Several health groups are worried that babies born to illegal immigrants could be denied essential medical care – such as immunizations and physical examinations – because of recent rule changes regulating government provided health care.

The babies automatically are United States citizens because they were born in U.S. hospitals. Under past policy, the federal government required states to provide the babies with a full year’s eligibility for Medicaid, the United States health insurance program for the poor, the groups said.

Now, mothers of the newborns will have to apply for Medicaid on behalf of their newborns, which many will not want to risk, say groups including the American Academy of Pediatrics, the American Academy of Family Physicians and the March of Dimes.

Medicaid officials voiced skepticism on November 9 about the groups’ claims. Leslie V. Norwalk, acting administrator for the Centers for Medicare and Medicaid Services, said in an interview that her agency investigated and found no instance where a baby was denied care under Medicaid.

“If people know of an instance where a state has denied eligibility because someone couldn’t produce evidence of citizenship, in particular among the most vulnerable, we would be interested in knowing about that,” she said.

New federal rules state that “a child born in the United States to an illegal alien mother is not a deemed newborn” – and therefore is not automatically eligible for Medicaid, the health insurance program for the poor. States may make exceptions on the basis of income.

The rules were in response to a new law designed to ensure that only citizens or qualified legal immigrants gain access to Medicaid.

The medical groups said denying newborns access to Medicaid would cost the health care system more in the long run.

“Preventive care saves money for states that provide Medicaid coverage and the federal government helps pay for it,” the groups said in a letter to the Centers for Medicare and Medicaid Services. “Some infants require immediate post-delivery care for conditions or illnesses detected immediately after birth.”

They said some doctors, already facing reduced Medicaid reimbursements, would be reluctant to care for these children.

Although the letter did not cite specific cases where care had been denied, the American Academy of Pediatrics had singled out four states – Georgia, Kentucky, Tennessee and Virginia – as denying health care coverage to babies born to illegal immigrants.

Asked for specifics, the pediatric group could not provide statistics. Instead, the organization cited the potential for care being withheld.

Norwalk said her agency contacted each of the four states. Medicaid directors there knew of no cases where access to the program had been denied to babies of illegal immigrants, she said.

Dr. Martin Michaels, president of the academy’s Georgia chapter, said documenting a baby’s eligibility for Medicaid is as simple as submitting a page from the child’s medical record showing the child was born in Georgia. But the question is whether families will be willing to do that.

“Some families will be afraid they could get deported and separated from the child,” he said.