LOS ANGELES - A new state audit suggests that county hospitals could save at least $130 million annually by limiting the nonemergency medical services it provides to illegal immigrants.

The audit, debated Tuesday by county supervisors, found that the county spends about $340 million a year treating undocumented immigrants at its health facilities and could save between $130 million and $138 million a year by discontinuing nonemergency services to them, according to the Los Angeles Daily News.

The county treats five times as many undocumented immigrants as required by state law, the audit found.

The audit found that 53 percent of the 800,000 annual users of the county's system are uninsured and receive care even though state law does not mandate it. The county health department has estimated that from 12 percent to 19 percent of its hospital discharges and clinic visits involve undocumented immigrants.

Supervisor Michael Antonovich hailed the report, saying the "county taxpayer can no longer be the HMO to the world." But others, including Supervisor Zev Yaroslavsky, blasted the audit, saying it showed a lack of understanding of the issues facing the county.

"They audited us like they audit General Motors or U.S. Steel," he said. "There is no critical thinking or sophistication to analyze an arcane health care finance system that we all have to live with in this county."

Federal waivers that have pumped $2.2 billion into the county healthcare system since 1995 are set to end this summer. The county is expected to have a $435 million shortfall by July 2006 that will grow to $1.4 billion by July 2008, according to the county.

"The county's data indicates that instead of becoming leaner, the county has essentially maintained the size of its overall work force and has become progressively less efficient in care delivery," the audit said.

County health director Dr. Thomas Garthwaite and other county officials said denying nonemergency care to noncitizens would create a public health catastrophe and argued the federal government is responsible for reimbursement because of its failure to properly secure the borders.

The state law governing what care California's 24 public hospitals must provide to undocumented immigrants and other non-mandated users is vague, said Rachael Kagan, spokeswoman for the California Association of Public Hospitals.

San Diego, Orange and Sacramento counties long ago closed their public hospitals and contract out with University of California hospitals to care for the indigent and uninsured.

Statewide, 20 counties still operate public hospitals, including San Bernardino, Ventura, Riverside, Kern and Los Angeles counties - and all have different policies on who they provide care to.