People who cannot afford to go to a private physician's office and who do not have health insurance turn to emergency departments, which serve as a vital part of America's health care safety net. Emergency departments are mandated by law to medically evaluate and provide stabilizing treatment of emergency conditions to everyone who comes through the doors.

Language and economic barriers also often limit illegal immigrants' access to health care. In addition, fear of detection by immigration authorities may account for why as few as a one-fourth of them use public health services. Furthermore, many illegal immigrants become migrant farm workers and their transient living arrangements jeopardize residency requirements for some community health clinics.

Generally no. Even if they were eligible for coverage, most could not afford it, nor could they afford to visit a private physician's office, and they are not eligible for Medicaid. Census data reveal a strong link between immigration and the rapid growth of the medically uninsured. At least one-third of all immigrants lack health care. Among Mexican immigrants this number is even higher, with an equal or greater than 50-percent uninsured rate.

Even some legal immigrants in this country who work as migrant farm workers find that Medicaid is frequently unavailable to them because of residency requirements, and it only covers emergency and obstetrical care when it can be obtained. Preventive care is completely unavailable.

Billions of dollars are estimated to be spent each year, although data are scarce on both the costs and use of health care. Transient living conditions, undercounting of migrant workers and desire to avoid contact with government agencies limit the nation's ability to accurately determine the costs of their medical care.

In some hospitals, as much as two-thirds of total operating costs are for uncompensated care for illegal aliens. As a result, hundreds of emergency departments have closed. In Los Angeles, for example, 10 hospitals have closed in the past five years because of uncompensated care.

Congress in 2005 authorized $1 billion in funding over four years to help physicians and hospitals recover costs of providing emergency care to illegal immigrants. This was a critical first step in recognizing the growing funding crisis in the nation's emergency departments, which affects everyone's access to emergency care.

Emergency physicians are patient advocates with moral, ethical, and legal obligations to care for patients. Emergency physicians don't require patients to have health insurance and don't check their legal documentation before treating them.

In some states, legislation has been proposed to require emergency physicians to report to immigration authorities any undocumented immigrants who seek care. Such requirements differ from other mandatory reporting requirements in that their purpose is not patient protection but policing of U.S. borders. If such reporting were successfully mandated, many acutely sick or injured persons would avoid seeking medical care for fear of detection and deportation. In addition to causing these illegal immigrants unconscionable pain and suffering, it would cause the spread of many contagious diseases that should be treated and stopped.