Although thankful that the governor restored some money for prenatal care for immigrant women, legislators and advocates said yesterday that other cuts to an immigrant health program will cost taxpayers millions more in emergency room visits and other expensive treatment.
Lawmakers said they expect yesterday's joint hearing of the House and Senate subcommittees that oversee state Medicaid spending to be just the beginning of an effort to have the administration restore more of the $7 million program to provide health care for children and pregnant women who are in the country legally but are not citizens.
Just days after announcing that the state has a $1 billion surplus, Gov. Robert L. Ehrlich Jr. decided last week to comply with the legislature's request that he restore $1.5 million to pay for prenatal care.
But that money will cover only women in the program before July 1, and immigrant advocates said yesterday that leaving other women out will increase the risk that their babies - who are automatically U.S. citizens at birth and thus eligible for traditional Medicaid - will suffer from costly medical problems that could have been prevented with proper prenatal care.
"This is a penny-wise, pound-foolish decision," said Dr. Ulder Tillman, the health officer in Montgomery County, where most of the women and children in the program live. "It is clear that ultimately with these women and children excluded from non-emergency care, they will be a burden on other health-care providers and emergency rooms, and therefore we will all end up paying more."
S. Anthony McCann, secretary of the state Department of Health and Mental Hygiene, said he regretted that budget constraints forced the cuts to the immigrant health care program, which the state has funded since the federal government dropped the coverage in 1996.
But he said the administration concluded that many of the immigrants could be served by other programs. Also, he said, legal immigrants are required to have sponsors in the United States who sign affidavits promising to support them, including paying for medical care and paying back the government if the immigrants take advantage of programs for the poor, such as Medicaid.
Republicans on the panel backed the administration. Del. Adelaide C. Eckardt, an Eastern Shore Republican, said that immigrants are often diligent about saving money or sending it back to their home countries, and that the government should "look at alternative ways to bring in personal responsibility" rather than giving immigrants benefits.
Jonathan Blazer, a lawyer at the National Immigration Law Center in Washington, said he has never heard of a state trying to enforce the affidavits. Most sponsors are family members, who often don't have much money, he said, adding that enforcement of financial support requirements is difficult.
Among the 18 states with the largest immigrant populations - which includes Maryland - only Arizona and New Mexico offer no health care coverage for legal immigrant children and pregnant women, Blazer said.
In Washington state, officials eliminated those programs a few years ago, but costs went up as immigrants experienced more expensive problems, he said. Subsequently, Washington restored programs and expanded access to them, Blazer said.