Thread: FREE MEDI-CAL FOR ILLEGALS : LOS ANGELES TIMES

Delivering dual benefits

Medi-Cal spends about $400 million a year on birth-related care for illegal immigrants. Private hospitals gain.

By Evelyn Larrubia,
Times Staff Writer
11:09 PM PST, December 22, 2006

Sandra Andrade lay in her hospital bed, overcome with anxiety about her newborn son.

All through her pregnancy, she had worried. The placenta was blocking her birth canal and growing into other organs. She knew she needed a Cesarean: If she went into labor, she might bleed to death.

Now her boy was in intensive care at Women's and Children's Hospital at Los Angeles County USC Medical Center. With his future — and her own recovery — on her mind, Andrade, 36, was relieved to be spared at least one worry: Who would pay for their care.

She'd been without private insurance since the premiums became too costly. But a friend assured her that, even as an illegal immigrant from Colombia, she would qualify for Medi-Cal, the state and federal health insurance program for the poor.

Andrade, a clothing exporter, is one of more than 100,000 undocumented women each year who bear children in California with expenses paid by Medi-Cal, according to state reports. They now account for about one in five births.

Regardless of their parents' status, the children are American citizens by law.

Many illegal immigrants who might otherwise shy away from government services view care associated with childbirth as something they can safely seek, a protected right.

"I wasn't afraid at all," said Andrade, who came to the United States with her daughters on a tourist visa and stayed here with her boyfriend after it expired. "I'd always heard that pregnant women are treated well here."

California long has been one of the more generous states in offering such benefits, covering everything from pregnancy tests to postpartum checkups for impoverished illegal immigrants.

'Birthright' citizenship

Such births and associated expenses account for more than $400 million of the nearly $1 billion that the program spends each year on healthcare for illegal immigrants in California, documents and reports show. Only about a dozen other states extend similar benefits to illegal immigrants, according to health and immigrant rights groups.

Although it has not so far figured prominently in the national discussion of immigration reform, a debate is simmering about the costs — and the rights — of illegal immigrants' American-born children.

Some advocates for immigration control want to abolish automatic or "birthright" citizenship for babies born to undocumented women in the United States. They consider it just the first in an unacceptably long line of public benefits flowing to children who were born here only because their mothers broke the law.

"I think most Americans think that — while they certainly don't want to do anything to harm children — you cannot have a policy that says anybody in the world come here and have a baby and we have a new American," said Ira Mehlman, a spokesman for the Federation of American Immigration Reform, an immigration control group based in Washington, D.C.

One of the most controversial aspects of coverage has been prenatal care. Labor and delivery long have been considered emergencies, entitled to some federal reimbursement. But federal officials have balked at covering prenatal care since at least the 1980s. (Generally, the state and federal governments share the cost of Medicaid programs — called Medi-Cal in California.)

In 1989, California passed a law guaranteeing prenatal care to all impoverished women, with the state footing the bill. Last year, it began to tap federal funds dedicated to healthcare for working families, under the theory that the fetus would ultimately be an American child. Some other states have done the same.

Those who favor such coverage say it's cheaper to pay for prenatal care than risk complications that could saddle the U.S. government with staggering medical bills.

An often-cited 1985 study by the Institute of Medicine found that every dollar spent on prenatal care saved more than $3 in medical costs by reducing the number of underweight babies and other problems.

'A serious risk'

"Without prenatal care, there's a serious risk that a child will be born with severe disabilities," said Lucy Quacinella, a lobbyist for the Los Angeles-based social service nonprofit group Maternal and Child Health Access. "The cost of caring for that child over a lifetime is astronomical when you compare the cost of having provided the prenatal care for the mother."

Investing in pregnant illegal immigrants and their children is no small undertaking.

Births and prenatal care are the biggest single outlay by Medi-Cal for illegal immigrants' healthcare, with the rest going for various other emergency treatments, limited breast and cervical cancer treatment, abortions and some nursing home care, according to the state.

In Los Angeles County's public and private hospitals, undocumented women accounted for 41,240 Medi-Cal births in 2004, roughly half the deliveries covered by the public program.

In the four county-run hospitals alone, undocumented women and their newborns will receive more than $20 million in delivery, recovery, nursery and neonatal ICU services this year, according to a county estimate.

