Oklahoma Lawmaker, State Official Divided Over Legality Of Medicaid Coverage For Prenatal Care To Undocumented Immigrants

Main Category: Medicare / Medicaid / SCHIP
Also Included In: Pregnancy / Obstetrics
Article Date: 03 Apr 2008 - 12:00 PDT

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The CEO of the Oklahoma Health Care Authority and a state lawmaker remain split on whether using state Medicaid funds to provide prenatal care services to undocumented immigrants will jeopardize federal funding for the program, the Oklahoman reports (McNutt, Oklahoman, 4/2).

The department last fall approved a rule allowing undocumented pregnant women to receive prenatal care as long as their infants become citizens upon birth. States are required by federal law to pay for emergency labor and delivery services of undocumented women, who do not qualify for other Medicaid services. The rule took effect at the start of the year. Under the rule, undocumented women receive coverage for prenatal care services that are needed to protect the health of the fetus. The women still do not qualify for full Medicaid benefits, according to officials. At least 12 other states, including Texas and Arkansas, have similar regulations (Kaiser Health Disparities Report, 10/12/07).

State Rep. Randy Terrill (R) contends that the rule should have been reviewed and approved by legislators and not the health authority. He said, "As a result, the Oklahoma Health Care Authority may soon be committing Medicaid fraud by billing the federal government for services provided to [undocumented immigrants] that the Legislature never authorized." He said that providing federally funded prenatal care services to undocumented immigrants sets a dangerous legal precedent because it does not clearly define the concept of "personhood" versus "citizenship." Terrill added that the rule could cost the state millions of federal dollars. Terrill and state Rep. John Wright (R) have filed a measure to overturn the department's rules.

A state immigration law, written by Terrill, states that the department cannot provide medical services to an undocumented immigrant over age 14. However, Mike Fogarty, CEO of the department, said that the law does not specify if the regulation applies to prenatal services, adding that the agency "has specific federal approval and encouragement to reimburse health care providers for prenatal care services to unborn children regardless of their mother's documentation status." The federal SCHIP program defines a child as an individual from conception to age 19, according to the Oklahoman. In addition, the program defines child health assistance as including prenatal care services, Fogarty said. "The Bush administration recognized the positive public policy associated with providing prenatal care for these babies and began encouraging states to adopt this option in 2002," he said (Oklahoman, 4/2).

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