The Buzz: Non-citizens to lose benefits
Wednesday, June 11, 2008
By Grace Hammond
Jackson Hole, Wyo.- In less than one month, pregnant women living in Wyoming will have something to prove: citizenship.
Beginning July 1, state public health offices can no longer grant uninsured pregnant women temporary access to prenatal benefits through EqualityCare, the state Medicaid program, without first determining U.S. citizenship.
Public health and social service employees met Friday in Jackson to address this change in policy, which one called “a crisis,” and another deemed “just sad.”
“It’s really concerning from a lot of people’s perspectives,” said Kathy Watkins, a certified nurse-midwife in Teton County. “We worry not just for the women, but for the [health] providers who will lose funding.”
When the change takes effect statewide, non-citizens will lose access to “presumptive eligibility,” a classification that provides pregnant women who meet financial guidelines with 60 days of state-funded prenatal care while their EqualityCare applications are being processed.
More than 150 women a year, on average, are granted Presumptive Eligibility (PE) in Teton County, said Terri Gregory, public health manager for Teton County Public Health. Some are ultimately denied EqualityCare benefits – sometimes due to lack of U.S. citizenship – but the PE classification allows them access before the denial is issued to one or more prenatal visits, including ultrasounds and lab work.
Some women wait until they are late in their pregnancies to apply for PE to avoid the cost of further visits if denied EqualityCare, Gregory said.
Many states have adopted citizenship requirements for PE in order to close what state and federal legislators call a loophole. EqualityCare administrators say they are only trying to follow federal regulations.
“Wyoming has delayed doing this for a while,” Gregory said. “There’s more pressure from the federal folks now. And Medicaid dollars only go so far.”
Doctors, obstetricians, gynecologists and hospitals are reimbursed directly by the state for services rendered under the PE classification, and they will be hard-hit by the new ruling, said Vida Sanchez, director of El Puente.
“In my opinion, the most significant burden falls on the already stressed current providers of prenatal care,” she said.
The Centering Pregnancy Task Force, formed in Teton County, aims to create alternatives for women affected by the change and “a solution that could be a model for the state,” Watkins said. The task force is seeking funding to provide group prenatal care on a sliding scale to financially eligible women, regardless of citizenship status.
Centering Pregnancy is a national model used with “real success” across the country, Gregory said. “Our hope is that by July 1, we’ll be ready for people to enroll. But that’s coming pretty fast.”
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