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DeSantis to Florida hospitals: how much are you spending on ‘illegal aliens’?

“Hardworking Floridians pay the price” for the care, one of DeSantis’ top health officials wrote.
As an organization, UndocUnited strive to provide resources to their undocumented population, whether that be through funds, events or support.
As an organization, UndocUnited strive to provide resources to their undocumented population, whether that be through funds, events or support. [ Courtesy of Sharon Benitez ]
Published May 6|Updated May 7

TALLAHASSEE — One of Gov. Ron DeSantis’ top health officials on Thursday wrote a letter to the head of the Florida Hospital Association to ask how much money state hospitals spent last year on caring for people living in the country illegally.

The letter, written by Agency for Health Care Administration Secretary Simone Marstiller, is part of a broader effort by the DeSantis administration to account for the ways in which the state is paying to support immigrants who are in the country illegally. In September, DeSantis signed an executive order directing state agencies to, among other things, issue a monthly report on the number of “illegal aliens” who have been criminally charged and account for taxpayer dollars spent caring for immigrants who entered the country illegally.

“As illegal aliens continue to cross the southern border unchecked in record numbers, hardworking Floridians pay the price, footing the bill for their medical care,” Marstiller wrote in her Thursday letter to Mary Mayhew, the CEO of the Florida Hospital Association.

The letter, which was first reported by Florida Politics, gave the hospital association a deadline of May 23 to submit the data, which it said will eventually be posted on the agency’s website.

Hospitals received a formal data request from the agency this week. The facilities have been asked to report “all costs and expenditures, including those that are written off as uncollected debt,” related to the inpatient treatment of people living in the country illegally.

In a statement, Mayhew said her organization had received the letter and would communicate with its member organizations. Mayhew served as DeSantis’ Agency for Health Care Administration secretary before Marstiller.

State Rep. Nick Duran, D-Miami, who served on the board of trustees of Jackson Health System until last year, said hospitals would likely be able to comply with the request. But he said the data would not be helpful without knowing what the health care figures were in previous years.

“This is really just red-meat politics. Our hospitals have been serving undocumented individuals for years,” Duran wrote in a text message. “This isn’t some new trend. And it feels like (DeSantis) is going to try to weaponize the data to show that undocumented (immigrants) are pouring into our health care system.”

A spokesperson for BayCare, which runs more than a dozen hospitals in the Tampa Bay area, said in a statement that the chain does not “directly record” the immigration status of patients. But the spokesperson said it is looking to see what information it will be able to provide to the state.

Marstiller’s letter noted the Florida Hospital Association had done its own study in 2009 on this subject, which showed care for undocumented immigrants had cost at least $40 million in unpaid medical bills.

Florida hospitals provided nearly $1.8 billion in total charity care in 2019. That figure represents the amount of care provided to poorer patients for which the hospitals were not compensated. Such care is often provided in instances in which the patient is not insured. Florida had one of the three highest uninsured rates in the country, according to 2020 figures from the Florida Hospital Association. That’s in part because of the Legislature’s refusal to expand Medicaid under the Affordable Care Act.

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The push from DeSantis comes amid an uptick of apprehensions of migrants at the U.S.-Mexico border that conservatives blame on the immigration policies of the Biden administration.

It also comes as immigration policy positions once thought to be extreme have become real considerations for major Republican Party figures. In Texas, Gov. Greg Abbott said this week he would like to see Texas challenge the precedent set by the U.S. Supreme Court in 1982 that found that states could not deny a free public education to immigrant children who were in the country illegally.

That case struck down a Texas law that would have charged those children a tuition fee to attend public school.

Editor’s note: This story was updated Saturday with comment from BayCare.

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