Undocumented Immigrants' Childbirth Is Top Emergency Medicaid Expense

About one-third of the remaining funds were spent on "sudden-onset" problems, such as injuries and poisonings. (Hispanic immigrants account for a disproportionate number of workplace injuries and fatalities in the United States, and motor vehicle injuries are the leading cause of death among Hispanics in North Carolina). Large chunks also went to complications of chronic disease, such as kidney failure.

The study found that the largest spending increases occurred among undocumented immigrants who were elderly and disabled.

Spending on pregnant women increased by 22 percent during the study period, by 70 percent for families with dependent children, by 82 percent for disabled patients and by 98 percent for elderly patients.

Still, only a small proportion of the undocumented population seems to be using Emergency Medicaid. The 16,106 patients utilizing Emergency Medicaid in 2004 represented only 5 percent of the total estimated undocumented immigrant population of North Carolina. Emergency Medicaid was less than 1 percent of the total state Medicaid budget, the study authors said.

The study authors wrote: "The availability of affordable culturally and linguistically appropriate primary care, however, will be a critical determinant of both the effectiveness and cost efficacy of health care for immigrants in new-growth areas."

But without Emergency Medicaid, many medical institutions and poor people would be lost.

"We're very happy that Emergency Medicaid covers women, especially the ones who have childbirth, or we wouldn't have funding. We would be destitute," said Dr. Leo B. Twiggs, chairman of obstetrics and gynecology at the University of Miami Miller School of Medicine, and clinical service chief at Jackson Memorial Hospital. Jackson is the safety-net hospital for Florida's Miami/Dade county and serves many undocumented immigrants who give birth.

"It's the right thing to do," Twiggs said.

More information

Learn more about immigrant health-care options at the U.S. Department of Health and Human Services.

SOURCES: Mara Youdelman, J.D., LLM, director, National Language Access Advocacy Project, National Health Law Program, Washington, D.C.; Leo B. Twiggs, M.D., chairman of obstetrics and gynecology, University of Miami Miller School of Medicine, and clinical service chief, Jackson Memorial Hospital; March 14, 2007,Journal of the American Medical Association