State figures indicate that regular births and prenatal and postnatal care cost an average of $3,224 and Caesarean deliveries $5,153.

But complications can cost tens or even hundreds of thousands of dollars.

Andrade's son, for instance, spent 10 days in an incubator. County officials said it costs about $3,000 a day to care for an infant in a neonatal intensive care unit.

Whatever the costs, some immigrants and their advocates insist that they can't be considered in a vacuum.

Illegal immigrants contribute to the economy in the form of cheap labor, as well as sales and payroll taxes, including payments to Social Security, which many will never collect.

'I didn't pay anything'

"My husband pays taxes. They take a bunch out of his paycheck," Ludys Ortiz, 36, said as she nursed her newborn son Christian at Women and Children's Hospital, down the hall from Andrade.

Her husband works for $12 an hour washing cars at a body shop.

Ortiz, who entered the U.S. illegally in 2004 from Honduras, worked as a caretaker for children and the elderly, then as a house cleaner.

The pregnancy was unexpected.

"I am embarrassed because I'm not from here, I didn't pay anything and they delivered my baby without my having to pay anything," she said.

"But I'm more grateful than ashamed, because there's no sin in asking for help, only in stealing.

"We all have some rights in life. No matter what, we're human beings," she added. "The only thing that divides us is a few pieces of paper."

Ortiz, who was caught by immigration authorities in Texas shortly after her arrival, is not planning to stay in the U.S., however. She said she desperately misses her daughter in Central America and will tell the judge she wants to go home, taking her son with her. Her family's mission in the U.S. was accomplished: earning enough money to build a tile-roofed house in the Choluteca province of Honduras.

In at least one sense, births to illegal immigrants contribute to the U.S. economy, or at least to hospitals that serve a large number of poor patients.

The federal government pays them a subsidy: For each Medi-Cal birth, hospitals can count two patients — mother and child — substantially boosting compensation for relatively inexpensive procedures.

Medi-Cal "pays even more than insurance" for obstetrics, said Gary Wells, chief financial officer of the Los Angeles County Department of Health Services.

Courting patients

As a result, some private hospitals have expanded their delivery wings in the last decade or so, advertising their services on billboards and fliers.

"At one time, there was a billboard next to County-USC encouraging expectant mothers to come to White Memorial," a nearby private medical center, Wells said.

Los Angeles County public hospitals — once so overwhelmed with deliveries that some women underwent labor in hallways — now are quiet. Most recovery beds at Women and Children's Hospital were empty during two visits this fall.

As the county hospitals slowed down, private hospitals — and the clinics that feed to them — became swamped. South Central Family Health Center sends patients mostly to California Hospital Medical Center in downtown Los Angeles, which delivers more than 4,000 Medi-Cal babies a year.

Pregnant women enter the nonprofit community clinic by the dozens on Monday afternoons, when three family doctors and a nurse provide prenatal care.

On one recent Monday, Dr. Kathryn White saw 11 patients in the afternoon, at least seven of them illegal immigrants.

One after another they came, needing care for gestational diabetes, anemia, a heart murmur and urinary tract infections. One returned to check her biopsy report. By 4 p.m., White was on her eighth patient and she'd stopped worrying about time.

"I'll give her a full physical," she said, almost to herself, after a teen reported some bleeding. "What am I going to do, give her an appointment for another slot I don't have?"

In some ways, this clinic's full load is a sign of progress in public health. In Los Angeles, 90% of women receive prenatal care in their first trimester, up from 81% in 1996. For Latinas, who make up the vast majority of undocumented women, the figure is 89%.

Undocumented women who rely on Medi-Cal during pregnancy often express gratitude. Some say they feel a bit guilty, but shame seldom enters the conversation, even when the recipients are from a middle-class background.

"What I think is that we're all immigrants in this country…. Those who were born here are merely children of immigrants, which doesn't give them the right to say that the rest of us don't have the rights," said Sandra Escobar, a Salvadoran who came to the U.S. illegally with her accountant husband to escape the collapsing economy and who unexpectedly became pregnant.

"My son will always be the child of an immigrant," she said, gazing at the moon-faced newborn she was nursing at Women and Children's Hospital.

