Audit: Errors rife when immigrants apply for health care

Legislative Auditor Jim Nobles
Legislative Auditor Jim Nobles.
MPR Photo/Lorna Benson

The debate over immigration, both legal and illegal, is making front page news across the United States. Hundreds of thousands of people have rallied to urge Congress to make changes to the system. At the same time, others are calling for greater enforcement on the nation's borders.

The issue of health care eligibility for non-citizens is also an issue at the state Capitol. The legislative auditor released a report detailing the number of non-citizens who receive state-subsidized health insurance. Legislative auditor James Nobles says the review found county workers are making a high number of mistakes when they process applications for health care from non-citizens.

"The error rate is high enough that some people are receiving benefits that they were not eligible for," he said. "We don't think they sought them in any abusive or fraudulent way, but there were certain factors in determining eligibility that were correctly determined."

Nobles says his office examined 137 cases in six counties, all of them involving non-citizens. He says there were mistakes in 70 percent of the cases. He says 18 percent of those mistakes affected eligibility for benefits, and cost state taxpayers $200,000.

Nobles was careful to say that lawmakers shouldn't assume the six counties are representative of the entire state. He says most of the mistakes were caused by workload and the complexity of the programs.

"Any of these program eligibility determinations are very complicated. They involve many factors, many rules, many regulations and laws, so they'll never be easy. But I think the sensitivity on this one is that there's just so much attention these days on immigrants and non-citizens," Nobles said.

Several lawmakers who have taken prominent roles in the state debate over immigration say they're troubled by the report's findings. Republican Rep. Tim Wilkin of Eagan requested the audit because he was worried that non-citizens were receiving benefits they shouldn't be receiving. He says lawmakers should try to find out if the mistakes were caused by sloppiness or by county workers who were looking the other way so immigrants can get coverage.

"We really need to watch the integrity of our public programs so that they are there and available for the people who really need it who are eligible and not for people who, frankly, are not eligible," he said.

An official with the union representing county workers disputed Wilkin's suggestion that workers might be looking the other way. He said most of the errors were caused by heavy caseloads.

The audit found that 64,000 non-citizens were enrolled in public health care programs in 2005. A large majority were refugees, asylum seekers and lawful permanent residents. About 15 percent were undocumented immigrants or people who didn't state their immigration status. Illegal immigrants -- except for pregnant women -- are not eligible for subsidized health insurance. The report found that more than 8,300 such women were eligible last year.

DFL Sen. Sheila Kiscaden of Rochester said the report also shows that illegal immigrants are not a drain on Minnesota's health care system.

"The audit report shows us that we are not spending much of our public-financed health care on undocumented aliens," she said. "What's unknown is uncompensated care in hospitals so there are still some unknowns but it does not appear to be a huge problem in Minnesota."

The legislative auditor recommended that the Department of Human Services improve its computer system and the training given to county workers. An official with the Department of Human Services says it's working on fixing its system to help case workers focus on more complicated cases.