- Associated Press - Wednesday, April 23, 2014

SIOUX FALLS, S.D. (AP) - Some Republicans in conservative South Dakota are putting the contentious politics of immigration reform aside and backing a measure to provide prenatal care to women living in the state illegally whose children will become citizens of the United States.

Gov. Dennis Daugaard, a Republican who’s up for re-election this November, supports prenatal care as a way to prevent huge costs from babies suffering health problems after birth.

The Republican-dominated South Dakota House of Representatives has passed such a measure in each of the last two years, and seven more lawmakers voted for it in 2014 than a year ago. But the bill was never brought to a vote of the state Senate this year. Supporters vow to try again next year.

Nearly 200 babies were born in the state last year to low-income immigrant mothers. Tania Jimenez-Flores was one of those mothers four years ago. With back pain, swollen feet and general fatigue, she endured longer-than-eight-hour shifts standing in the kitchen of a Sioux Falls restaurant cooking meals throughout her pregnancy.

Jimenez was counting pennies to afford the cost of care throughout her pregnancy because she lacked health insurance or access to state-sponsored help. Every hour in that kitchen in 2010, no matter how painful, would get her closer to paying all the medical bills. With that goal in mind, she worked up until three weeks before her son was born.

Jimenez, a Guatemala native, has been in the U.S. illegally for 11 years. She said that if the assistance proposed by lawmakers had been available to her then, her pregnancy would have been a better experience.

“The women need that help,” Jimenez, 35, said in Spanish. “I had to be standing. I couldn’t walk anymore, and they (her bosses) weren’t considerate. You have to keep working or you get in trouble and you need the money to pay the bills.”

A local hospital reduced the cost of her medical bills after she showed proof of income, but she ended up paying $1,000 for prenatal care.

A child born to a noncitizen is considered a citizen if born on U.S. soil. So in the case of low-income families, the state must cover the child’s medical costs upon birth. Without prenatal care, the risk of complications increases and so do the costs.

The proposed South Dakota measure would expand the low-income health insurance program for children who don’t qualify for Medicaid. The proposed expansion of the Children’s Health Insurance Program - funded with state and federal dollars - would make fetuses eligible for coverage.

The bill’s chief sponsor this year was a Republican, Rep. Scott Ecklund, who said the change would be “pro-life” - a term often used to describe opposition to abortion - because prenatal care could save the lives of babies.

“We can’t close that border, that’s up to the federal government,” said Ecklund, a family physician from Brandon who also delivers babies. “But we have to treat people the best we can while they’re here.”

Critics have said it could make South Dakota a sanctuary for immigrants living in the country illegally, although they did not provide evidence for that assertion.

“We should take care of our own citizens first, prior to taking care of those that are here illegally,” said Rep. Gary Cammack, a Republican from Union Center.

Daugaard’s staff said that in the fiscal year that ended in June, 195 immigrant women gave birth in the state. Of those, 11 babies needed $160,000 in care from a neo-natal intensive care unit. The prior year, 10 babies in that category needed intensive care, costing $313,000. Those costs were split between state and federal funds. In some cases, hospitals simply write off these visits as bad debt.

Supporters of the prenatal care measure estimate the preventative services will cost nearly $247,000 annually, shared between federal and state governments. During prenatal visits, physicians monitor the baby’s heart rate, estimate the mother’s due date and check her blood pressure, among other things.

Babies of mothers who do not get prenatal care are three times more likely to have low birth weight and five times more likely to die than those born to mothers who do get care. Lack of prenatal care can also lead to children being born early and needing to stay in a neo-natal intensive care unit for weeks, which hospitals say can cost about $60,000.

If South Dakota passed the measure it would join at least 16 states - including neighboring Nebraska and some with huge immigrant populations such as Texas and Illinois - in offering offer some medical coverage to pregnant women regardless of their immigration status, according to data collected by the National Immigration Law Center.

Nebraska, which passed the measure in 2012, estimates it has provided care to over 650 women a month since it started, at a cost of $9.4 million shared between the state and federal government.

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