. District 6 in Greeley spends $2.7 million – less than 1 percent of its total budget – on programs to reach illegal immigrants: second-language programs and migrant education programs. Yet, despite the problems, you won’t find school officials blaming illegal immigrants for its current woes. “I do not want to see kindergartners made an enemy of this district,” said Wallace at one of his last school board meetings. “If most have been born in the United States and came into the school system not speaking English, then it is not the kindergartner’s fault.”Verdugo said he believes the school district has a societal responsibility to provide education to children whose parents help fuel the economy.
“Public education has a duty to educate all our kids,” Verdugo said. “If we don’t educate all the kids that come into this nation, this country will go down quickly.” The wrong directionCooke and Weld District Attorney Ken Buck said illegal immigrants cause a significant drain on criminal justice resources in Weld County. Weld County Sheriff John Cooke and Weld District Attorney Ken Buck said illegal immigrants cause a significant drain on criminal justice resources in Weld County. Cooke estimated the county spends about $1.5 million a year on foreign-born inmates, who account for between 15-20 percent of the inmates in the jail system. Not all foreign-born, however, are illegal immigrants.For instance, on Oct. 27, ICE identified 43 of the 85 foreign-born in jail Thursday as illegal immigrants who had committed serious enough crimes to be held in the jail. Weld County sheriff’s deputies send information on all foreign-born criminals to ICE officials, who then flag the most serious cases for possible deportation. The rest – DUI, shoplifting, habitual traffic offenses – move through the system as if they were U.S. citizens. “A guy can go out here and drive drunk and kill somebody and most likely not get deported,” Cooke said. “Most aren’t afraid of the system because they know nothing’s going to happen to them.”Buck said the county spends another $1 million annually on transporting inmates to other county jails.”If you figure 10-15 percent of the occupants are illegal, that would drop us to being barely overcrowded,” Buck said. The Greeley police gang unit estimates that 10 percent of gang members are foreign born. Of those, about 8-10 individuals, or 2 percent, fit the profile to be deported, said Greeley Police Captain Jack Statler. Mark Hurlbert, Fifth Judicial District Attorney for an area that covers Eagle, Summit, Lake and Clear Creek counties, said the impact in his region comes from large numbers of people moving in. “Anytime you get more people into a place, there is a going to be a criminal impact,” said Hurlbert. “A certain amount people of any group are going to commit crimes. It doesn’t matter if it’s undocumented people coming in from another country or a bunch of Americans from California or some other place.”Hurlbert said illegal immigrants in his region commit serious crimes at similar rates as U.S. citizens. They commit more minor crimes, though, like driving without a license or insurance, which he said is a matter of education. “I don’t think these foreign countries are exporting their worst criminals to America,” Hurlbert said. Even though illegal immigrants account for a small percentage of the jail population, Buck has been lobbying for a placement of an ICE office in Greeley that would work with the gang unit to deport known illegal immigrant gang members and other criminals. Buck worries that, without immigration reform, Weld County will become a community of haves and have nots. He believes law-abiding illegal immigrants will grow tired of their lack of rights and representation and tension will erupt.
“I think we are headed in the wrong direction, and things are getting worse,” Buck said.Cooke believes the broken immigration system burdens city, county and state governments with social problems from other countries. “By accepting everybody and anybody into our country, and that’s basically what we’re doing, we’re trying to solve wherever they come from’s social ills,” he said. Vail, Colorado