Increasing Number of Undocumented Pregnant Women Financially Straining Philadelphia-Area Maternity Care System, Officials Say
The "small but increasing" number of pregnant, undocumented immigrant women in the Philadelphia area is adding a "financial stressor" to the region's "strained" maternity care system, according to health officials, the Philadelphia Inquirer reports.
According to the Inquirer, although "inadequate" Medicaid reimbursements and high malpractice insurance costs are "big problems" facing the region's maternity care system, "poor funding" for undocumented women is "rising in importance." Medicaid funding covers emergency services but not prenatal care for undocumented women, which leaves doctors and hospitals in a "quandary" of whether to subsidize prenatal care or risk "bigger problems" when undocumented women arrive at the emergency department, the Inquirer reports.
Pregnant women typically receive about 12 prenatal visits and two ultrasounds, Barbara Hand, infant health coordinator for the Montgomery County Health Department, said. Undocumented immigrants might receive these services through a "mishmash" of programs subsidized to varying degrees by hospitals, obstetricians and governments in the region, the Inquirer reports.
Four city health systems provide care at no cost at Philadelphia health clinics. Undocumented women make up 60% to 65% of the nearly 3,000 prenatal patients treated at the city health clinics annually, Kate Maus, director of Maternal, Child and Family Health at the Philadelphia Department of Public Health, said, adding that eight years ago "all of [the patients] were insured." Jack Ludmir -- chair of obstetrics and gynecology at Pennsylvania Hospital -- also noted that the percentage of women in Philadelphia who did not provide a Social Security number after giving birth rose from 4.8% in 2003 to about 7% to 8% this year.
The Montgomery health department is providing two suburban hospitals grants of $800 per patient for pregnant women who are ineligible for Medicaid -- "overwhelmingly" undocumented immigrants, the Inquirer reports. Philadelphia has been paying doctors at city clinics $450 per patient until the money runs out.
Maus said she knows that the city's payments are insufficient and that the department is working to develop a new payment system, the Inquirer reports. According to Maus, the previous system for the city assumed Medicaid beneficiaries would subsidize the uninsured; however, today nearly all pregnant patients in some clinics are undocumented (Burling, Philadelphia Inquirer, 7/8).