Moving to implement the new federal welfare reform law, California Gov. Pete Wilson has cut off payments for prenatal care for illegal immigrants.
The governor's executive order actually implements a provision of Proposition 187, a controversial 1995 ballot initiative Wilson, a Republican, used as a springboard to an aborted presidential bid. The initiative, which would deny nonemergency medical and social services to illegal immigrants, had been blocked by a federal judge, but Wilson believes the federal law clears the way for that portion of the state law.
About 70,000 illegal immigrant women received prenatal care in the state last year at a cost of $69.3 million, according to Lisa Kalustian, spokeswoman for the California Health and Welfare Agency.
State healthcare officials decried the governor's order and said it will not save the state money but will instead add millions to healthcare costs. The state is still required to provide emergency care-including hospitalization-to illegal immigrants, and infants and mothers denied prenatal care are more likely to require those services.
Denying prenatal care is "putting patients' lives in jeopardy," said Elizabeth Forer, executive director of the Venice (Calif.) Family Clinic, a private facility that serves the indigent. "Prenatal care prevents infant mortality and maternal death," she said.
Forer said the clinic will try to find a way to continue providing prenatal care to 400 women now in the program. The Venice clinic provides 3,000 prenatal visits annually at a cost of more than $300,000, she said.
Forer said opponents of Wilson's order are exploring options, including a legal challenge.
"It's a classic case of penny-wise and pound-foolish," said Jim Lott, senior vice president at the Healthcare Association of Southern California.
Los Angeles County stands to lose about $9.2 million a year in Medi-Cal payments as a result of the governor's order, Lott said. Medi-Cal is the state's Medicaid program.
Together, public and private-sector clinics and physicians providing prenatal care could lose $20 million, he said.
In addition, because every dollar spent on prenatal care saves $17 on adverse consequences of not receiving care, "you're talking about adding $340 million" to the cost of medical services for illegal immigrants, Lott said.
Infants requiring neonatal intensive care can run up bills of $300,000 per case, he said.
But the state will continue to fund care for elderly illegal immigrants, at least temporarily. The governor said he will ask the Legislature to pass a bill allowing about 200 infirm illegal aliens in nursing homes to receive transitional care until they can be placed elsewhere or the federal government assumes responsibility for them.
The program costs about $10 million a year, Kalustian said.
"We're not going to put an 85-year-old immigrant out on the street," she said. "It doesn't make sense."
The governor has asked his staff to advise him whether the welfare reform law requires further actions to cut benefits to illegal immigrants in California.