Arkansas To Expand Medicaid Prenatal Care Coverage to Immigrant Women by Defining Fetuses as ‘Children’

Arkansas is changing the definition of a "Medicaid-eligible child" to include fetuses to allow prenatal care coverage under its SCHIP program, the Arkansas Democrat-Gazette reports. Under current state rules, undocumented immigrants and documented immigrants who have been in the United States for less than five years are not eligible to receive benefits from the state for prenatal care and other medical services, leading many to seek care at local health department units, the Democrat-Gazette reports. However, budget constraints and the growing number of uninsured people in the state have made it difficult for the local health centers to provide prenatal care to all of the women who need it, according to the Democrat-Gazette. Under the new guidelines -- which will go into effect July 1 -- an estimated 800 to 1,000 immigrant women in Arkansas are expected to receive prenatal care each year (Smith, Arkansas Democrat-Gazette, 4/26). The change was made under a regulation issued by Bush administration officials in September 2002, which permits states to define fetuses as "unborn children" eligible for health coverage under SCHIP. The new rule eliminates the need for federal waivers by clarifying the definition of "child" by saying that states can include coverage for children "from conception to age 19." Under the rule, states also can extend SCHIP coverage to the fetuses of undocumented immigrants (Kaiser Daily Health Policy Report, 6/13/03). Illinois, Massachusetts, Michigan, Rhode Island, Minnesota and Washington also have opted to provide prenatal care under the rule, according to Center on Budget and Policy Priorities Outreach Director Donna Cohen Ross, the Democrat-Gazette reports. The new program could cost the state Medicaid program $1.3 million if the maximum 1,000 women expected to participate do so, according to the Democrat-Gazette. "It just makes good sense," Bob Trevino, state director of the League of United Latin American Citizens, said, adding, "[W]omen who don't get proper prenatal care are at large risk." It costs about $1,800 for an infant to spend one day in intensive care, although it costs Medicaid $1,300 to cover prenatal care, delivery and postpartum care for a pregnant woman, Roy Jeffus, director of Arkansas Medicaid, said. However, abortion-rights advocates fear that the change is meant to "elevate the status of the fetus and infringe on a woman's right" to choose an abortion, according to the Democrat-Gazette. Under the plan, a fetus "would have different rights than the woman carrying it," Wanda Stephens, president of the Arkansas chapter of the National Organization for Women, said, adding, "This is another underhanded anti-woman attempt to make a [fetus] a person" (Arkansas Democrat-Gazette, 4/26).