Texas Hospitals Reflect Debate on Immigration

By JULIA PRESTON
Photo by Misty Keasler for The New York Times

DALLAS — The doctors and nurses at Parkland Memorial Hospital knew a lot about Zahira Domínguez, a maternity patient who was beginning to feel the squeeze of her contractions.

They knew that she had been born in Mexico, was a 15-year-old student at a Dallas high school and had gone to her prenatal checkups. They knew she was scared about giving birth.

What the hospital staff did not know, because they did not ask, was whether Ms. Domínguez was an illegal immigrant.

“I don’t want my doctors and nurses to be immigration agents,” said Dr. Ron J. Anderson, the president of Parkland.

Patients like Ms. Domínguez — uninsured Hispanic immigrants with uncertain immigration status — have flocked in recent years to public hospital emergency rooms and maternity wards in Texas, California and other border states. Their care has swelled costs for struggling hospitals and increased the health care bills that fall to states and counties, giving ammunition to opponents of illegal immigration who complain of undue burdens on local taxpayers.

As a result, health care has become one of the sorest issues in the border states’ debate over illegal immigration. Facing harsh criticism from residents, public hospitals are confronted with an uneasy decision: demand immigration documents from patients and deny subsidized care to those who lack them, or follow the public health principle of providing basic care to anyone who needs it.