Republican plans to widen Arizona's controversial illegal immigration crackdown by making hospitals check whether patients are in the US legally have enraged medical professionals who fear becoming de facto government agents.
Medics blasted the bill as it was scheduled for a hearing by the state Senate Judiciary Committee and doctors talked of scenarios in which immigrants with contagious diseases such as tuberculosis would avoid clinics or hospitals and put themselves and the public at a grave health risk.
"This is making us into a police state that will try to catch people when they are sick," said George Pauk, a retired doctor with an organisation called Physicians for a National Health Programme. "Do we want to stop sick people from coming in for health care?"
Arizona's legislature is the first to take up such a measure amid a national push in conservative states to crack down on illegal immigration, according to the National Conference of State Legislatures.
State politicians ignited the debate a year ago when they passed a bill that required police, while enforcing other laws, to question the immigration status of those they suspected were in the country illegally. A judge later put that provision on hold.
But supporters say the hospital bill is necessary to fight illegal immigration at a time when hospitals lose tens of millions of dollars treating illegal immigrants in casualty units.
Arizona senate president Russell Pearce, a Mesa Republican who was chief sponsor of last year's immigration law, says the hospitals bill is part of a broader effort to crack down on illegal immigration. He said it would not bar people from receiving care, but would put the onus on hospitals to "do due diligence". "It's the law. It's a felony to (aid and) abet. We're going to enforce the law without apology," Mr Pearce said.
The proposed law would require hospitals, when admitting non-emergency cases, to confirm that a person seeking care was a US citizen or in the country legally. In emergency cases where the patient was not there legally, the hospital would be required to call immigration authorities after the treatment was done. Hospitals in non-emergency situations would also be required to contact government immigration authorities, but would have more apparent discretion about whether to treat illegal immigrants.
Opponents say the bill could pose serious health risks to those here legally and illegally. They believe the threat of deportation would keep some people from seeking health care for everything from emergency situations to measures such as vaccinations, potentially leading to preventable deaths. They also said it would increase hospitals' already-strained workloads.
"You are now turning medical professionals into full-time INS (Immigration and Naturalisation Service) agents," said Democratic state senator Steve Gallardo. "Doctors that should be working to help treat ill patients are now turning into ICE (Immigration and Customs Enforcement) agents."