"Data on health care costs for illegal immigrants are sketchy because hospitals and community health centers don't ask about patients' legal status. In California, a 2004 study by the Federation for American Immigration Reform put the state's annual cost at $1.4 billion.
But while they account for less than 2% of national medical spending, their growing presence is a problem in places such as eastern North Carolina, one of the nation's poorest areas.
Statewide, illegal immigrants accounted for one in four new residents from 1990 to 2004, according to a University of North Carolina study. The state ranks ninth in the nation for illegal immigrants with more than 300,000, according to the Pew Hispanic Center.
For hospitals, "the burden of the uninsured immigrant is huge," says Jeff Spade, vice president of the North Carolina Hospital Association. "It's exploded the amount of work that they have to do."
Steven Camarota of the conservative Center for Immigration Studies says offering non-emergency Medicaid to illegal immigrants would be more expensive than leaving them uninsured and in need of occasional hospital care. In those cases, hospitals lose money, and taxpayers pick up the tab."Either you enforce the law and don't have so many illegals, or you shut up about the cost," he says."
San Francisco goes further, adding adults at local expense. Some cities, including New York, encourage illegal immigrants to use public services such as health clinics without risking deportation.
At Duplin General Hospital, the challenge is staying afloat. Because so many patients are seniors on Medicare, low-income residents on Medicaid or uninsured people who can't pay their bills, it's difficult to turn a profit. "We're living off reserves," CEO Harvey Case says.
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