Court Upholds Decision to Bar Prenatal Care for Illegal Immigrants

Pregnant immigrant women illegally in the United States do not have the right to Medicaid-provided prenatal care, although their U.S.-born children are automatically entitled to Medicaid benefits for their first year, the U.S. Second Circuit Court of Appeals in Manhattan ruled Tuesday. The New York Times reports that the ruling overturned a 1987 federal district court decision that required the federal government to provide prenatal care for illegal immigrants. The appeals panel based its decision on a 1996 federal overhaul of welfare laws that contained "explicit language barring prenatal care just for illegal immigrants," part of an effort to limit immigration by reducing benefits. Without such action, the appeals court, which sent the case back to a district court judge, said, "We conclude that the denial of prenatal care is not unconstitutional. However, we also conclude, in agreement with the district court, that citizen children of alien mothers are entitled to automatic eligibility for Medicaid benefits for a year after birth."

To ensure that children receive their year of benefits, the judges proposed the "unusual procedure" of permitting pregnant illegal immigrants to apply for a Medicaid number for their future child. It is "not immediately clear" when the ruling will take effect, but New York State officials said that it is possible that the Legislature may pass a law permitting state funding of prenatal care for illegal immigrants, as the ruling applied only to federal financing. The appeals court ruling means that more than 13,000 illegal immigrants per year will not receive prenatal care in the state of New York, saving the $30 billion state Medicaid program $15.5 million per year. However, a New York State Department of Health study noted that the birth of a low-weight infant, a risk when women do not obtain sufficient prenatal care, results in costs of $10,000 to $65,000 in addition to the costs of any long-term disabilities linked to some birth defects. This cost is compared to $1,200 for the birth of a healthy baby (Wakin, New York Times, 5/23).