State sued over prenatal services

LINCOLN — Eight months pregnant and with a history of gestational diabetes, an Adams County woman faces birth complications and brain and heart defects in her baby.

She went to court Thursday seeking to reverse the state’s decision to end government-paid, prenatal services for illegal immigrants and some other low-income women.

The 38-year-old woman, identified as “Jane Doe” in court documents, is one of about 1,550 pregnant women who lost prenatal services as of March 1.

In a lawsuit filed on behalf of these women, the Nebraska Appleseed Center claimed the state is required to provide such services for unborn children under its Children’s Health Insurance Program, or CHIP.

The Appleseed Center feared there would be cases like “Doe,” in which poor women, with no prenatal care, would face higher-risk deliveries and greater chances of birth defects for their children, said Becky Gould, the center’s executive director.

While some public health clinics and hospitals in the Omaha, Lincoln and Columbus areas have “stepped up” to provide care for the women, “once you get out of those areas, there really isn’t any access to this kind of health care,” Gould said.

“(This decision) was a step backwards for the future of our state and stands in contradiction to the policy adopted and maintained by the Nebraska Legislature over the last 30 years,” Gould said, adding that all children deserve a healthy start.

Spokeswomen for Gov. Dave Heineman and Attorney General Jon Bruning declined comment Thursday. A spokeswoman for the Nebraska Department of Health and Human Services, which shut off the coverage, said the agency has not had a chance to review the lawsuit.

The prenatal care issue was one of the most emotional in the 2010 legislative session.

Some framed it as a “right to life” issue, saying vital health-care services should be provided to unborn babies regardless of their mothers’ immigration status. A handful of women told physicians this spring they planned to get abortions rather than face a pregnancy without prenatal care.

Others framed it as a fiscal issue, saying such low-cost, preventive care would save thousands and perhaps millions in taxpayer dollars later by preventing birth defects and complicated deliveries. Such babies, who are citizens at birth, are eligible for tax-funded Medicaid.

Heineman and others framed it as an immigration issue, saying state funds should not be used to aid illegal immigrants.

In the end, the Legislature didn’t restore the services but pledged to monitor the situation.

Doe, a working mother with three children, had gestational diabetes in her last two pregnancies.

The condition is easily treated, but if left unchecked, it increases the risks of stillbirths, brain and heart defects, and larger-than-normal babies that require expensive caesarean section deliveries to avoid injury to the baby and mother.

With an income of $16,000, Doe could not find affordable prenatal care privately in central Nebraska, and she was turned down last month for state-funded services.

“She hasn’t been able to see a doctor,” Gould said. “She’s obviously very concerned about what that meant for her and her unborn child.”

Appleseed asked a judge Thursday to issue a temporary injunction that would serve to reinstate the dropped prenatal care. Lancaster County District Judge Karen Flowers gave state attorneys until Monday to file their response.

Attorneys also asked Flowers to allow the lawsuit to proceed without identifying Doe because of a “growing climate of hostility” toward immigrants in the wake of anti-immigration laws being adopted in Fremont, Neb., and the State of Arizona.

Court documents indicated that Doe is an immigrant who is legally in the country after obtaining a U Visa because of continuing domestic abuse.

That status, however, was not sufficient to qualify her for state-funded prenatal care, a July 14 notice from HHS stated:

“In order to qualify for Medicaid, you have to be a Citizen or a Lawful Permanent Resident of the USA. You only have an authorization to work.”

World-Herald staff writer Martha Stoddard contributed to this report.

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