Limited coverage

For many undocumented women, pregnancy and child birth will be the only time in their lives they'll qualify for Medi-Cal or any other state subsidized medical care.

Petra Escobar, a 35-year-old Mexican immigrant who has been living in the United States illegally for 20 years, developed high blood pressure in May while pregnant with her third child. Twice, it shot so high she had to be hospitalized. After the second episode, worried doctors performed an emergency C-section to deliver her seven-month fetus. She said Medi-Cal covered both hospitalizations.

In September, three months after the birth of her son, she had another episode on a busy city street. An ambulance took her to California Hospital Medical Center.

The unemployed former garment factory worker, now ineligible for Medi-Cal, said she received a prescription for a blood pressure medication that costs $100 a month and a bill for $45,000.

It may have to be written off by the private hospital as charity care.

"I don't have that kind of money," she said, arching a brow and showing an empty hand.

http://www.latimes.com/news/local/la-me ... -headlines


--------------------------------------------------------------------------------
evelyn.larrubia@latimes.com



Dr. Kathryn White, center, checks paperwork at the South Central Family Health Center, a nonprofit community clinic that provides care for the working poor and uninsured residents of South-Central Los Angeles. It refers most of its pregnant women to California Hospital Medical Center for childbirth. On one recent Monday, White saw 11 patients in the afternoon, at least seven of them undocumented.

State figures indicate that regular births and prenatal and postnatal care cost an average of $3,224 and Caesarean deliveries $5,153.

Where in the heck are they getting that figure? The most recent numbers I've seen was 10k for a normal birth and up to 20k for a Ceasarean. Ask anyone that has recently had a baby what it cost.

Also, the federal gov. is about to quit sending money to the states, to cover cost for illegal aliens.

Dixie

Well my last child was in 2004 in Florida (not c-section) and the hospital bill, just the hospital not the doctor, was $13,000. I think they are fudging the numbers.

I am tired of these illegal criminals being provide health care that even American poor cannot get especially the working American poor. Parasites!

In a way, it is STEALING from the system. They are fully aware of what that can get from this country and what it means to have an "anchor baby."

In a way, it is STEALING from the system.

Of course they are stealing from the system - that system being US, every tax-payer. And they simply do not care.

And to say that they have a God-given right to free medical care while our tax dollars pay for this even though other poor citizens without health insurance cannot get care? And, well, we are all just immigrants anyway?????

These people will talk themselves into anything to justify the fact that they are STEALING!

Dixie, your newest nutcracker looks like she is screaming, which is what I want to to do!

SAME STORY IN THE NORTH COUNTY TIMES BUT TONED DOWN

Medi-Cal pays for over 100,000 births by undocumented women

By: North County Times -

LOS ANGELES (AP) -- More than 100,000 undocumented women each year bear children in California with expenses paid by Medi-Cal, according to state reports.

http://www.nctimes.com/articles/2006/12 ... 122509.txt

Comments On This Story

Note: Comments reflect the views of readers and not necessarily those of the North County Times or its staff.

Skip wrote on December 24, 2006 9:33 PM:"Before anyone makes any nasty or racist comments on Christmas Eve, don't bother. California has lots of Money."

Dixie wrote on December 24, 2006 9:34 PM:"Where in the heck are they getting that figure? The most recent numbers I've seen was 10k for a normal birth and up to 20k for a Ceasarean. Ask anyone that has recently had a baby what it cost. Also, the federal gov. is about to quit sending money to the states, to cover cost for illegal aliens. "

Crusader wrote on December 24, 2006 9:36 PM:"I am tired of these illegal criminals being provide health care that even American poor cannot get especially the working American poor. Parasites!"

Adam wrote on December 24, 2006 9:38 PM:"Proof positive that the Average California Taxpayers are Subsidizing the Illegal Alien crisis whether they want to or not."

DMann wrote on December 24, 2006 9:54 PM:"Just More Costs of illegal immigration, great job washington. Your suppose to help Americans, NOT Canadians, Frence, German or Mexican. We are the greatest country on the planet, so why are we Mexicos bitch? Again, good job Washington."

