http://www.nytimes.com/2006/11/11/opini ... ref=slogin

A new crackdown on Medicaid fraud is forcing states to follow the letter of the law to a harsh and dismal place. Under orders from the Bush administration, they are erecting unnecessary paperwork obstacles that could deny medical care to poor newborns in the crucial first weeks and months of life.

This development is a side effect of the nation’s sour immigration debate. Since July, federal law has required that Medicaid recipients prove citizenship with passports, birth certificates or other documents. The goal is to prevent “theft of Medicaid benefits by illegal aliens,” according to the legislation’s main sponsor, Representative Charlie Norwood, a Georgia Republican who has worked tirelessly to make life in the United States as difficult as possible for people who lack papers.

Illegal immigrants have no right to Medicaid, except in emergencies, which includes labor and childbirth. Perinatal care given to illegal immigrant women has routinely been extended for a year to their newborns, too, on the simple assumption that they need it and are automatically entitled to it, if they were born here. (The 14th Amendment grants citizenship to “all persons born or naturalized in the United States.”)

But now, in a pointless exercise of bureaucratic obstinacy, these children will have to prove what is already self-evident. They must receive a birth certificate and have a Medicaid application approved before receiving a doctor’s care. This could take days, weeks or months — a critical time for newborns, who receive a barrage of immunizations and well-baby checkups in the first year. Some babies may get no care at all, if their noncitizen parents, fearing arrest and deportation, decide not to seek it.

That the children of illegal immigrants can be blessed with citizenship by accident of birth sticks in the craws of many immigration hard-liners. They include members of Congress who have voted to challenge the Constitution’s citizenship clause, saying they want to stop women from sneaking over the border to have babies.

No doubt many pregnant women and new mothers are among the estimated 12 million illegal immigrants in this country. But to demonize them all — and to punish their babies — is to take the immigration debate into depths of cruelty and paranoia.

Medicaid rules should be enforced in a way that is strict but fair and sensible. Turning more illegal immigrants away from the health care system may bolster short-term budgets and satisfy a thirst for righteousness. But if building new barriers to basic care ends up filling emergency rooms with ever-sicker immigrants — and their citizen children — then the effort will have been a sorry example of self-defeating spite.