Immigration

The Entire Expense Should Be Borne by the Federal Government: A 1913 Report from the Commissioners of Accounts

A recent search for reports about immigration in the Municipal Library, showed that the earliest report in the collection was issued by the Office of the Commissioner of Accounts in 1913. Sent to the Honorable Ardolph L. Kline, Mayor, the subject was the treatment of indigent aliens, free of charge, at Bellevue and Allied Hospitals.

Report on Bellevue and Allied Hospitals, Care, Treatment and Maintenance of Indigent Aliens, Free of Charge, 1913. Office of the Mayor (Kline) Collection, NYC Municipal Archives.

The Office of the Commissioner of Accounts (Accounts) was created in 1873 to investigate the City’s operations and financial controls after the Boss Tweed scandals. It evolved into the Department of Investigation and Accounts and today exists as the Department of Investigation. Reviewing files in the Office of the Mayor collections in the Municipal Archives, it would appear that the Commissioners of Accounts covered a lot of territory. In 1913, report topics ranged from the administration of the many courts within the City of New York, to an examination of Police Pension Fund accounts, to an investigation at the request of Mayor William Gaynor and Fire Commissioner Joseph Johnson into firefighters involvement in passing “two platoon” legislation and more.

One document in Mayor Kline’s Departmental Correspondence Received series resonates today: the aforementioned memo regarding the cost of hospital care.

According to the National Archives, more than 20 million immigrants arrived at Ellis Island between 1892 and 1924. Not all stayed in New York City, but many did. Seventy-five percent of New York City residents were immigrants or born to immigrants, the Library of Congress reports. New York was known, then and now, for the diversity of its population. Immigration and industrialization went hand-in-hand and New York’s immigrant residents made the City a manufacturing hub. The new arrivals also faced discrimination and endured harsh living conditions. Federal regulations permitted the deportation of immigrants who might become a public charge.

Report on Bellevue and Allied Hospitals, Care, Treatment and Maintenance of Indigent Aliens, Free of Charge, 1913. Office of the Mayor (Kline) Collection, NYC Municipal Archives.

In 1913, there were three public hospital systems in the City. One operated by the Department of Public Charities oversaw operations at ten hospitals. The Health Department had oversight of six hospitals. The third, the Bellevue and Allied Hospitals, consisted of five institutions: Bellevue Hospital, Harlem Hospital, Gouverneur Hospital, Fordham Hospital and Emergency Hospital. A lengthy December 26, 1913 report from Accounts described this system as “archaic and ineconomical,”(sic) leading to “conflict of authority.” It reported horrific patient treatment, unsanitary conditions, and lax practices. The final sentence in the report comes under the heading Free Treatment of Aliens. “A report (file NO1852) upon the free treatment of aliens, and its very large cost to the city was submitted to the mayor under date of September 25, 1913.”

The Accounts report stated that 57,422 persons were treated at the Bellevue and Allied hospitals. A sampling of the 11,224 records of cases treated in a three-month period showed that “671 were less than three years in this country, and consequently were not citizens.” In the margin of the report is a handwritten calculation in pencil showing that the percent of noncitizens was 6% of those treated. We expect this was calculated by Mayor Kline. Further down, the Accounts report stated that using the percent derived from their sampling, “approximately 9,879 aliens, not citizens of this country, were treated without charge.” The average cost of treatment of each patient during these three years was $21.10, and on this basis the total cost of the aliens treated during the three years therefore amounted to $208,446.90. An inflation calculator shows this would be $6,464,510. in 2023 dollars.

Report, page 2. Office of the Mayor (Kline) Collection, NYC Municipal Archives.

Report, page 3. Office of the Mayor (Kline) Collection, NYC Municipal Archives.

The author took pains to note that the calculations were for people residing in the U.S. for less than three years and stated, “The inclusion of aliens of more than three years’ residence, who have been treated free of charge in these institutions, would considerably augment this sum... The imposition of this burden upon the municipal government it is contended is an injustice.” The report cites the then-existing federal law which provided that the Commissioner-General of Immigration was responsible for “the support and relief of such aliens as may fall into distress or need public aid.”

The report criticized the low reimbursement rates paid by the federal government and the process by which the payments were calculated. Payments were made only for cases in which deportation warrants were issued, which occurred after the individual was housed in the city hospitals while Immigration doctors determined whether they should be deported so they wouldn’t become a public charge, which triggered deportation.

Report, page 4. Office of the Mayor (Kline) Collection, NYC Municipal Archives.

“The city is not reimbursed for expenses incurred for the care and treatment of these patients at the hospitals during the investigation, which often consumes several weeks before the issue of the warrant. If the investigation fails to develop facts sufficient to warrant deportation the city receives nothing for care and treatment during the period of detention.” Between 1902 and December 1913, the City was reimbursed only $1,149—far less than the Commissioners of Accounts calculated was fairly due.

The report recommended that the Trustees of the Bellevue and Allied Hospitals begin negotiations with federal authority “with a view to relieving the City of New York of the unjust share of this federal burden which it bears at the present time…”

It’s not clear that City officials acted on this recommendation. There are no letters in the Mayor Kline collection to the federal government requesting full reimbursement. It is clear, though, that the City took on the responsibility of caring for immigrants in poor health, even if not fully compensated.

