NMDA Journal Fall 2019

nmdental.org 23 The Cost of Illegal Immigrant Dental Care: We Really Don't Know By Shelly L. Fritz, DDS Our four border states are projected to see ap- prehensions of 1,072,000 immigrants this year. This number decreased by 25% this summer as a U.S. agreement with Mexico is keeping many immigrants on the Mexican side of the border and preventing Central Americans from coming into Mexico on their southern border. There is no estimate as to howmany are not apprehended, but 800 immigrants arrive at the El Paso crossing a day. All the checkpoints in the state, including the two checkpoints in Otero County which cover Holloman Air Force Base, ranch land, pistachio orchards, and na- tional parkland on U.S. Routes 54 and 70, have been shut down. This second line of defense was closed so that Border Control agents could meet the influx on the border. Of course, illicit drug—including methamphetamines, fen- tanyl, and marijuana—seizures increased by 3,500% according to the Otero County Sheriff Deputy Office. The Lincoln, Otero, and Sierra County Board of Commissioners in the spring voted to pass resolutions opposing reloca- tion of immigrants to their communities and funds to house them. In June, NewMexico and Albuquerque (which receives 250 asylum seek- ers a week) sued the Trump Administration to receive reimbursement for temporally (one or two nights) sheltering asylum seeking mi- grants as they pass through the state to areas where sponsors, families, or hosts have agreed to accept themwhile they await their court hearings. Most illegal immigrants move on to the bigger cities in the U.S. for this support. The southern border has always been fluid. Violence from Texas independence from Mexico, the bandits of the Mexican Revolu- tion, and the drug cartels in the 80’s to the present have institutionalized border control on the American side as the U.S. assumes that Mexico City has never controlled their north- ern border. The current migrant crisis is the current border iteration. Migrant families pay up to $7,000 to Coyotes (human smugglers) including a “tax” to the cartel that controls the border they cross. In April, the U.S. Bor- der Patrol encountered 67,000 family units and minors along the border. If they paid the average fare of $4,000, the cartels made $268,000,000 that month. I spent a week this past spring on the southeastern border of Mexico visiting ancient Mayan cities. Along the way, we also visited indigenous villages that have lived communally for centuries. Their land is divided between themselves; there is no room for immigrants from Hondu- ras, El Salvador, or Guatemala. The immigrants move from village, town, and city to the north where the U.S. has provided open arms. These open arms in the form of NGO’s (Non- Governmental Organizations), churches, and local and state governments are burnt out. Non-profit shelters in Las Cruces have cared for 9,000 migrants since the middle of April and are overcrowded and are low on food and clothing. Deming has 4,700 migrants and only has a population of 14,000 people to support this influx. In May, the immigrants were dropped off at the Las Cruces bus sta- tion costing the taxpayer $4,000 a trip to travel to Denver and further north and west to California. Custom and Border Protection schedule daily flights out of the state costing the taxpayer $6,000 a trip to travel in the U.S. or south deporting some to the country they fled. How many undocumented immigrants stay in New Mexico is unknown or, at least, I could not find current numbers. How much do dentists and the taxpayers spend on illegal immigrant dental health care in New Mexico? The numbers are hard to tease out. I asked the state and they have no numbers. On many occasions, as a private practice dentist, an employer, church mem- ber, or friend of an undocumented migrant has come in and the host has paid for their dental care. Many of us will donate dental care, but we don’t advertise or document these services. Mission of Mercy offers mini- mal services to this population but does not ask patients about their citizenship status. The largest provider of illegal immigrant care is provided by the 53 FQHC (Federally Qualified Health Center) dental clinics. We know they treated 19,370 legal migrant/seasonal farm workers last year, but they were legally here. There are no numbers available on how many illegal immigrants are treated. According to Pew Research Center, in 2016, there were 11,300,000 illegal immigrants. Other estimates currently suggest that there are as many as 21,000,000. Chris Conover from the Apothecary Contributor Group writes that Americans cross-subsidize health care for unauthorized immigrants to $11,900,000,000 of uncompensated costs. Dental care amounts to 4% of our health care dollar. Federal policy prohibits federal tax funding through Medicaid and the Affordable Care Act for many of these people. Illegal im- migrants in the U.S. are estimated to receive $4,650,000,000 in health services from federal taxes, $2,830,000,000 from state and local taxes, $3,030,000,000 through cost shifting from higher insurance premium payments to cover hospital uncompensated care losses, and $1,500,000,000 in charity care. Most of the dental care provided in New Mexico is through our FQHC dental clinics. The two largest providers told me they “think” they provide about $4,000,000 in dental care for illegal immigrants. How much this popula- tion costs to treat is truly unknown. Are these numbers bogus since we don’t know how many illegal immigrants we host? We can only guess...