CALIFORNIA: GOV. SETS DATE TO END IMMIGRANT PRENATAL CARE

      Gov. Pete Wilson (R) announced a set of emergency
 regulations Friday that will require the state to "stop providing
 prenatal care to 70,000 undocumented pregnant women on December
 1."  Wilson said that the move is part of the state's effort to
 comply with the federal welfare reform law which he contends
 requires him to "end all state aid to illegal immigrants"
 (Lucas/Tuller, SAN FRANCISCO CHRONICLE, 11/2).  U.S. District
 Judge Mariana Pfaelzer agreed with Wilson and refused an ACLU and
 immigrant activist groups' request for a temporary restraining
 order to block the cutoff of prenatal services (see AHL 10/16)
 (SAN DIEGO UNION TRIBUNE, 11/3).  In her decision, Pfaelzer said,
 "Congress has decided that the states should deny health benefits
 to illegal aliens" (McDonnell/Ellis, LOS ANGELES TIMES, 11/2). 
      STATE OF EMERGENCY:  Wilson said he needed to issue
 emergency regulations because the federal welfare reform law
 "precludes the states from giving illegal immigrants non-
 emergency health care."  Emergency regulations can take effect
 faster than normal regulations and are not subject to a 60-day
 public comment period.  Tom Peters, director of Marin County
 Health and Human Services, "disputed" Wilson's interpretation of
 federal welfare law.  "The federal welfare bill does not mandate
 this cutoff.  It makes it a state option," he said.
      DON'T STOP:  County health departments in the San Francisco
 area "said they will continue providing prenatal care to
 undocumented women," but acknowledged that "other health services
 may suffer as a result."  David Kears, director of health care
 services for Alameda County, said that if the state stops the
 coverage, his county is "still going to deliver the services,"
 noting, "Half the people we see, we don't get payment for
 anyway."  He added, "It's a no brainer.  Why would you not
 provide prenatal care if you're going to end up paying the costs
 of delivery or hospitalization?  Why would we not provide
 something if it will end up costing us more?"  However, Marin
 County's Peters, who is also chair of the Association of Bay Area
 Health Officials, "cautioned" that providing prenatal care "will
 pose other dilemmas for cash-strapped counties."  He said, "The
 standard outcome is that the triage decisions become more
 painful, the waits at hospitals and clinics become longer, and
 the clinical consequences become more severe" (CHRONICLE, 11/2).
      HISTORY:  California had been providing the prenatal
 services under a 1988 state law that bypassed federal Medicaid
 guidelines prohibiting such aid to illegal immigrants.  The
 program had been funded solely by the state at an annual cost of
 $69 million (TIMES, 11/2).  CHRONICLE reports that Wilson has
 "tried repeatedly" to end the program, proposing such a move in
 both his January '95 and January '96 budget proposals.  However,
 neither proposal was adopted by the state Legislature (11/2).
      LEGAL ACTION:  Despite the federal ruling, one immigrant
 advocate said further legal action is possible.  Mark Rosenbaum,
 legal director for the American Civil Liberties Union of Southern
 California, "predicted other legal assaults ... including a
 possible challenge under constitutional guarantees of equal
 protection for all."  He said, "Denying prenatal care to citizen
 children is an open question that could be litigated" (TIMES,
 11/2).