I Lift My Lamp Beside the Golden Door

Signed into law on November 29th, 1990 by President George H.W. Bush, the Immigration Act of 1990 reformed the Immigration and Nationality Act of 1965, fundamentally changing the way the United States evaluates and admits immigrants. In order to explore what this reform would mean for one of the greatest immigrant cities in the world, WNYC-TV produced an extra-long episode of their current events show, New York Hotline. This episode assembled a panel reflecting perspectives from City demographers, anti-immigration groups, recent immigrants to the City and experts from CUNY and Columbia University. Produced in 1993 after the end of the Bush presidency, it aired one year after the law took effect.

Passed by significant bipartisan majorities in the House and Senate, the Immigration Act of 1990 made a number of basic changes to America’s immigration system, by:

  • Increasing the worldwide limit for immigration visas from 540,000 to 700,000[i]

  • Specifically increasing the number of visas used solely for family unification

  • Creating diversity immigrant visa lotteries to increase immigration from countries under represented in coming immigrant groups

  • Clarifying the authority of Immigration and Naturalization Service enforcement officers to make arrests and carry firearms

  • Expanding the number of non-immigrant H1-B visas and green cards for foreign laborers

  • Providing for the more expeditious deportation of violent offenders

  • Eliminating exclusion of homosexual immigrants by labeling them as mentally unfit or “sexual deviants”

  • Ending English language tests for naturalization tests

President Bush commented at its signing that “The Act maintains our Nation’s historic commitment to family reunification by increasing the number of immigrant visas allocated on the basis of family ties.”[ii] This increase in visas to family members would prove to be a deeply controversial aspect of the 1990 Immigration Act. Opponents of the law, both then and now, argue that this policy leads to an unfair pattern of ‘chain migration.’ For advocates and those who benefit from the law, it is a humane way to keep families together and creates tighter community bonds.

REC0047_II_150_2007: Frank Vardy describes the historic family nature of immigration into the United States. WNYC collection, NYC Municipal Archives.

Perhaps more than any part of the country, New York embodies the country’s ‘historic commitment’ to immigrants, with more migrants passing through its port during the 20th century than any other city in the United States. Frank Vardy, then a demographer in the City’s Planning Department, traced the movement of immigrant communities through different City neighborhoods. He did this so the City could provide better services to new arrivals, like adult English language education, foreign language signs in public buildings or interpreters in schools. More than anything else, Vardy argued in his interview, the opportunity to find work and a better life for their families is historically what drove most immigrants to New York, no matter where they came from. Crucially, though, it was the family ties to already established prior immigrants that helped new arrivals find work, learn English and ultimately begin the process of becoming American.

One organization featured in this Hotline episode was FAIR, or the Federation for American Immigration Reform. FAIR, founded in 1979 by ophthalmologist John Tanton, sought to repeal the Immigration and Nationality Act of 1965 as well as the 1990 reforms.  The organization wanted to significantly reduce immigration into the United States on environmental, cultural and economic grounds. FAIR, still in existence today, has been a controversial group despite its non-partisan and non-profit status. On one hand, it has advised major politicians for years, contributed to countless studies on immigration and its representatives have testified in front of Congress many times. On the other hand, FAIR was labelled a hate group by the Southern Poverty Law Center in 2007 and its founder has made a litany of explicitly racist remarks in official internal memos, often referring to people of color in inhuman terms.[iii]

REC0047_II_150_2012: FAIR advisory board member Edward Levy expresses his concern that the 1990 law’s expanded family unification policy will fundamentally damage American democracy. WNYC collection, NYC Municipal Archives.

In the middle of this were people like Yan He, a Chinese immigrant who had arrived in New York in 1990 just as the Immigration Act was being debated in Congress. Following family members who had already emigrated from China, Yan He and her husband came to the United States seeking work and opportunities. Throughout her interview, Yan He details the difficult and often complex experience of coming to America, including conflicts with abusive employers and the hope she has for her children to get better jobs through the American education system.

REC0047_II_150_2010: Arriving in America was only one step in a much longer journey for Yan He, her family and the City of New York. WNYC collection, NYC Municipal Archives.

The NYC Municipal Archives has hours of interviews with Frank Vardy, Edward Levy, Yan He and other experts on the subject of the 1990 Immigration Act. Although in this blog post we focused primarily on family unification, the other provisions of the Act like the diversity immigrant lottery or the expansion of H1-B visas have also proven to be controversial. Underneath the debates over these narrow issues lies the larger questions that residents of New York and America have been asking about the place immigration holds in American society. Digitizing these interviews from the 1990s helps preserve the history of this debate for future New Yorkers of all kinds, whether they be native- born citizens or one of the 3 million-plus foreign-born residents in the City.

[i] Highlights of the U.S. Immigration Act of 1990, by Warren Leiden and David Neal, Fordham International Law Journal

[ii] Statement on Signing the Immigration Act of 1990, President George H.W. Bush https://www.presidency.ucsb.edu/documents/statement-signing-the-immigration-act-1990

[iii] https://www.splcenter.org/fighting-hate/extremist-files/group/federation-american-immigration-reform