Serial Health Care Misinformer McCaughey Just Won't Stop Misinforming

Betsy McCaughey has a long history of misinforming on health care. In 2009, she received Media Matters' 2009 “Health Care Misinformer of the Year” award for relentlessly attacking health care reform, spreading falsehoods and distortions through opinion pieces and television appearances at nearly every stage of the debate. She has rarely appeared on television, written an opinion piece, or given a speech that doesn't contain at least one falsehood associated with health care. In her appearance Monday on Neil Cavuto's Fox News show, McCaughey lengthened that streak.

Aside from her bogus claim that health care reform will have the effect of killing jobs, McCaughey asserted that community health centers “largely” cater to unauthorized immigrants. In her rush to tar the health care reform law as a “spread-the-wealth and buy-the-folks program,” she stated of the Obama administration: “They're spending some $11 billion on community organizations that serve illegal immigrants, largely. So this is a spread-the-wealth and buy-the-folks program.”

But unless McCaughey has some insider information to which even community health clinics aren't privy, her claim stretches the boundary of fact.

As McCaughey noted, the Affordable Care Act provides $11 billion to support community health centers, including $1.5 billion to “support major construction and renovation projects at community health centers nationwide” and $9.5 billion to:

  • Create new community health center sites in medically underserved areas; and
  • Expand preventive and primary health care services, including oral health, behavioral health, pharmacy, and/or enabling services, at existing community health center sites.

According to the most recent data by the National Association of Community Health Centers, "[c]urrently, 1,200 health centers deliver care through over 8,000 service delivery sites in every state and territory." From NACHC:

Community Health Centers serve the primary health care needs of more than 20 million patients in over 8,000 locations across the United States. Health centers play a crucial role during tough economic times, providing affordable health services for millions of uninsured and newly jobless Americans. Health centers provide a unique and comprehensive approach to health care that saves money, improves patient health, and creates good local jobs in the communities that they serve.

Community Health Centers save money every time an uninsured patient opts for an exam and treatment at the first sign of a health issue instead of waiting until a costly Emergency Room visit is the only option. Health centers also save money for Americans looking for work whose families could otherwise face poor health without care, or piles of medical debt.

The center reports that of the 20 million people clinics serve, "[n]early all patients are low income, with 72% of health center patients having family incomes at or below poverty." And most are ethnic minorities. According to the center, of patients served in 2011, a third were white, about 34 percent were Hispanic or Latino, 26 percent were black, and the rest were split between Asian, Native American, and mixed ethnicity:

But community health centers, like hospitals, don't ask patients about their immigration status, nor do they collect data related to citizenship. Reported in August:

“Health centers do not, as a matter of routine practice, ask about or collect data on citizenship or other matters not related to the treatment needs of the patients seeking health services at the center,” [Health Resources and Services Administration spokeswoman Judy] Andrews said.

Further, the grant recipients are required to serve “all residents” who walk through their doors.

“The Program's authorizing statute does not affirmatively address immigration status,” said Andrews. “Rather, it simply states that health centers are required to provide primary health care to all residents of the health center's service area without regard for ability to pay.”

Some patients served at these clinics are indeed undocumented, but no data exists to break down exact figures. In 2008, USA Today noted: “Illegal immigrants can get emergency care through Medicaid, the federal-state program for the poor and people with disabilities. But they can't get non-emergency care unless they pay. They are ineligible for most other public benefits.” The article continued: “Data on health care costs for illegal immigrants are sketchy because hospitals and community health centers don't ask about patients' legal status.”

So where is McCaughey getting her information? It could be that she may have been referring to the community health centers that cater specifically to migrant and seasonal farm workers. But even if she had been, the numbers still don't add up in her favor.

According to the Center for American Progress, community clinics attend to about 941,000 migrant and seasonal workers and their families -- or 4 percent of the clinics' total patients. While the Pew Hispanic Center puts the number of unauthorized migrant workers at 25 percent, the Department of Labor estimates that the number is around 50 percent. However, note that "[h]ired farmworkers make up less than 1 percent of all U.S. wage and salary workers."

Another thing to keep in mind:

[A] new study published online in the journal Health Affairs suggests that, contrary to popular perception, immigrants actually cost the health care system less per person than do natives of the United States. Nor do illegal immigrants make up a disproportionate share of the costs to public programs like Medicaid, researchers found.

The study examined health care spending (which includes public, private and out-of-pocket spending) between 1999 and 2006 for three groups: adult naturalized citizens; immigrant noncitizens, including undocumented immigrants; and native citizens.

Over all, spending increased across all groups during the study period. But spending for noncitizens was on average about 50 percent less than spending for United States natives, the study found. In 2006, for example, per capita spending for native-born United States citizens was $3,723, while spending for noncitizens was $1,904. (The Medical Expenditure Panel Survey, on which the analysis was based, doesn't break out the proportion of noncitizens who were in the country illegally.)

A similar pattern emerged for spending on public programs like Medicaid and the Children's Health Insurance Program (CHIP): Public spending for immigrants was slightly lower per capita than spending for United States-born natives in each of the eight years studied.

Unlike McCaughey's apparent disdain for these clinics, former President Bush recognized that community health centers are a vital part of our health care system. As Texas governor, he reportedly “came to admire the missionary zeal and cost-efficiency” of the centers that he “pledged support for the program while campaigning for president in 2000 on a platform of 'compassionate conservatism.' ”

According to the New York Times, during a visit to a clinic in Omaha, Bush stated: “They're an integral part of a health care system because they provide care for the low-income, for the newly arrived, and they take the pressure off of our hospital emergency rooms.”

Is McCaughey really advocating that health care centers refuse to treat undocumented immigrants who are unable to pay for their care? Besides it being illegal, if not downright immoral, what happened in Arizona earlier this year shows how popular that extreme position is.