Plan to End Funding for Prenatal Care Is Assailed

The Los Angeles County Medical Assn. Wednesday assailed Gov. Pete Wilson’s planned cutoff of public prenatal care to illegal immigrant women as “repugnant’ and said the ban would result in greater infant mortality and increased emergency room costs.

“Cutting prenatal care for pregnant women will cause unwarranted suffering, avoidable birth complications, sicker, smaller babies and needless disability,” said Dr. Brian D. Johnston, president of the county doctors’ group, which is associated with the American Medical Assn., the leading national organization for doctors. “It is also going to cost the taxpayers a lot of money.”

The association held a news conference at its downtown offices to blast the governor’s plan, underlining concerns among health professionals about an aid cutoff that state officials say is imminent. Immigrant advocates are challenging the state move in U.S. District Court in Los Angeles, and California officials have agreed not to move to end the aid until at least next Thursday.

The California Medical Assn., representing 34,000 physicians statewide, also opposes the governor’s move to cut prenatal care, said Dr. Jack Lewin, the group’s executive vice president.

“This will cause an epidemic of low-birth-weight babies and expectant mothers presenting late to emergency rooms,” said Lewin, a San Francisco doctor, said Wednesday. “This is absurd public policy for the state.”

As a possible cutoff approaches, the doctors’ comments reprise the heated debate over Proposition 187, the 1994 state initiative that sought to end most public benefits for illegal immigrants. Physicians and health professionals also lined up solidly against the initiative, which was approved by a landslide but has since been blocked in large part in federal court.

Since the federal welfare overhaul was signed into law in late August, some care providers say they have seen a decline in the number of illegal immigrants seeking prenatal care--a scenario that they say developed in the wake of Proposition 187’s passage.

“I don’t know if it’s fear or disinformation, but the women haven’t been showing up,” said Rodolfo Diaz, executive director of the Community Health Foundation of East Los Angeles, the state’s largest private provider of care to undocumented residents.

The county doctors cited another fear: heightened liability for physicians who are called upon to treat women arriving at hospitals in active labor without any history of prenatal care. The physicians urged Gov. Wilson to delay enactment of any ban.

Wilson has not disputed the health benefits of prenatal care, which include a broad regimen of treatment for pregnant women, including regular checkups, nutritional supplements and fetal monitoring. Physicians say treatments for infants born with health problems linked to a lack of prenatal attention easily exceed the price tag of prenatal care.

However, the governor has said that the state cannot afford the cost of prenatal care. Lisa Kalustian, a spokeswoman for Wilson, said that cost totals more than $69 million annually, including care for about 70,000 women.

California, which has the nation’s largest illegal immigrant population, is one of the few states that subsidizes prenatal care for illegal immigrants. The Legislature authorized the aid in a law passed in 1988 and signed by Gov. George Deukmejian.

Under federal Medicaid guidelines, illegal immigrants are generally ineligible for subsidized prenatal care and other nonemergency benefits. The new federal welfare law also bans most local government assistance for illegal immigrants absent specific new state laws allowing such aid. Wilson says he is merely abiding by the new federal mandate.

“What we’re saying is that people who are in this country illegally, who broke the country’s laws, should not have this care paid for by California taxpayers,” said Kalustian. “They should be getting aid in their own countries.”

Physicians of the L.A. County Medical Assn. said the illegal immigrants are unlikely to go home and therefore should receive prenatal care here. Their children, they said, will be U.S. citizens if born in the United States--and thereafter eligible for full Medi-Cal coverage.

“We are attacking one of the weakest but most important links in our society--that is the mother,” said Fred Quevedo, former executive director of the Philippine Medical Society of Southern California.