Dynamic Diaspora: Women and Immigration
Part: 2
Nebraska Prenatal Bill Stirs Fight Over Immigration
By Sharon Johnson
WeNews correspondent
Wednesday, March 10, 2010
Nebraska votes this month on a bill that would provide prenatal care for all pregnant, low-income women regardless of immigrant status. The governor says he plans to veto, because tax-funded programs should only benefit full citizens.
Steven A. Camarota, research director of the Washington-based Center for Immigration Studies, say prenatal coverage of undocumented women is a matter of national concern.
"About 370,000 children--one out of 10 children born in the United States each year--is the child of an illegal alien," he said.
Camarota added that the federal government has no coherent immigration policy, "so states are left in the unenviable position of having to decide whether they should spend limited funds on prenatal care for future citizens of the state, medical care for legal residents, roads or other programs."
Federal Policy Change Impacts State
For more than 20 years, Nebraska provided prenatal care under its Medicaid program to all pregnant, low-income women regardless of their citizenship status. In November, the federal government notified the Nebraska Department of Health and Human Services that federal Medicaid policy does not allow coverage of an "unborn child."
The Centers for Medicare and Medicaid Services also advised Nebraska officials that the state could continue to provide prenatal care to pregnant women who do not qualify for Medicaid by covering unborn children under CHIP.
On March 1, Nebraska ended Medicaid benefits for 1,540 women, about 25 percent of the pregnant women eligible under the old rules. Seven hundred were U.S. citizens and legal immigrants and the other 840 were undocumented immigrants.
Expectant mothers who have undocumented status are already feeling the impact of the loss of Medicaid-supported prenatal care, said Dr. Kristine McVea, chief medical officer of the One World Community Health Center in Omaha.
"In January, the state notified women who were newly pregnant and had applied for Medicaid that they would be ineligible for benefits," McVea said. "Many of these women have gone without care because there is a lack of facilities that can provide free or low-cost services where they live. Others have received basic care at community health centers like ours."
However, McVea said that their facility doesn't have ultrasound and other equipment needed to treat women who develop complications during pregnancy and are at risk for premature births.
An Institute of Medicine study found that every dollar spent on prenatal care for women at high risk of delivering a low-birth weight infant saves $3.38 in medical care expenditures. Hospital stays for premature births average 12.9 days and cost $15,100, compared to 1.9 days and $600 for a normal birth.
Campbell says shifting prenatal care coverage from Medicaid to CHIP will save Nebraska money.
"Providing prenatal care for women with undocumented status under the CHIP program would save Nebraska about $4 million a year because (federal) reimbursement under CHIP is higher than Medicaid," she said.
Sharon Johnson is a New York-based freelance writer.
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