RomneyCare subsidized care for illegal immigrants?

The Los Angeles Times dropped a political bombshell on Mitt Romney today with its report on a key component of RomneyCare and its use by illegal immigrants to receive taxpayer-subsidized care.  Romney has attacked Rick Perry for providing a “magnet” for illegal immigration with tuition breaks for some students of illegal immigrants in Texas, so this has the potential for substantial backfire in the presidential race:

The Massachusetts healthcare law that then-Gov. Mitt Romney signed in 2006 includes a program known as the Health Safety Net, which allows undocumented immigrants to get needed medical care along with others who lack insurance.

Uninsured, poor immigrants can walk into a health clinic or hospital in the state and get publicly subsidized care at virtually no cost to them, regardless of their immigration status.

The program, widely supported in Massachusetts, drew little attention when Romney signed the trailblazing healthcare law. But now it could prove problematic for the Republican presidential hopeful, who has been attacking Texas Gov. Rick Perry for supporting educational aid for children of undocumented immigrants in Texas.

“We have to turn off the magnet of extraordinary government benefits,” Romney said at the recent Fox NewsGoogle debate in Florida.

This looks worse than it really is, however, mainly because of the reality of American health care in every state.  Anyone who walks into an emergency room gets care whether they pay for it or not.  That was true in Massachusetts before RomneyCare, and it’s true everywhere else.  In fact, this was one of the prime issues that drove health-care reform in Massachusetts — how to reduce the burden on taxpayers from the high cost of unnecessary emergency-room care.

The Health Safety Net program was intended to shift those visits from emergency rooms to clinics where possible.  Clinic visits cost less and don’t tie up scarce resources in emergency rooms.  The only other option would have been for Massachusetts to deny care to the indigent at any level, a step that would have hardly been adopted in deep-blue Massachusetts, and probably not anywhere else, either.

Still, this will almost certainly sting Romney in the political battles of the primary and offer Perry a rebuttal point in the debates.  After all, he made a similar point about the economic benefit of ensuring that students get educations to stay off of welfare rolls and end up as net contributors rather than net recipients to society.  Romney’s argument is more directly tied to the economics of health care than Perry’s is on education, but that’s a nuance that likely won’t survive in the presidential debates.

Update: Some commenters are apparently unable to comprehend the nuance of my post, so I’ll be a little more blunt: any kind of cost reduction effort has to address the people using emergency rooms as clinics.  Since it’s nearly impossible for nurses to do immigration checks, illegals will get health care regardless of whether they get forced into emergency rooms or have an option to go into clinics.  The only other way around that is to deny care without insurance or cash, which is politically untenable even in red states, let alone Massachusetts.  RomneyCare, with its mandate for universal insurance, had to have a structure for clinics to address those who couldn’t afford any in order to reduce those costs, which is why HSN was inevitable, regardless of when it started.

Update II: The HSN existed prior to RomneyCare, however, when it was called the Uncompensated Free Care Pool.  That was established in 1985, but the Chapter 58 bill (RomneyCare) relied heavily on the UFCP for its savings claims.  The UFCP was renamed the Health Safety Net in 2007.  Far from ending the pool, Romney used it to help fund RomneyCare — and for good reasons.

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