CALIFORNIA: GOV. SETS DATE TO END IMMIGRANT PRENATAL CARE
Gov. Pete Wilson (R) announced a set of emergencyThis is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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,