Press 1 for English, Press 2 for Deportation wrote on December 24, 2006 10:26 PM:"Why is there even a debate on whether illegals should be given free medical care? They shouldn't be here. The US government should keep track of how much of MY tax money it spends on each illegal's babies, then send a bill for that amount to the country from which the illegal came. It is not the obligation of the US government to treat people from another country."

mindless reproduction wrote on December 24, 2006 11:15 PM:"Does anyone ever think of birth control?"

Out Out OUT wrote on December 24, 2006 11:42 PM:"Enough is enough. The fact is clear, they are draining all the financial resources of hard working citizens of this state. The pregnant ILLEGAL immigrants need to go back to their own country and have their babies. This has got to stop right now. There should be no remorse, no excuse, no reason to give them any benifit whatsoever. They need to be denied help, if it is an absolute emergency then the reimbursement needs to be collected promptly and in full, every penny, the full cost, not discounted or any silly thing like that."

Getting in deeper and deeper: wrote on December 25, 2006 1:45 AM:" Sometimes it seems that the American people are standing up against their own country and are working very hard to achieve its undoing and demise. First it isn't CA money alone - is Federal dollars also. Second it all is really my money and that of illegal citizens. Third the people of the United States raises up and shouts aloud when our government releases the news that they are going to spend 100 plus more billion on the war in Iraq. That money will help get that war over with and save American lives. But, here we are giving over 400 billion a year for the medical care for illegal aliens that have not earned it. It is not a matter if investing in illegal alien medical care. It is a matter giving away the country. Take a look at the National Debt. Who do you think that money is owed to - other countries of course? We are getting it from three sides by our government representatives – the war, illegal aliens, and to pay for those two, in our economy. And those that stand up for giving away the country will be the first hurt when our economy fails - which is not but a few years away if we continue as we are. Wise up! Send the illegal aliens back to their own countries to work and fight for their rights."

Is this news? wrote on December 25, 2006 2:18 AM:"Duh! I am just waiting for someone to use the 'r' word!"

Send this article wrote on December 25, 2006 5:05 AM:"to all your Congressmen and Congresswomen. Put the pressure on the State of California and Washington DC that we want the invasion stopped. "

Let's try compassion wrote on December 25, 2006 7:29 AM:"In 1990 due to personal reasons I found myself pregnant, homeless, and ill. I had my baby prematurely, had a c-section to remove the cancer. Of course it was a long healing process. My baby and I were hospitalized for almost two months. After that I had to undergo radiation and chemotherapy. I did not have health insurance at the time and when I was admitted into the hospital a nice lady came into my room with a clipboard in hand and had me sign some forms and poof just like that I had Medi-Cal. Medi-Cal paid for all my medical expenses. Should I have been allowed to die along with my baby? Should I have been made to have my 10 year old son deliver my premature baby in my car? At times we all find ourselves in need of some help. I think we must live by the rule if not for the grace of God there go I. Merry Christmas and Happy New Year."

El Guero wrote on December 25, 2006 7:54 AM:"Fortunately, stories like this (which also ran in today's Union-Tribune) will keep amnesty, 'earned legalization,' and citizenship for illegal immigrants off the table and cause the same headaches for Democrats as they did for Republicans. The injustice of this situation is just not acceptable to anyone in his or her right mind."

Randy wrote on December 25, 2006 7:57 AM:"Has the breast of every North County woman run dry of the milk of human kindness? Have we forgotten that it is better to give than to receive? Weren't each of us brought into the world with the love of mother and father? We are talking about babies! No baby has earned anything before it enters the world. No one succeeds in anything in life apart from the grace of God. "There, but for the grace of God, go I." You are acting like selfish, greedy animals!"

To Skip wrote on December 25, 2006 7:58 AM:"Hey Skip, if California has lots of money then why are they running an annual budget defecit of $15 billion (more or less)?"

El Jefe wrote on December 25, 2006 8:15 AM:"Just stop granting automatic American citizenship to children born to illegals period & watch these numbers drop! Anchor babies granted citizenship, that is the whole incentative."

GFN wrote on December 25, 2006 8:20 AM:"Skip, California has lots of money? Are you talking about the state with a structual deficit of at least $5 billion a year? Actually, it's not this cost that is the problem, it is the fact that the illegal parents will then demand that they be allowed to stay in the US because their child is an "American Citizen"! Christmas or not, this is wrong."

