Along the Border, Who’s an ‘Anchor Baby’ Is a Guessing Game

The mother arrived at the hospital last week in need of an emergency caesarean section, saying she had crossed the border to run an errand in town, not so her baby would be born an American citizen.

She assured the doctor that she arrived at the hospital just “because [she] was here.”

Dr. Rolando Guerrero listened skeptically. “They always have a story,” he said after delivering her 8-pound boy, Dylan.

Doctors here at Starr County Memorial Hospital deliver about 30 babies a month, including those of mothers in the country illegally, hospital officials said. In this county in the heart of the impoverished Rio Grande Valley, so-called anchor babies have been delivered for decades, some to women who have already settled in Texas, others to those who crossed the river expressly to give birth on U.S. soil.

“About six months ago I got one who was literally still wet from the river,” Guerrero said.

Sometimes pregnant Mexican women arrive at the nearby border bridge. “They’ll find a Border Patrol agent on the banks and say, ‘I need help,’ because they know they’re going to get the care,” said Dr. Javier “Jake” Margo Jr., president of the local medical society. “It’s a strain on the physicians and the smaller hospitals.”

The phenomenon has become a focus of the Republican presidential battle, with both Jeb Bush and Donald Trump questioning the motives of immigrant mothers who give birth after traveling to the U.S. And some residents complain that the children are a drain on taxpayer-supported social services.

But the issue is often not so black-and-white here. Many families have relatives scattered on both sides of the border, and people often live and work across the mostly unmarked line as if it weren’t there.

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“They do come on purpose,” said Thalia Munoz, chief executive of Starr County Memorial. “We have to absorb the costs. . . . It’s a persistent problem. It’s a fact: They come over here for the anchor baby, they come over for the benefits.”

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Expectant mothers who live in Texas–whether they are legal residents or not–qualify for a state program providing prenatal care. If the mothers can’t pay for deliveries, Medicaid pays doctors and the hospital a portion of the cost.

Mothers lacking documentation do not qualify for Medicaid afterward, but their babies usually do, doctors say.

Medicaid payments to doctors here have declined by half in the last decade, they say–to about $550 for a vaginal delivery; $600 for a caesarean section. Medicaid compensated the hospital about 40 cents on the dollar, Chief Financial Officer Rafael Olivares said.

As a result, the hospital picks up more of the cost of the care of people in the country illegally.

Rio Grande Valley hospitals reported more than $131 million in uncollected medical bills as of 2013, the most recent year available, according to the Texas Hospital Assn. They don’t tally how much of that is for people in the country illegally.

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Many of the women that [Guerrero] and other doctors see are poor, but others are not, and some of them have crossed the border legally. Professionals from Mexico–doctors, dentists and graduate students–will schedule caesarean sections at a U.S. hospital, paying for the services, sometimes in cash, the doctors said.

Guerrero recalled a Mexican dentist who crossed the border so her delivery would be paid by Medicaid, which she qualified for because she was born in the U.S. “She should have paid for it. You work for a living, you have the money. I guess it goes to character,” he said.

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