Based on 2000 Census estimates of the undocumented population, Utah may access up to $1.5 million.

"That money isn't near enough to cover the extent of the problem," Krella said.

Applying for the money also presents hospitals with a bit of a Catch-22. Although they aren't supposed to inquire about a person's immigration status, they must identify the patient as an undocumented immigrant to be eligible for the reimbursement. In addition, Krella says the application process is cumbersome.

"The bottom line is, these immigrants are getting care, but it's just one more strain on the system and how much more can it take?" he said.

The four hospitals IASIS Healthcare owns in Utah began seeking citizenship information from patients in June to apply for the federal reimbursement, spokesman Doug Boudreaux said.

Many undocumented people wait until an ailment turns acute before seeking medical attention, and when they do, it is typically at a hospital emergency room. Some lack health insurance or the means to pay. Others fear revealing personal information that could lead to being deported.

In Mexico, hospitals are the center of the health-care system. It is the place to go for everything from a sore throat to a heart attack. Not so in the United States.

"In a lot of ways, it's a cultural thing," said Bette Vierra, executive director of the Association of Utah Community Health. "It's not just because they're afraid to go someplace else."

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Coming Saturday: Solutions

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