A bill providing state-funded prenatal care for pregnant illegal immigrants sidestepped controversy Thursday, despite pitting two powerful currents in the conservative movement against each other.
Advocates for the bill said that in addition to saving the state money by preventing pregnancy complications, it was a moral imperative to help save the lives of infants.
"If you’re a fiscal conservative, you have to vote yes on this bill," said Rep. Melissa Magstadt, R-Watertown. "If you’re pro-life, you need to vote yes on this. If the immigration part is the big part, I guess that’s where this starts getting muddy."
For one day, at least, most lawmakers said the issue was clear despite the clash between “pro-life” interests and anti-illegal immigration interests.
"I look at it as a moral responsibility of this state, because these will be U.S. citizens," said Rep. Manny Steele, R-Sioux Falls and one of the Legislature’s most prominent opponents of illegal immigration.
The proposal was backed by a range of medical and social groups, including the state medical association and the Catholic Diocese of Sioux Falls.
Lawrence Fenton, a doctor who specializes in caring for infants, said many conditions that can lead to death or lifelong disability in infants can be prevented by simple prenatal checkups and inexpensive treatments like vitamins.
"Little or no prenatal care leads to prolonged stays in the (newborn intensive care unit) because it leads to increasing prematurity," Fenton said. "Good prenatal care can prevent so many complications."
Fenton cited South Dakota statistics that an infant who receives no prenatal care is six times more likely to die.
Low-income citizens are already eligible for prenatal care through the Medicaid program. But illegal immigrants aren’t in South Dakota, even if their children would be American citizens upon their birth. With no coverage, these financial reasons can keep those immigrants away from the health system until they give birth.
"There’s not a lot of things (to lower infant mortality) unless you can get to the moms," said Deb Fischer-Clemens, an Avera Health executive. "If the moms are not going to seek care because they don’t have the resources, we can’t make a lot of change. "
Providing prenatal care through Medicaid costs about $2,000 per woman. With just under 200 births last year to women here illegally, that’s a total annual cost of around $400,000, split between the federal government and the state.
But medical experts said the state would make back that cost almost instantly by avoiding expensive complications that put infants into intensive care.
An infant in intensive care costs about $3,000 per day, Fenton said.
"Even babies born a few weeks early can wind up in special care for a couple of weeks," he said. "You can see that it would not be difficult for a baby (born earlier) than 32 weeks… to easily become a million dollar baby."
Those costs are currently absorbed by the state and by the hospitals.
The lone dissent Thursday came from Rep. Jenna Haggar, R-Sioux Falls, who worried about the precedent.
"I’m viewing it as expanding Medicaid eligibility to illegal immigrants," Haggar said.
The House Health and Human Services Committee voted 11-1 to approve the bill and send it to the full House.
Last year, a similar measure passed the House but died in the Senate near the end of the legislative session despite support from Gov. Dennis Daugaard.