Reardon wrote on December 25, 2006 9:48 AM:"I am shocked! Shocked! Duh! More than 100,000 new anchor babies, assuring the mother , father, and siblings the ability to remain -- and each to bring their Aunties and... Gosh! I wonder why our immigration system isn't working?"

Not only do we have to stop the invasion wrote on December 25, 2006 10:18 AM:"but we need to change our federal laws. The United States is the ONLY country in the world that offers FREE medical care to anyone. A friend recently suffered a heart attack while in Europe and she had to show her medical insurance to be treated. Americans are traced by their social security number and forced to either pay their bill, or file bankruptcy. Illegal aliens just go to the swap meet and buy a new number and disappear leaving the American taxpayer with the bill. They are TAUGHT to have a child as soon as they turn 18 to assure their right to stay in the US with their anchor baby. That too much change. Don't look to Senator Boxer or Senator Feinstein to do anything though. They both are PRO illegal immigration and want to give them amnesty even though it has never worked before."

fedup wrote on December 25, 2006 12:30 PM:"Once again, ILLEGALS are a drain on our rightful residents. I say deport all of them and their babies! If the United States was taking care of their own, as in Veterans, homeless, elderly, poor, etc. Then and only then should we even consider any free care to any ILLEGALS. Notice, not one singel word that is racist! Merry Christmas everyone!"

Check Your Facts wrote on December 25, 2006 12:39 PM:"Please be careful, commenters, with your facts & figures. Don't compare the UNTOLD billions of dollars the Iraqi blood-bath fiasco has cost American tax payers with the 400 million dollars spent to try & ensure the healthy birth of an INNOCENT baby. "

Insurance Bill wrote on December 25, 2006 1:49 PM:"In the new year, my insurance premiums are rising 17%! This is outrageous!"

Skip wrote on December 25, 2006 2:08 PM:"A Los Angeles Newspaper also ran a story on this same topic and the Financial Numbers they disclosed were astronomical as compared to this story. At the rate we are going we might as well just have a system of socialist health care, as we are paying for this broken system whether we like it or not. After all does anyone out there really think that these medical costs are not passed on to the California taxpayers either by increased taxes or reduced services. Why should the taxpayers subsidize Illegal Aliens while employers get a free ride? AND DO NOT FORGET THE COSTS ASSOCIATED WITH EDUCATION AND INCARCIRATION."

Say What! wrote on December 25, 2006 6:23 PM:"Maybe Skip would like to send the state a check to help pay these expenses. Every thing I hear is the state is always in the red and has to cut programs regularly."

To "Mindless Reproduction" wrote on December 25, 2006 7:48 PM:"Why use birth control - giving birth to kids in a US hospital is the ticket for these crooks to stay in this country. Oh sure there has been the occasional situation where parents have been sent back to their home country, but you can bet that's the very rare exception, not the rule. "

Dave wrote on December 25, 2006 7:59 PM:"Just back the Border Patrol Van up to the discharge door. Make sure it's equipped with a infant seat."

bob wrote on December 25, 2006 10:51 PM:"We're being robbed,,, to think working citizens without healthcare are one medical mis-hap from losing everything...Unbelievable, a broken system here and nothing gets done."

Add Your Comments or Letter to the Editor

POST OF THE DAY !

Dave wrote on December 25, 2006 7:59 PM:

"Just back the Border Patrol Van up to the discharge door. Make sure it's equipped with a infant seat."

The federal government pays them a subsidy: For each Medi-Cal birth, hospitals can count two patients — mother and child — substantially boosting compensation for relatively inexpensive procedures.

So, once again, follow the money. The only thing is--the "federal government" is the taxpayers! It's not "free" money dropping from out of the sky! Now they are tapping into money meant for working American families because the illegals' children are considered American citizens even before they are born???

And for Mrs. Ortiz--yes, she "accomplished her mission." She got enough money to build her house in Honduras, freeloaded off of the American people to deliver her baby, and now gets to go home scott free. What a deal! But, it's all ok. We're all human beings, after all. Here's another thought: her son is considered a US citizen and can come back in the future to claim his rights as an American!

Are these the people our president and politicians are telling us only want a chance to become part of our country like the immigrants in the past?

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