A large majority of emergency Medicaid expenditures are for childbirth and complications of pregnancy for patients who are undocumented immigrants, although spending for undocumented elderly and disabled patients is increasing at a faster rate, according to a study in the March 14 issue of JAMA.
The researchers, who analyzed administrative claims data related to the emergency Medicaid program in North Carolina from 2001 to 2004, found that 99% of the patients were undocumented, 93% were Hispanic, 95% were female, and 89% were in the 18-to-40 age group. Approximately 82% of emergency Medicaid spending in 2004 was for childbirth and complications of pregnancy, and these accounted for 91% of hospitalizations. Injury and poisoning accounted for approximately one-third of the remaining spending. Although spending for pregnant women increased by 22% during the four-year period, spending increased by 70% for families with dependent children, 82% for disabled patients, and 98% for elderly patients.
“Emergency Medicaid is predominantly a program for childbirth coverage, although use and spending are shifting toward nonpregnant adults, particularly those who are elderly and disabled,” write the authors. “Increased access to comprehensive contraceptive and prenatal care, injury prevention initiatives, preventive care, and chronic disease management may make better use of the public healthcare dollar by improving the health status of this population and alleviating demand for costly emergency care.” Read the press release.
