BILL ANALYSIS
SENATE HEALTH AND HUMAN SERVICES
COMMITTEE ANALYSIS
Senator Martha M. Escutia, Chair
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|BILL NO: |SB 82 | S|
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|AUTHOR: |Vasconcellos | B|
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|AMENDED: |As introduced | |
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|HEARING DATE: |March 10, 1999 | 8|
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|FISCAL: |Appropriations | 2|
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|CONSULTANT: | | |
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|Margolis | | |
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SUBJECT
Medi-Cal: pregnancy-related services
SUMMARY
Extends medically necessary pre-natal care to Medi-Cal
income-eligible undocumented and other aliens not covered
under federal laws.
ABSTRACT
Under existing California law, any alien who meets income
eligibility for Medi-Cal services, but who does not meet
residency requirements, is eligible for care and services
that are necessary for the treatment of an emergency
medical condition (and medical care directly related to the
emergency) and for medically necessary pregnancy-related
services. However, federal law prohibits the state from
providing medically necessary pregnancy-related services,
unless new state legislation is enacted subsequent to
August 22, 1996.
This bill would provide that any alien who is otherwise
eligible for Medi-Cal services, but who does not meet
specified requirements relating to residency status, is
eligible for medically necessary pregnancy-related
services.
FISCAL IMPACT
The Governor's budget contains $63.76 million for budget
year 99-00 for pregnancy-related services. This bill would
not become operative until July 1, 2000, unless an
appropriation is made in either the Budget Act of 1999 or
in another statute enacted during the 1999 portion of the
1999-2000 Regular Session.
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BACKGROUND AND DISCUSSION
Previous legislation:
1.This bill is identical to last year's SB 34
(Vasconcellos) which the Governor vetoed. In his veto
message, Governor Wilson acknowledged the value of
prenatal services, but also expressed the opinion that it
is wrong for California and California taxpayers to have
to provide care to illegal aliens, services that he felt
should be paid for by the aliens' "home country."
2.Prior to August 1996, the federal government, through
Medicaid, paid for both treatment for emergency medical
conditions and nonemergency pregnancy-related services
for undocumented aliens who were otherwise Medicaid
eligible, but did not meet residency requirements.
However, the federal Personal Responsibility and Work
Opportunity Reconciliation Act of 1996 ("welfare reform")
ended the nonemergency coverage for aliens who entered
the United States after August 1996. The emergency
services continue to be covered under the federal-state
program. The nonemergency pregnancy-related services for
aliens who entered after August 1996 are covered in
California law in a state-only program; however, the
federal Budget Act of 1997 requires states to enact new
legislation in order to provide these services.
Public health:
According to supporters of the bill:
1.Prenatal care has long been recognized as a means of
reducing the incidence of low birth weight infants and of
birth complications by identifying mothers at risk of
adverse birth outcomes and by providing medical,
nutritional, and educational interventions necessary to
reduce the risk of those outcomes.
2.Studies show that for every one dollar ($1) spent on
prenatal care services, three dollars ($3) are saved in
medical costs associated with pregnancy, birth, and
postnatal care.
3.While the cost of prenatal care and normal delivery is
under three thousand dollars ($3,000), the cost of a low
birth weight baby, including the first year of care,
averages seventeen thousand dollars ($17,000). Charges
for initial hospitalization can reach one million dollars
($1,000,000).
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4.Since any infant born in the United States is deemed a
citizen, all the costs associated with an infant's
adverse birth outcome will be covered by the state
through Medi-Cal and other programs. Infants with
adverse birth outcomes are more likely than other infants
to experience long-term medical, educational, and social
problems, demanding additional long-term costs borne by
the state.
POSITIONS
Support: ACLU
AFSCME
Alameda Health Consortium
American College of Obstetricians and
Gynecologists
Arroyo Vista Family Health Care
Asian Pacific American Legal Center
Association of Regional Center Agencies
(ARCA)
Bay Harbor Center for Women's Health
California Academy of Family Physicians
California Association of Public Hospitals
and Health Systems
California Catholic Conference
California Church IMPACT
California Conference of Catholic Bishops
California Healthcare Association
California Immigrant Welfare Collaborative
California National Organization of Women
California Nurses Association
California State Association of Counties
(CSAC)
CalWACHC
Children's Advocacy Institute/ Center for
Public Interest Law
Coalition for Humane Immigrant Rights of Los
Angeles
Community Health Clinic
Council of Community Clinics
Friends Committee on Legislation of
California
Huntington East Valley Hospital
JERICHO
Los Angeles County
March of Dimes
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Maternal and Child Health Access
Mission City Community Network, Inc.
MOMS
Monterey County Health Department
Napa County Medical Society
National Center for Youth Law
National Council of Jewish Women
National Health Law Program
National Immigration Law Center
NEUHC
Northern California Coalition for Immigrant
Rights
Northern California Lawyers for Civil
Justice
Pediatric and Family Medical Center
Planned Parenthood Affiliates of California
(PPAC)
Project NATEEN
Queen Of The Valley Hospital
Sacramento County
San Judas Medical Group
UCLA OB-GYN Clinic
University Children's Medical Group
(Pediatric Management Group)
Vista Community Clinic
Western Center on Law and Poverty, Inc.
Oppose: None to date
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