LINCOLN -- One of the most controversial issues of the year -- whether illegal immigrants should get government-paid prenatal care -- will be debated again in 2011 by the Nebraska Legislature.
That was the word from three lawmakers after hearing reports Friday that four stillbirths and one premature death had occurred since the state decided to end prenatal services for such women.
Charity health-care facilities in Omaha and Columbus also said they have been overwhelmed since the prenatal coverage was dropped.
“This is not an immigration issue, this is about the health and well-being of our children,” said State Sen. Brad Ashford of Omaha.
Ashford, along with Sens. Kathy Campbell of Lincoln and Bob Krist of Omaha, said a bill will be introduced next year to resurrect prenatal services.
The debate was a battle royale last spring, pitting the issues of illegal immigration against protecting unborn life with preventative health care that saves money in the long run.
In the end, lawmakers decided against an election-year showdown with Gov. Dave Heineman, who indicated he would block providing such services to illegal immigrants.
He insisted that charities would provide what had been state policy for more than two decades.
A special committee headed by Campbell took testimony Friday about the impact of ending the prenatal services.
While charities and university facilities are picking up much of the slack, their services are being taxed to the limit, advocates said.
Several people said it didn't make moral or budget sense to end preventative care that can cost as little as $800 per expectant mother.
They said the alternative is risking birth defects and delivery complications that can translate into $5,000-a-day bills for stays in intensive care units.
Because the children become citizens at birth, the state ends up paying the consequences for the lack of prenatal care, they said.
“It's shocking that the State of Nebraska has chosen to disregard the huge weight of medical evidence,” said Dr. Paul Welch, an obstetrics-gynecology physician from Columbus.
Welch said the unborn were being “punished” for a decision by their parents.
“They're the next generation of Americans, whether we like it or not,” he said.
About a year ago, federal Medicaid officials informed Nebraska that it had to change or drop its decades-long policy of providing government-paid prenatal care because it was being done improperly.
The state restored the care for some women, but about 1,600 low-income women lost the coverage March 1, including 840 who were in the country illegally.
Rebecca Rayman of the Good Neighbor Community Health Center in Columbus said her clinic has seen four stillbirths since March, after having none in the previous six years.
“Only God knows” whether all those deaths were attributable to the lack of prenatal care, Rayman said. She believes at least one of the stillbirths was.
Two emergency births took place at a South Omaha clinic because women were afraid of the high costs they might incur if they went to a hospital.
One of the infants was delivered at 20 weeks and died, said Andrea Skolkin of OneWorld Community Health Centers. The infant's mother had received no prenatal care.
Medical officials said many of the women who cannot afford prenatal care have discussed having abortions.
Former U.S. Rep. John Cavanaugh, who now heads an effort to improve education for the poor in the Omaha area, was among those asking legislators to restore the prenatal services.
“This is a domino of destruction that will follow (these children) and us,” Cavanaugh said, in terms of higher costs for special education and poorer academic performance.
Rayman said the number of women coming to her clinic in Columbus has doubled as word spread that the clinic was continuing to offer prenatal care despite the lack of Medicaid reimbursement.
Some patients have come from as far away as Lexington because they can't get help locally, she said, taxing medical providers in Columbus.
Welch, the Columbus physician, said his clinic has provided $100,000 in unreimbursed care and doesn't expect to be reimbursed for at least 30 emergency deliveries it performed.
Campbell, who many expect will be elected chairwoman of the Legislature's Health and Human Services Committee next year, said she wants more information on the fiscal benefits of restoring the care and whether any of the increased need is due to people losing private health insurance.
“I want U.S. citizens, when they are born, to have as healthy a beginning as we can give them,” Campbell said.
Contact the writer:
402-473-9584, paul.hammel@owh.com
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