Undocumented Immigrants' Childbirth Is Top Emergency Medicaid Expense

TUESDAY, March 13 (HealthDay News) -- The lion's share of Emergency Medicaid expenditures in North Carolina covers undocumented immigrants' pregnancy and labor complications, a trend that's probably occurring in other states, a new study found.

The findings are one of the first close-up looks at the health care needs of the growing numbers of immigrants in the United States, and they appear to question the monetary costs of excluding undocumented immigrants from routine health care, especially prenatal care.

Other experts agreed.

"Providing a dollar's worth of prenatal care can save $3 of postnatal care," said Mara Youdelman, director of the National Language Access Advocacy Project at the National Health Law Program in Washington, D.C. "It's much more costly to use Emergency Medicaid to pay for prematurity and low birth-weight babies and postnatal complications."

The research is published in the March 14 issue of theJournal of the American Medical Association, which has a series of articles on health care.

Undocumented immigrants are estimated to account for 29 percent of the total foreign-born population in the United States. Many "new growth" states that previously did not have large immigrant populations, such as North Carolina, are getting many of the newcomers. These "new growth" states may be less prepared to meet the health-care needs of the new arrivals, the study authors suggested.

In North Carolina, the total foreign-born population grew by 274 percent during the 1990s, and included about 300,000 undocumented immigrants by 2004. These immigrants face a host of barriers to accessing health care, not the least of which is federal law.

Undocumented immigrants and legal immigrants who have been in the United States less than five years are generally excluded from Medicaid benefits. But they can receive emergency medical care (known as Emergency Medicaid) if they are children, pregnant women, families with dependent children, or elderly or disabled.

For pregnant women, Emergency Medicaid funds cover labor but not routine prenatal care.

In their study, researchers at the University of North Carolina analyzed administrative claims data for Emergency Medicaid, which showed that 48,391 people in the state received emergency care between 2001 and 2004.

Within that group, 99 percent of patients were undocumented immigrants, 93 percent were Hispanic, 95 percent were female and 89 percent were between the ages of 18 and 40.

In addition, the data showed, about 82 percent of Emergency Medicaid spending in 2004 was for childbirth and pregnancy complications, which accounted for 91 percent of hospitalizations.