Study: Emergency Health Care for Recent, Illegal Immigrants in N.C. Costly

http://www.wral.com/news/state/story/1232932/

RALEIGH, N.C. — Paying for basic checkups and pregnancy care for illegal immigrants would save money in the long run, possibly averting expensive emergency treatment, say researchers who studied immigrants in North Carolina.

Federal law generally excludes illegal immigrants and legal immigrants who have been in the U.S. less than five years from Medicaid, a joint state-federal program that provides health care coverage to the poor and disabled. But the law also allows Medicaid to pay for emergency medical care needed by some immigrants, including those who are pregnant or disabled.

Researchers looking at so-called emergency Medicaid in North Carolina found that the overwhelming majority of such patients were female Hispanic illegal immigrants, and more than 80 percent received care related to childbirth and complications of pregnancy.

And while spending on care for pregnant women increased 22 percent between 2001 and 2004, the cost of covering the emergency health care needs of elderly and disabled illegal and recent immigrants rose about four times as fast.

"I hope that it helps us think about whether there are better ways to allocate health care services to this population that has such limited access to primary care," said Dr. Annette DuBard, a researcher at the University of North Carolina at Chapel Hill and lead author of a study that appears in Wednesday's Journal of the American Medical Association.

DuBard and Dr. Mark Massing, of the Cary-based Carolinas Center for Medical Excellence, examined administrative data for 317,090 paid Medicaid claims in North Carolina during the four-year study period. They found that 99 percent of the 48,391 people who received emergency Medicaid were illegal immigrants, 95 percent were female and 93 percent were Hispanic.

Overall, the study found the cost of treating the emergency health care needs of recent and illegal immigrants made up less than 1 percent of the overall spending on Medicaid in North Carolina each year studied. While such spending rose 28 percent during that time, the increase was less than the overall 35 percent increase in Medicaid spending in the state.

But the study found that emergency Medicaid spending increased 70 percent for families with dependent children, 82 percent for disabled patients and 98 percent for elderly patients. Those figures suggest immigrants have come to North Carolina to stay, said Dr. E. Richard Brown, director of the UCLA Center for Health Policy Research and a professor of the UCLA School of Public Health.

"This is not just a population that's dropped in for a while to work then leave, but that people are forming established communities in the state," he said.

The study said an estimated 300,000 illegal immigrants lived in North Carolina in 2004. Like many states with once-small immigrant populations, North Carolina is not among the nearly two dozen where lawmakers have decided to provide recent immigrants, and pregnant women and children who are illegal immigrants, with additional health care coverage.

Brown said several studies have shown taxpayers can save about $3 for every $1 spent on prenatal care.

"The resulting births are going to be to U.S. citizens, children, and why wouldn't we want to have our citizen children and immigrant children be as healthy as we can make them be?" said Brown, who was not involved in the North Carolina research.

Offering preventative care makes sense if illegal immigrants are going to be allowed to remain in the United States, said Steven Camarota, director of research at the Washington-based Center for Immigration Studies, which supports enforcement of the nation's existing immigration laws.

"The question is should we let them stay," he said. "Either you enforce the law and cause the illegals to go home or you stop complaining about the cost."