California Group Seeks Tighter Rules for Public Benefits, Citizenship

Fifteen years ago, with California mired in a recession and looking for relief, voters approved an initiative prohibiting undocumented immigrants from using state-provided health care, education and other social services.

Proposition 187, called the “Save Our State” initiative, was championed by Gov. Pete Wilson (R) and passed with about 59% of the electorate’s approval. However, a number of lawsuits challenged the new law in court and eventually it was found unconstitutional in a federal court. After several appeals, state officials gave up.

Fast forward to summer of 2009, with California again in recession and battling a huge budget deficit. Now comes a new group — Taxpayer Revolution — with plans for a new initiative to end public benefits for undocumented immigrants, deny welfare payments for their children and establish new rules for birth certificates.

“Our goal is not to be cruel by denying care, it is to serve as a deterrent to people who come into California to give birth and then soak up too much of our resources,” said Ted Hilton, a leader of the new group.

Health advocates say the plan to withhold non-emergency health services from pregnant women and newborns is a bad idea, both morally and financially.

“This is a very dangerous proposal for children of California, as well as their mothers,” said Lucy Quacinella, an attorney representing Maternal and Child Health Access, a statewide advocacy group based in Los Angeles.

“If this measure were to actually make it to the ballot, get approved and not get struck down by the courts, it would have a dramatic impact on the health of a lot of Californians. And ultimately on the state’s financial situation as well.”

Challenges Citizenship-By-Birth Concept

Taxpayer Revolution, based in San Diego, hopes to collect at least 488,000 signatures to place the initiative on the June ballot next year.

Judging from early response to the first petition drives and from donations, Hilton said he’s optimistic the measure will qualify.

Hilton said his group has raised $350,000 so far.  The going rate to get a petition on the statewide ballot in California is about $4 million.

If the initiative qualifies for the ballot and if voters approve, it could present a significant challenge to the widely accepted understanding that children born in this country are United States citizens whether the parents have documents or not. 

The 14th Amendment to the Constitution says, in part, “All persons born or naturalized in the United States, and subject to the jurisdiction thereof, are citizens of the United States and of the State wherein they reside.”

Hilton and other supporters of the initiative say undocumented immigrants are here illegally and not “subject to the jurisdiction” of the U.S. and therefore their U.S.-born children should not be citizens.

“We’re confident we won’t run into any constitutional issues,” Hilton said. “We’re not trying to eliminate emergency medical services and that’s where problems have arisen in previous attempts. We’re going after other parts of the system.”

Federal law requires emergency departments to treat all patients, regardless of citizenship.

The proposed initiative would:

  • Deny all non-emergency health benefits, including prenatal care, to undocumented residents;
  • Deny welfare eligibility for children born in California to undocumented parents;
  • Require new parents who are not citizens or permanent legal residents to submit identification to the U.S. Department of Homeland Security before receiving a birth certificate for a newborn; and
  • Direct the Department of Homeland Security to review approved applications for federal, state or local benefits available to undocumented residents because of their U.S.-born child.

Estimated Savings

Overall, ending public services for undocumented immigrants could reduce state spending by more than $1 billion annually, according to the Legislative Analyst’s Office. 

This year, California is expected to spend about $703 million on health care for as many as 780,000 undocumented immigrants. Most of that — about $486 million — will go toward emergency services.

State welfare officials estimate cutting payments to undocumented immigrants for U.S.-born children could save about $640 million annually.

California’s 2.7 million undocumented immigrants represent about 7% of the state’s population, according to the Pew Hispanic Center, and they add between $4 billion and $6 billion in costs to the state’s overall budget of $105 billion, according to state officials. Immigration advocates point out undocumented immigrants also contribute to state and federal coffers through income taxes, sales taxes and to the state’s economy as consumers and workers.

Opposition Lining Up

A wide array of organizations, ranging from the California Medical Association to the Latino Coalition for a Healthy California, is lining up in opposition to the proposed ballot measure.

Although the CMA has not yet issued a formal position, spokesperson Andrew LaMar said the petition drive “runs counter to CMA policies. We are advocates of providing health care to everyone.”

Ellen Wu, executive director of the California Pan-Ethnic Health Network, said the initiative “is the wrong approach on several different levels. It’s wrong fiscally because this kind of penny-wise policy will cost us more in the long run. It’s pretty well-known that emergency medical services are more expensive than preventive services.”

“It’s also wrong socially,” Wu added. “There always will be a small faction of us who aren’t looking after the common good, looking at things myopically, but I would like to think that with our president talking about social responsibility and doing the right thing, hopefully that sentiment will rise above the other scapegoating voices,” Wu said.

Al Hernandez-Santana, executive director of the Latino Coalition for a Healthy California, says the challenge to the citizen-by-birth concept is worrisome.

“Citizenship by birth is fundamental to our Constitution. We’re not a country like Kuwait where people can live there all their lives and never gain citizenship. If this idea actually gains any traction, it could have a huge impact on our country,” Hernandez-Santana said.

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Health Care Costs Insight Insurance Medi-Cal