Doctors around the state say a rising fervor over illegal immigration may scare illegal immigrants away from seeking health care.

In Alamance County, a recent case where medical records may have been used to prosecute a library worker who was in the country illegally has prompted many doctors to speak out about what they see as a breach of doctor-patient trust.

"Whether you're legal or illegal, it's always been assumed that your medical information is private and can't be used against you," said Dr. Christopher Snyder III of Concord, president of the N.C. Academy of Family Physicians. "The doctor-patient relationship is sacred, and I'm not sure that has really been challenged until now. We're in uncharted territory."

Snyder said that if the trend continues, infectious diseases could spread, infant mortality could rise and emergency costs could increase.

Immigrants often have a high rate of infectious diseases such as tuberculosis and often do not have health insurance. (N&O) 

State driver's licenses have been restricted in the past decade.

In the late 1990s, a group of officials in Gov. Jim Hunt's administration worked with Latino leaders to address the problem of illegal immigrants driving on state roads.

Their solution was to expand the ways that the N.C. Division of Motor Vehicles could determine residency, including accepting utility bills and lease agreements. The goal was to get immigrants to drive legally and get car insurance.

After the 9/11 attacks, concerns about security led lawmakers to turn instead to the Individual Taxpayer Identification Number, which is issued to anyone working in the U.S. regardless of immigration status.

Though that added a new hoop for some illegal immigrants to get a license, it did not make it impossible. Over the following three years, the DMV issued about 179,000 licenses to people who only had taxpayer ID numbers.

In 2004, the DMV went a step further. Facing concerns about fraud and identity theft, it stopped accepting the matricula consular, a form of identification issued by the Mexican government, among other foreign documents.

And in 2006, legislators ordered the agency to stop accepting taxpayer ID numbers, making it impossible for illegal immigrants to get a state driver's license. However, they stopped short of ordering a recall of older licenses issued with the numbers.

When those licenses expire, drivers will not be able to renew them.

With illegal immigration a hot-button issue in the U.S. Senate race, Dome has been looking at state Sen. Kay Hagan's record.

Although a number of bills have been filed in the legislature on the issue in recent years, the Senate's Democratic leadership has sent most to die in committee, so there are not many votes on record.

But one stands out. In 2006, the legislature voted to make it impossible for illegal immigrants to renew their driver's licenses.

Advocates and law enforcement officials say that many of the estimated 300,000 illegal immigrants in the state are now driving without licenses, failing to register cars or get auto insurance.

Hagan voted for the restrictions, although the bill took a circuitous path through the legislature.

More after the jump.

   Comments (5)

Bob Orr wants to cut back on health insurance mandates.

On his Web site, the Republican gubernatorial candidate says North Carolina needs to reduce "excessive coverage mandates" to allow the market to work:

North Carolina has 46 coverage mandates (government dictated policy benefits) resulting in 41% higher premiums and preventing you from choosing a basic plan. We must reduce coverage mandates so that you can choose a basic plan that meets your health needs and does not include benefits that you do not need, like for example, coverage for a chiropractor.

As noted previously, North Carolina has 25 benefit mandates.

The state also requires coverage of 17 types of providers, including chiropractors, pastoral counselors and social workers; and six groups, including adopted children, handicapped dependents and newborns.

Orr later had a back-and-forth with health care advocate Adam Searing on The Progressive Pulse blog.

He recently noted on his campaign blog, More from Orr, that the discussion made him "go back and research the issue further."

North Carolina has 24 health insurance benefit mandates.

According to the Council for Affordable Health Insurance, an insurance industry group that generally advocates against increased mandates, North Carolina has the 18th most mandates in the United States.

Idaho has the fewest mandates, with seven; while Maryland has the most, at 39. The median was 21 mandates, which Kentucky and Tennessee have.

Among the most common benefits in North Carolina's mandates: Mammograms, maternity stays, breast reconstruction, alcoholism, diabetes supplies and emergency services.

Among the least common: Birthing centers, cleft palate, bone mass measurement, human papilloma virus vaccine, newborn hearing screenings and TMJ disorders.

North Carolina also requires insurers cover clinical trials, mastectomies, hospital stays after a mastectomy, colorectal cancer screening, cervical cancer screening and contraceptives, among other things.

Although it's not yet listed, the General Assembly recently added a 25th benefit mandate: mental health parity.

* The federal government's final environmental impact statement recommends not building the "Road to Nowhere." U.S. Rep. Heath Shuler pleased. (AC-T)

* U.S. Rep. Robin Hayes asks House Speaker Nancy Pelosi to make approving spending on Fort Bragg and other military bases "your first priority." (Fay-O)

* U.S. Rep. Mel Watt questions linking car insurance premiums to credit rating: "If I got my credit score up, would that make me a better driver?" (AP)

* U.S. Rep. Patrick McHenry releases a poll that shows him beating District Attorney Jay Gaither and Catawba County Sheriff David Huffman in the primary. (Hickory Daily Record)

A former state legislator says this was a "do-something" session.

Former Rep. Wayne Goodwin, who is married to Hamlet Democratic Rep. Melanie Wade Goodwin, writes on his blog "Wayne's World" that the 2007 legislature had a number of "great accomplishments."

Among the achievements: Creating a high-risk insurance pool, ending counties' Medicaid burden, enacting ethics law changes, starting a pilot program for publicly financed campaigns and requiring mental health parity on insurance.

He argues that Republicans are wrong to call this a "do-nothing legislature":

I beg to differ. If anything, the Democratic leaders in Raleigh made this a "Do Something" session. And they did it quite well.

Some major bills passed on health care this session.

The bills will:

Create a new state medical form for end of life choices, revises health-care power or attorney language.

Require group health insurance plans to cover treatment for mental illness services at the same level that they cover physical illnesses.

Create a program for residents whose long-term illnesses make buying health insurance too expensive or unavailable because no company is willing to sell it to them.

Set up a system of rating adult-care homes, strengthen health-care personnel registry and set up regular meetings of Penalty Review Commission.

Require state and local public agencies to disclose the total compensation paid to top officials, but gives public hospitals the right to deny such information for the rest of their employees. Also bars the public from learning the details of medical practice purchase contracts struck by public hospitals.

John Edwards' health-care plan is a Trojan horse.

A review of the plan in Slate says that Edwards' real goal is to create a single-payer, government-run universal health care system.

But rather than create one immediately, Edwards proposes setting up a number of regional health markets that would serve as idea labs:

The experiment would be whether the private health-insurance plans could compete effectively with "a public insurance plan modeled after Medicare, but separate and apart from it." 

Reporter Timothy Noah argues that past research shows consumers will prefer the public plan. After the government insurance wins in several of the smaller markets, the momentum in the debate will shift towards creating a single-payer plan.

North Carolina insurance companies may soon be required to treat mental health like a physical ailment.

A Senate committee unanimously endorsed a bill Wednesday that would require mental illnesses such as schizophrenia be treated the same way as physical problems such as heart disease, Lynn Bonner reports.

In the past, insurance companies have objected to expanded coverage, but the state's largest insurer, Blue Cross and Blue Shield of North Carolina, worked on this bill.

Other states have found that few companies drop coverage and the cost increases are minimal when mental health parity is instituted.

Still, the bill only requires treatment of nine major ailments, including obsessive-compulsive disorder, post-traumatic stress disorder and bulimia. It does not cover drug and alcohol treatment, sex changes or sexual dysfunctions for psychological reasons.