Immigrant women and the emergency department: the juncture with welfare and immigration reform.

This article discusses the Personal Responsibility and Work Opportunity Reconciliation Act and the Illegal Immigration Reform and Immigrant Responsibility Act and their potential impact on immigrant women's access to medical services. Current federal mandates assuring access to emergency medical services and new restrictions on financing of health care under federal programs such as Medicaid and Medicare would appear to be on a collision course. Both acts specifically reaffirm federal law on delivery of emergency services without addressing the financing of that care. Unfunded mandates in an era of diminished ability to shift costs onto insured patients are problematic for the institutions that provide uncompensated care. Specific protections for victims of domestic violence are also discussed.