A Crackdown on
Newborns
EDITORIAL, NYTimes on
the Web. November 11, 2006
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.
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