The Personal Responsibility and Work Opportunity Act of 1996 has severely limited immigrants' access to medical care. In enacting the legislation, Congress stated that immigrants were too great a burden on the U.S. medical system and cost the federal government too much. In reality, immigrants do not place an unduly high burden on the medical system. The Act also limits the autonomy of local medical providers by restricting their ability to provide preventive medical care, care that is better for patients’ health and, in the long run, more cost effective. Further complicating this issue is that medical providers are often unable to recover complete reimbursement from the federal government because the Act authorizes repayment only for services rendered to patients in an emergency condition. This note calls for a repeal of the anti-immigrant provisions of the Act and suggests that decisions regarding the provision of care are best left to medical providers at the local level.