New York is upset that Medicaid is no longer allowing chemo for illegals.

The federal government has told New York State health officials that chemotherapy, which had been covered for illegal immigrants under a government-financed program for emergency medical care, does not qualify for coverage. The decision sets the stage for a battle between the state and federal governments over how medical emergencies are defined.

The change comes amid a fierce national debate on providing medical care to immigrants, with New York State officials and critics saying this latest move is one more indication of the Bush administration’s efforts to exclude the uninsured from public health services.

State officials in New York and other states have found themselves caught in the middle. The New York dispute, focusing on illegal immigrants with cancer — a marginal group of unknown size among the more than 500,000 people living in New York illegally — has become a flash point for health officials and advocates for immigrants in recent weeks.

Under a limited provision of Medicaid, the national health program for the poor, the federal government permits emergency coverage for illegal immigrants and other noncitizens. But the Bush administration has been more closely scrutinizing and increasingly denying state claims for federal payment for some emergency services, Medicaid experts said.

Last month, federal officials, concluding an audit that began in 2004 and was not challenged by the state until now, told New York State that they would no longer provide matching funds for chemotherapy under the emergency program. Yesterday, state officials sent a letter to the federal Medicaid agency protesting the change, saying that doctors, not the federal government, should determine when chemotherapy is needed.

The problem with that argument is not, of course, that th federal government is defining what is needed. Rather, it is defining what is "emergency" care, and determining whether or not medical care is entitled to reimbursement from federal funds. And since long-term chemotherapy is chronic, rather than emergency, care, it clearly is not covered under the limited exception to the law that is intended to provide critical care in the case of an immediate medical crisis.

If an illegal immigrant needs chemo, let him or her return to the country of origin and receive the health care there under whatever medical program their home country has. And if the home country has no such program, explain to me again why I, as an American taxpayer, should provide it for a persona who is in this country in violation of our nation's laws.

However, if the state of New York disagrees, it may opt to spend its own tax dollars for the non-emergency treatment of border-jumpers. Similarly, private charities can step in and cover the cost. But the demand for illegal reimbursements for medical care for illegal aliens is unacceptable.

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