Washington -- The House overwhelmingly rejected a controversial bill Tuesday that would have denied most types of emergency room care to illegal immigrants and required hospitals to report them to the government to be deported.

The lopsided 331-88 vote against the bill by Rep. Dana Rohrabacher, R- Huntington Beach (Orange County), was a sign of how much the immigration debate has changed since California voters passed Proposition 187, the 1994 measure to deny heath care, education and other social services to undocumented immigrants. Lawmakers, Democrats and Republicans, now are actively courting Latino voters and are loath to back any measure seen as anti- immigrant.

Even supporters of Rohrabacher's proposal acknowledged that in today's political climate, a bill to limit public services for undocumented workers had little chance of being passed.

"We are all suffering deteriorating health care as a result of illegal immigration, and we have two political parties that are unwilling to address the issue head on," said Dan Stein, executive director of the Federation for American Immigration Reform, which backed the measure.

The bill was strongly opposed by medical groups such as the American Hospital Association, which claimed it would turn doctors, nurses and other hospital employees into border control agents.

Most Republican lawmakers joined Democrats in rejecting the measure, arguing it could dissuade undocumented immigrants from seeking life-saving care or treatment for communicable diseases.

GOP leaders never wanted the bill debated on the House floor and agreed only after Rohrabacher made it a condition of his vote in favor of the Republican-sponsored Medicare prescription drug law, which passed narrowly last November.

The Medicare prescription drug law provided $1 billion over four years to reimburse hospitals that treat illegal immigrants. The provision was included by Sen. Jon Kyl, R-Ariz., who said some hospitals in his state were closing emergency rooms because of the high costs of treating undocumented immigrants.

Rohrabacher, an outspoken opponent of illegal immigration, strongly opposed the provision, saying it would encourage foreigners to enter the country illegally to receive treatment. His bill would have blocked hospitals from receiving federal reimbursements unless they agreed to report illegal immigrants to the federal government.

"If we know that an illegal alien is in the United States -- especially one that is consuming resources that are taking health care resources away from our people -- they should be deported," Rohrabacher said on the House floor. "Their own country should be taking care of them."

The bill would have required hospital workers to ask patients whether they are U.S. citizens. It also would have required that immigrant patients without a green card or other proof of legal status be photographed or fingerprinted by the hospital. The information then would have been entered into a database monitored by immigration officials at the Department of Homeland Security, who could initiate deportations.

Undocumented immigrants also would have been asked their employer's name, and those employers would have been required to pay any unreimbursed costs of emergency room treatment.

The bill sparked fierce debate on the House floor this week, with opponents saying doctors and nurses should not be required to ask sick people their citizenship status before providing care.

"This proposed (bill) would turn hospital emergency rooms into immigration processing facilities, or worse, detention facilities," said Rep. Ruben Hinojosa, D-Texas.

The measure also would have denied treatment to illegal immigrants unless it was a life-threatening emergency or urgent care was needed to "protect the health and safety" of U.S. citizens. But critics, including some Republicans, warned that the measure could endanger public health by making undocumented immigrants too afraid to seek treatment.

Rep. David Dreier, R-San Dimas (Los Angeles County), who chairs the powerful House Rules Committee, said he feared the measure would "send a message to many (illegal immigrants), who may not know they have a contagious disease, that the threat of deportation is on the horizon."

House Democratic leader Nancy Pelosi of San Francisco said the measure would create unwanted bureaucratic red tape for hospitals, diverting money from serving patients.

"Hospital caregivers are already overburdened with paperwork, which requires at least 30 minutes for every hour of patient care," Pelosi said.

Even the U.S. Chamber of Commerce opposed the bill, citing its potential effect on hospitals and public health. But Rohrabacher accused the "rich corporations in the chamber" of profiting from the taxpayer-subsidized treatment of undocumented workers.

"They don't have to provide health insurance anymore because all these illegals are willing to work (without it) anyway," Rohrabacher said.

The cost to hospitals of treating illegal immigrants is estimated at nearly $1.5 billion a year.

Hospital groups helped seal the defeat of the measure by lobbying heavily against it. Supporters of the bill said the hospital industry was more interested in preserving the $1 billion in reimbursements than in working to solve the root problem of illegal immigration.