Welfare Cuts Stir Fear at Health Fair

Hundreds of families descended Saturday on a health fair in Boyle Heights to avail themselves of a wide array of free services, from blood pressure tests to respiratory and dental exams, to family planning education and HIV screening. It is the kind of event that health professionals call an important strand in the often-frayed safety net for the nation’s low-income communities, with their huge uninsured, working-poor populations.

But as a festive air predominated amid colorful booths set up in a schoolyard, an organizer voiced deep concerns about how the sweeping welfare overhaul recently approved by Congress would affect health services here and elsewhere.

“There’s so much uncertainty now, we just don’t know what’s going to happen,” said Leonor Lozano-Ramirez, a social worker who helped put the fair together under the aegis of East L.A. Neighborhood Link, a coalition of community groups. “What we do know is that a lot of people are going to be cut off from the system.”

Her comments reflect the deep anxiety among social service agencies and health providers nationwide in the wake of congressional passage of the broad welfare legislation. President Clinton has indicated that he intends to sign the measure into law, calling it an important step to reform the nation’s welfare system.

Nonetheless, critics say the new measure could push 1 million children into poverty, along with many adults. That translates into severe health and social problems, say advocates for the poor, who are bracing for what they view as its predictably bleak consequences.

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“With people getting thrown off foods stamps and welfare, hunger is going to increase, homelessness is going to increase, and more people are going to get sick,” said Linda Mitchell of the International Institute of Los Angeles, a social service agency that helped sponsor Saturday’s fair. “We’ll see more communicable disease.”

Public attention has focused on cutbacks and new eligibility restrictions for big-ticket items such as food stamps; Aid to Families With Dependent Children, the basic national welfare outlay, and Supplemental Security Income, which provides cash payments for low-income aged, blind and disabled persons.

But the wide-ranging welfare law has repercussions for scores of programs, from job-training efforts to government contracts to initiatives aimed at removing lead paint from people’s homes. Numerous health and nutrition measures will be affected. Yet, no one seems to have a handle on the full sweep of the measure. Regulators still have to determine guidelines interpreting the law, portions of which are likely to face court challenges.

“This is a massive piece of legislation, and we’re doing an in-depth analysis to get our arms around what this is going to mean,” said Lisa Kalustian, a spokeswoman for the California Health and Welfare Agency, which will have a key implementation role.

Under the law, California and other states will be given broad new authority to redesign welfare programs and impose major new restrictions. Among other things, states will have the option to ban hundreds of thousands of legal immigrants from receiving cash welfare payments and nonemergency benefits under Medicaid, the federal health insurance plan for the poor. (Still open to all, regardless of immigration status, will be emergency treatment, immunizations and the testing and treatment of the symptoms of communicable disease.)

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The welfare overhaul does not directly target events such as Saturday’s community health fair. But the law’s broad tentacles will inevitably reach this far down, health workers say.

Many of the participating clinics and agencies rely on Medicaid payments and other government money. Consequently, these organizations would feel the sting, either in cutbacks or in new eligibility restrictions. Some providers may even have to begin affirming people’s legal residence status under a still-undefined, Proposition 187-like verification scheme--an anathema to many social workers.

For instance, one booth Saturday was set up by the supplemental nutritional program for women, infants and children, a federally funded effort that provides food and educational services for pregnant women, new mothers and their children. Now open to all who qualify under income guidelines, the welfare law allows California and other states to bar such benefits for illegal immigrants and other noncitizens deemed “unqualified,” a catch-all category that includes many people now residing legally in the country.

Women such as Maria Torres, a mother of two and an immigrant from El Salvador, could henceforth be ineligible for the nutritional supplements. Torres, who has a minimum-wage job at a chicken-processing factory, said she had never received any form of cash welfare in her life, and has no health insurance for her family. But she called it “unjust” to exclude her and other immigrants.

“I don’t understand why it is better to allow people to get sick,” said Torres, who was tested for high blood pressure, anemia and other ailments during the fair. “Doesn’t sickness spread to everyone, whether they have papers or not?”

The elementary school on whose grounds the health fair was held sits across the street from the Aliso Village public housing project, part of the sprawling Pico-Aliso complex that occasionally makes the headlines because of rampant gang violence. Many of the more than 1,200 families there consider public assistance a lifeline that helps maintain a basic standard of existence.

Maria Lopez, a 28-year-old single mother and resident of the projects, says the prospect of losing welfare payments is a daunting one. The monthly checks allow her to continue her education while paying day care and providing for her child’s well-being, she says.

“I want to be off welfare one day, but it helps me right now,” Lopez said as she strolled through the health fair. “I don’t know what we’d do without it.”