BILL ANALYSIS
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|SENATE RULES COMMITTEE | SB 82|
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THIRD READING
Bill No: SB 82
Author: Vasconcellos (D), et al
Amended: 4/22/99
Vote: 21
SENATE HEALTH & HUMAN SERV. COMMITTEE : 5-1, 3/10/99
AYES: Escutia, Figueroa, Hughes, Solis, Vasconcellos
NOES: Mountjoy
NOT VOTING: Haynes, Morrow, Polanco
SENATE APPROPRIATIONS COMMITTEE : 10-3, 6/8/99
AYES: Johnston, Alpert, Bowen, Burton, Escutia, Karnette,
Kelley, McPherson, Perata, Vasconcellos
NOES: Johnson, Leslie, Mountjoy
SUBJECT : Medi-Cal: pregnancy-related services
SOURCE : Author
DIGEST : This bill extends medically necessary pre-natal
care to Medi-Cal income-eligible undocumented and other
aliens not covered under federal laws.
ANALYSIS : 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
CONTINUED
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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.
Comments
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 1996 federal welfare reform law requires states to
re-enact programs providing benefits to residents who are
"non-qualified aliens" or to discontinue the benefits.
(For the most part, non-qualified aliens are non-citizens
who are not legal residents of the United States.) In 1996
Governor Wilson, through executive order, initiated efforts
to end prenatal benefits to undocumented women. The
implementation of this order has been blocked by a series
of preliminary injunctions issued in state court in three
suits. The suits raise a variety of issues related to the
procedures used to implement the order and issues related
to the content of the proposed regulations. Two of the
suits are still pending. A fourth suit pending in federal
court raises constitutional issues regarding the federal
government's authority to require the state to reenact
statutes for immigrants to allow benefits to continue.
Prior legislation
This bill is similar 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
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and California taxpayers to have to provide care to illegal
aliens, services that he felt should be paid for by the
aliens' "home country."
SB 34 passed the Senate 21-10, as follows:
AYES: Alpert, Burton, Calderon, Greene, Hayden, Hughes,
Johnston, Karnette, Kopp, Lee, Maddy, McPherson,
O'Connell, Polanco, Rosenthal, Schiff, Sher, Solis,
Thompson, Vasconcellos, Watson
NOES: Brulte, Haynes, Johannessen, Johnson, Kelley,
Knight, Lewis, Monteith, Mountjoy, Rainey
NOT VOTING: Ayala, Costa, Craven, Dills, Hurtt, Leslie,
Lockyer, Peace, Wright
Assembly Members who are new Senators votes:
AYES: Baca, Bowen, Escutia, Figueroa, Murray, Ortiz,
Perata
NOES: Poochigian, Morrow
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: Yes
According to Senate Appropriations Committee:
Fiscal Impact (in thousands)
Major Provisions 1998-99 1999-2000 2000-01
Fund
Prenatal benefits 32,000* 64,000 64,000
General
Savings unknown General and
federal
*This amount is included in the Governor's proposed budget.
Staff comments:
The cost-effectiveness of prenatal care has been well
documented. Without it, the extra cost of treating newborn
babies and the emergency complications of the birth could
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be more than the outlays for prenatal care. But savings to
the state may not fully offset the total cost of prenatal
coverage because an unknown number of these women, even
though they lose Medi-Cal coverage, will continue to
receive prenatal care through indigent care programs
offered by the counties and community clinics.
SUPPORT : (Verified 6/9/99)
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
League of Women Voters
Los Angeles County
March of Dimes
Maternal and Child Health Access
Mission City Community Network, Inc.
MOMS
Monterey County Health Department
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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.
American Academy of Pediatrics
Alameda County Board of Supervisors
American Jewish Congress
California Association of Catholic Hospitals
California Interfaith Coalition
California Primary Care Association
City and County of San Francisco
County Health Executives Association of California (CHEAC)
County Welfare Directors Association
Frank D. Lanterman Regional Center
KIDS Network of Santa Barbara County
Lieutenant Governor Cruz Bustamante
North Los Angeles Regional Center
Santa Barbara County
Santa Clara County Board of Supervisors
South Los Angeles Health Projects
Urban Counties Caucus
ARGUMENTS IN SUPPORT : 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,
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nutritional, and educational interventions necessary to
reduce the risk of those outcomes.
2.Studies show that for every $1 spent on prenatal care
services, $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 $3,000, the cost of a low birth weight baby,
including the first year of care, averages $17,000.
Charges for initial hospitalization can reach $1,000,000.
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.
CP:sl 6/9/99 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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