Oklahoma Divided Over Legality Of Medicaid Coverage For Prenatal Care

The CEO ofthe Oklahoma Health Care Authority and a state lawmaker remain spliton whether using state Medicaid funds to provide prenatal care services toundocumented immigrants will jeopardize federal funding for the program, the Oklahoman reports (McNutt, Oklahoman,4/2).

The department last fall approved a rule allowing undocumented pregnant womento receive prenatal care as long as their infants become citizens upon birth. Statesare required by federal law to pay for emergency labor and delivery services ofundocumented women, who do not qualify for other Medicaid services. The ruletook effect at the start of the year. Under the rule, undocumented womenreceive coverage for prenatal care services that are needed to protect thehealth of the fetus. The women still do not qualify for full Medicaid benefits,according to officials. At least 12 other states, including Texasand Arkansas,have similar regulations (Kaiser HealthDisparities Report, 10/12/07).

State Rep. Randy Terrill (R) contends that the rule should have been reviewedand approved by legislators and not the health authority. He said, "As aresult, the Oklahoma Health Care Authority may soon be committing Medicaidfraud by billing the federal government for services provided to [undocumentedimmigrants] that the Legislature never authorized." He said that providingfederally funded prenatal care services to undocumented immigrants sets adangerous legal precedent because it does not clearly define the concept of"personhood" versus "citizenship." Terrill added that therule could cost the state millions of federal dollars. Terrill and state Rep.John Wright (R) have filed a measure to overturn the department's rules.

A state immigration law, written by Terrill, states that the department cannotprovide medical services to an undocumented immigrant over age 14. However,Mike Fogarty, CEO of the department, said that the law does not specify if theregulation applies to prenatal services, adding that the agency "hasspecific federal approval and encouragement to reimburse health care providersfor prenatal care services to unborn children regardless of their mother'sdocumentation status." The federal SCHIP program defines a child as anindividual from conception to age 19, according to the Oklahoman. Inaddition, the program defines child health assistance as including prenatalcare services, Fogarty said. "The Bush administration recognized thepositive public policy associated with providing prenatal care for these babiesand began encouraging states to adopt this option in 2002," he said (Oklahoman,4/2).

Reprintedwith permission from kaisernetwork.org. You can view the entire Kaiser Weekly Health Disparities Report, search the archives, and sign upfor email delivery at kaisernetwork.org/email . The Kaiser Weekly HealthDisparities Report is published for kaisernetwork.org, a free service of TheHenry J. Kaiser Family Foundation.