Study Looks at Medicaid Impact of Immigrant Emergency Care

CHAPEL HILL, N.C. — Whether immigrants are in this country legally or not, they are ineligible for Medicaid in North Carolina if they have been in the United States for fewer than five years.

They can get some coverage for health emergencies, however.

Researchers at the University of North Carolina at Chapel Hill looked at how much Medicaid money is spent that way, and the Journal of the American Medical Association has published their findings.

UNC researcher and family physician Annette Dubard treats a lot of Latino immigrants. She studied state Medicaid spending on emergency care for immigrants.

The study tallied state emergency Medicaid spending from 2001 to 2004 and found it increased from $41 million to $53 million. The program served 48,000 immigrants.

Dr. Dubard said some people might think it's a lot of money, but she added, “It's important to keep in perspective that this accounted for less than 1 percent of total Medicaid spending in North Carolina.”

“Nine out of 10 were pregnant women receiving care for labor and delivery or for emergency complications of their pregnancies,” Dubard said.

The immigrant women in the study had no coverage for prenatal care except in emergency rooms. Spending for elderly and disabled immigrants increased at a faster rate, however. If they weren't immigrants, they might be able to get coverage through Medicare instead of using Medicaid dollars.

“We are spending at the wrong end of care, and we could stretch the health-care dollar further by emphasizing preventive care,” Dubard said.

Mariela Hernandez, one of Dubard’s patients, came from Mexico as a child. She said she has many friends who struggle to get health care.

“The way to help would be to have the insurance not to be so expensive,” Hernandez said. That would help more immigrants access and help pay for health care, she added.