In life, we need to pick our battles. Gov. Chris Gregoire has chosen to battle the federal government over a new policy to check the citizenship of immigrant children before they receive state health services.
It's a battle worth waging.
Almost all of the 8,000 babies born to poor immigrant mothers in Washington each year have qualified for prenatal care from the state. The state provides care based on the assumption that the children are U.S. citizens. That's because children born on U.S. soil - even if the parents are illegal immigrants - are granted citizenship status.
"It's about a baby born in the United States and thus is a United States citizen, and is entitled to equal treatment under our Constitution," Gregoire said. "The baby needs to have these routine medical checkups and preventative medical care without delay."
The governor is right. To deny service while parents scramble for birth certificates or other paperwork is ludicrous. The babies are U.S. citizens deserving of all the rights accorded any other citizen.
The citizenship check was part of the Deficit Reduction Act, passed by Congress in 2005. Only U.S. citizens and legal immigrants who have been in the country five years or more are eligible for Medicaid, which is funded equally by the state and the federal government.
Following the federal dictate, the state has spent $5 million to verify the citizenship of 1 million people on Medicaid, the state's health care program for the poor, and in related state programs. The state was forced to hire 22 employees to process the paperwork and might need to hire another 16 workers. The checks weeded out 200 individuals.
"You have to ask yourself, why are we doing all this paperwork, when ... without question it's discrimination," Gregoire said.
It takes about 60 days to establish a child's citizenship, according to Doug Porter, director of the Medicaid program under the state Department of Social and Health Services.
That, too, worries Gregoire. She fears that delaying Medicaid services to infants would lead to expensive emergency room visits in the future and might scare some mothers out of seeking health care for their newborns.
"I think it's a bureaucratic morass. I think it's legally wrong, and our Founding Fathers made that clear. And I absolutely think from a moral perspective it's wrong, fundamentally wrong," she said.
She has as her target the Bush administration ruling last year that poor immigrant mothers of newborns must hand in paperwork and proof of citizenship for their babies, like a birth certificate, in order to receive coverage.
But according to Porter, the Centers for Medicare and Medicaid had previously ruled that unborn children of Mediaid clients qualify for prenatal care. He said the state also automatically provides care for the first year of the child's life. Porter said that almost all the babies born to poor immigrant mothers appear to have previously qualified for the neonatal care.
Gov. Gregoire has decided that the state must file suit to challenge the citizenship check. It's regrettable it has come to that, but a lawsuit is necessary to resolve this dispute between state and federal officials over something as simple as providing medical care to vulnerable children.