Limited success in challenges to cuts

By Evvie Becker, PhD
University of Connecticut

Cuts in fundamental prevention services for immigrants, mandated by the 1996 welfare reform law (P.L. 104-193), have faced repeated court challenges.Yet such efforts to stop cutbacks in Medicaid funding, food stamps and disability payments generally have been unsuccessful. In fact, some cuts targeting both legal and illegal immigrants have been reversed by legislative action.

Primary prevention: prenatal care cuts in California

The fight over funding of prenatal care for undocumented women has dragged on in California courts. Last August, the state court of appeals ruled that California could stop funding prenatal care for illegal immigrants in compliance with the 1996 federal welfare reform law. In December, another California court dismissed a suit (Clementina Doe vs. Wilson, C97 2427SI, USDC N.D. Calif., Dec. 16, 1997) that had attempted to have the welfare law declared unconstitutional on grounds that the law denied states? rights as guaranteed by the Constitution.

Yet three days after this rebuke of the constitutionality challenge to the welfare law, California Superior Court Judge Sandra Margulies granted an injunction to delay implementation of the prenatal funding ban, which had been scheduled to begin Jan. 1 (Yvette Doe vs. Belshe, 785153-7, Calif. Sup. Ct., Dec. 19, 1997). Then, in another about face, within a month of the superior court ruling, the state of California was again given a green light to deny funding for prenatal care: The state appellate court in January lifted the injunction put into effect by Judge Margulies.

Gov. Pete Wilson, who has advocated the denial of prenatal care to undocumented women, announced in January that the state would refuse all new applications for such care beginning March 1. In addition, about 70,000 pregnant women currently receiving care would be removed from eligibility rolls as of April 1. However, two court challenges were pending that could push implementation of the ban still further into the future.

The cut-off of prenatal funding would leave illegal immigrants eligible only for emergency medical care. Advocates of primary prevention noted this policy will create a wave of babies delivered through county emergency rooms to mothers who had not had the benefit of prenatal care to ensure a healthy birth. Meanwhile, the California Primary Care Association announced they will defy the ban in their 250 member clinics, continuing to provide care and to encourage all women to seek prenatal care.

In addition to the cost to communities in ethical, public health and humanitarian terms, the fiscal costs of discouraging prenatal care is likely to be greater than the cost of providing it.

As the Los Angeles Times editorialized in January: 'Californians will be paying for a pound of cure rather than an ounce of prevention. Study after study has shown that mothers who do not receive prenatal care are more likely to give birth to sickly, low-weight infants. These children?American citizens by birth?will be delivered at California hospitals and clinics, at sometimes staggering intensive-care costs that are eventually passed on to all state residents. The poor start they receive may follow them throughout their lives in the form of higher health care costs' (Jan. 30, 1998; 'Babies will pay for this one'; p. B8).

Other court challenges to welfare cuts

Court challenges to other welfare cuts have been similarly discouraging. Last July, a federal court in New York ruled that cuts to food stamps and disability for legal immigrants were permissible and did not constitute bias against immigrants.

However, Congress has subsequently restored Supplemental Security Income (SSI) disability payments to legal immigrants. Food stamp restoration for legal immigrants has been slower to gain approval. President Clinton allocated $2 billion in his budget proposal to restore food stamps to legal immigrants, and a Congressional bill that would restore these food stamp provisions is pending (H.R. 1507, 'Hunger Has a Cure Act'). The latter bill would also increase funding for child nutrition programs, including WIC, the nutritional program for Women, Infants and Children.

Legislative action may be most effective recourse

For psychologists concerned about these threats to basic prevention programs for poor families, the lesson appears to be that, in the case of current welfare policy, advocating legislative action through our congressional and state representatives may be a more effective course of action than seeking redress through the judicial system.

'Judicial notebook' is an effort by the Courtwatch Committee of APA?s Div. 9, the Society for the Psychological Study of Social Issues, to encourage involvement by psychologists in judicial decision-making.

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