PIERRE | South Dakota legislators deadlocked last year on providing prenatal care to pregnant women who are poor and not U.S. citizens.
One year and 195 births later, the issue is back and the outcome seems just as uncertain.
The House of Representatives voted 46-22 in favor on Feb. 10. The Senate Health and Human Services Committee voted 4-3 Wednesday to endorse the legislation’s passage and referred it to the Senate Appropriations Committee for budgeting purposes.
The average cost of prenatal services to pregnant women under South Dakota’s Medicaid program is about $3,400, according to state officials. That is about 80 times less than the average cost for a prematurely born baby in South Dakota.
The goal of expanding the prenatal services is to help the mothers and children be healthier and reduce premature deliveries. Premature birth is the leading cause of death for infants in the state.
Gov. Dennis Daugaard supports HB 1158, according to Deb Bowman, one of his senior aides.
But Bowman recommended the bill be sent to the appropriations committee because provisions of the state Medicaid plan typically aren’t put in state law for flexibility reasons.
“I don’t want to hurt the bill at all,” she said.
Normally, Medicaid help isn’t available for people who are in the U.S. illegally. But if the children are born here they become citizens and are eligible for government programs.
Sen. Jim Bradford, D-Pine Ridge, asked how mothers will get over their fear against coming forward.
“I wish I had a really great answer for you, senator. I don’t,” Bowman said.
Federal law, however, prohibits Medicaid providers and officials from reporting people if they’re here illegally, she said.
The bill’s prime sponsor is a doctor, Rep. Scott Ecklund, R-Brandon. He said statistics show there will be large savings if there is more prenatal care.
“My goal is to get lives saved,” Ecklund said. “We’re losing six kids a year that are U.S. citizens if you look at statistics by not doing this.
“This does not make a statement on either side of the immigration debate,” he said. “I am not for illegal immigration.”
The House passed a similar bill in 2013 on a 39-28 vote.
But the legislation was changed by the Senate to provide broader Medicaid coverage to pregnant women with incomes up to 140 percent of the federal poverty level. The House and the Senate couldn’t agree and the legislation died.
House Democratic leader Bernie Hunhoff of Yankton testified Wednesday for Ecklund’s bill and complimented the Daugaard administration for its efforts on infant mortality.
“You’ve got a bill before you today that can make a difference,” he said.
Rep. Manny Steele, R-Sioux Falls, an illegal-immigrant opponent, also spoke up for the bill.
“We’re going to be responsible because this baby is going to be born here,” said Steele, adding that the legislation is logical as a matter of compassion and as a savings to the public.
No opponents testified.
Sen. Phil Jensen, R-Rapid City, proposed that the legislation go to appropriations without recommendation.
“We really do not know how much this is going to cost,” he said. “I think that would be a right move.”
A fiscal note hasn’t been prepared yet by the Legislative Research Council. The 2013 fiscal note estimated costs at $241,777 in state general funds and $286,119 in federal Medicaid funds.
Bowman explained the expanded Medicaid coverage would be only for pregnancy-related matters and wouldn’t pay for unrelated health problems such as a broken arm.
All seven members of the health committee agreed with sending the bill to appropriations. They split on whether to endorse it. Jensen’s motion for no-recommendation fell short 3-4. The committee then voted 4-3 to endorse its passage.
“We want this to go through. We just need to do the details on it,” said Sen. Jean Hunhoff, R-Yankton, chairwoman of the Senate health committee.