Prenatal Care Cut Urged for Illegal Immigrants

Gov. Pete Wilson proposed Friday to end prenatal health services for illegal immigrant women and shift some money to prenatal and well-baby care programs for low-income California families.

Critics of the plan, which is contained in Wilson’s proposed 1994-95 budget, reacted with anger and surprise, saying Wilson was pitting one group of needy pregnant women against another. They predicted a legislative fight over Wilson’s plan.

The proposal is a major policy shift for Wilson, who has always argued that the health benefits of prenatal care pay for themselves because unhealthy mothers and babies pose huge potential costs for the health system.

Numerous studies have shown that prenatal care--including counseling on nutrition, warnings about the dangers of substance abuse and standard medical checkups--can reduce the risk of low-weight babies and premature deliveries.

The U.S.-born children of illegal immigrant women are U.S. citizens and thus the responsibility of the state, which must pay medical and other expenses. Delivery costs for low income women are paid by the state because it is regarded as emergency care.

Long and expensive stays in pediatric intensive care and children born with learning and other disabilities are some of the problems linked to inadequate prenatal care.

Wilson and Administration officials claim that there is not enough money to pay for prenatal care for all needy women.

Finance officials estimate that the state would save $92 million by canceling prenatal care for illegal immigrants.

Some of the money saved by cutting off care to illegal immigrants would be used to shore up another prenatal program, Access for Infants and Mothers, which provides prenatal and well-baby care for uninsured Californians. Created by Wilson, AIM has been so popular that it is expected to cut off enrollment of new women Feb. 1 unless it gets an infusion of money.

Wilson said he will ask the Legislature to pass emergency legislation to end payments to illegal immigrants in time to meet the Feb. 1 cutoff.

Jennifer Nelson, a spokeswoman for the state Health and Welfare Agency, said: “In this budget there are a lot of tough choices. When you are looking at the choice between providing prenatal care to legal residents who are low income versus undocumented immigrants, the choice is clear.”

She added: “The governor has made the choice that what we need to do is make sure the people who are legally in the state have access to these kinds of services versus providing them to undocumented immigrants.”

The governor’s plan took longtime budget watchers by surprise. “It is hard to understand. These prenatal programs have always produced huge savings. It really is penny-wise and pound-foolish,” said Marjorie Swartz, a consultant with the Assembly Ways and Means Committee.

In Los Angeles County, where about two-thirds of the state health care dollars going to illegal immigrant care wind up, the proposal could have a major impact. Prenatal services for thousands of women could be eliminated.

Lynn Kersey, who operates a maternal and child health advocacy program in Los Angeles, said she was surprised because prenatal programs had always been part of Wilson’s health policy agenda, called Healthy Start.

“I’m shocked. The state just spent millions of dollars on outreach programs to pull people in, and now that they have it up and running they want to cut out a major portion of the population they were trying to serve,” she said.

“I think (Wilson) is setting himself up for a big fight.”

Sharon Wanglin, a spokeswoman for the Los Angeles County Department of Health Services, said that if state funding stops, the county would try to keep the program running anyway because it has proven to be cost effective. “It means we will have to eat it. We will go on providing care,” she said.

Wilson’s budget also foresees a sharp drop in revenues in a special health fund built up by a surtax on cigarettes and tobacco products.

California hospitals, which this year received $146 million in tobacco tax grants, would receive about $18 million less statewide. That money has been earmarked to help hospitals defray the costs associated with treating uninsured or underinsured patients.

Hospital officials say the tobacco tax revenues have played a big role in allowing them to keep emergency rooms and trauma centers open.

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