ANNAPOLIS – Virginia Adegboyega sat patiently in the crowded waiting room of Cheverly Health Center, prepared a bottle of milk for her 8-month-old son Eldad and began to worry.
Now pregnant with her third child, she frets about the medical bills that loom ahead. Since she has been in the country less than five years and did not apply for state Medicaid assistance by June 30, she is not eligible to get help with the cost of prenatal care.
“It’s somewhat expensive here,” said the Nigerian immigrant. Her husband, a corrections officer, does not receive health insurance for the whole family. “Especially when only one person is working and you have a big family.”
Many of the women around her – some waiting for pregnancy tests and others for sonograms and check-ups – are facing the same problem.
This year the administration of Gov. Robert L. Ehrlich, Jr. eliminated funds for health care coverage for an estimated 1,000 pregnant woman and 3,000 children who are legal immigrants who have been in the country for less than five years. The governor later restored some of that money to cover prenatal care for women already signed up for Medicaid.
But Wednesday afternoon, a legislative committee refused to lend its approval to the cuts. Although the action by the joint Administrative, Executive and Legislative Review Committee is not binding on the governor, it does send Ehrlich a strong message that the General Assembly wants the money restored.
“My hope is that the governor will decide to go back next year and put money back in the program for these women and children,” said Delegate Richard Madaleno Jr., D-Montgomery County. “We should stop these regulations now, especially considering the improved financial condition of the state.”
Critics of the administration’s decision to cut funds say the lack of prenatal services will force many women and children to rely on emergency rooms for care, which will end up costing the state more in the long run. Also, pregnancy complications may go undetected and cause birth defects that may require expensive care down the road.
“Giving pregnant women and small children health care just makes sense if you want to have healthy citizens,” said Mary Jelacic, who runs the Pregnancy Aid Center in College Park. The clinic sees about 50 women each day, most of whom are uninsured immigrants. Jelacic relies on grants to keep physicians and midwives in the office.
To make up for some of the lost dollars, the state has increased funding for local health centers, where many women now receive prenatal services.
“For a significant number of pregnant women, federally qualified health centers and county health departments can step up and fill the gaps,” said Maryland Health Secretary S. Anthony McCann at a hearing on the issue two weeks ago. “This is not a situation where there are no options for prenatal care.”
Home to the largest number of immigrants in the state, Montgomery and Prince George’s counties have felt the strain of the funding cuts.
At Holy Cross Hospital, where many of Montgomery County’s immigrant residents receive health care, women sit shoulder to shoulder in the obstetrics clinic, listening for their name. The majority of patients are Latino, but African, Asian and Middle-Eastern faces also dot the crowd. The clinic treats between 75 and 130 women a day.
Holy Cross provides care for pregnant women regardless of their eligibility for state aid, said Nancy Nagle, the clinic’s director. But that may be more difficult if the state does not restore funds to care for this population.
“It takes a lot of resources to make this program work,” she said.
Veronica Rodriguez, 29, moved to Silver Spring from Bolivia two years ago and is relieved she doesn’t have to worry. Nine-months pregnant, she already receives coverage that will last until two months after her expected delivery next week. She is relieved her daughter will be an American citizen, automatically qualifying her for Medicaid.
The influx of uninsured women has some county health officials worried they may not be able to sustain the increasing demand for services without the Medicaid funds.
“This is having a significant impact on our county dollars to have to pick up the slack,” said Montgomery County Health Officer Ulder J. Tillman, who is concerned the county will run out of money for the clinics before the current fiscal year ends in June.
“It’s a short-sighted decision,” she said.
As for Adegboyega, she’s decided the child she now carries will be her last. She can’t afford the medical costs, especially for her two Nigeria-born children who, under the current budget, aren’t eligible for Medicaid. “It’s very hard … but I’ll do my best,” she said, cradling her son in her lap. “It’s all I can do.”