Court uses 1996 welfare 'reform' to bar prenatal care
funds
By Ellen
Catalinotto,
Certified Nurse-Midwife
New York
Pregnant women who are in this country without legal
immigration status are to be denied prenatal care under
Medicaid, ruled a federal court May 22 here in Manhattan. The
1996 welfare laws explicitly bar such care, said the Second
Circuit Court of Appeals in making its ruling, even as it
acknowledged that providing prenatal care would reduce
government costs.
With the so-called welfare reform act of 1996, Democrats
and Republicans made a bi-partisan attack on the poor,
targeting women and children, especially women of color. The
act was also meant to discourage immigration by denying
benefits to undocumented immigrants even as businesses, large
and small, were profiting from exploiting immigrant labor and
many professional families depended on immigrant women to
care for their children.
In recent years, despite the economic boom of the late
1990s, increasing numbers of working people are without
health insurance as companies cut benefits. Young adult
women-the group most needing prenatal care-are among those
least likely to be insured.
Advocates for women, children, public health, and the
right of choice in reproductive decisions can all gain by
uniting to fight this latest anti-immigrant ruling. The
court's ruling is a challenge to these progressive movements
to develop a united struggle.
The birth of a healthy baby costs $1,200 according to the
New York State Department of Health. Prenatal care is
economically sound preventive medicine, which screens for
infections and other conditions in mothers to avoid tragic
outcomes and life-long disabilities for their babies.
Lack of prenatal care puts a woman at increased risk of
delivering a low birth-weight infant, whose care costs
$10,000 to $65,000 in the first weeks of life alone, in
addition to the poor quality of life such children may
suffer. These babies, if born in the United States, are
eligible for Medicaid as U.S. citizens no matter what the
status of their parents. Thus the court ruling spends more
government funds to deliver less care.
New York State's program
New York State spends $15.5 million on prenatal care for
the 13,000 undocumented women who give birth in the state
each year, a tiny fraction--one two-thousandths--of the $30
billion state Medicaid budget. The state's Prenatal Care
Assistance Program provides care, regardless of legal status,
to women whose income is less than twice the poverty line.
Thousands of uninsured women, working and unemployed,
citizens or not, benefit from this program.
Many hospitals depend on PCAP to pay for prenatal care and
delivery for women without other health insurance. The
federal government reimbursed half of these costs under a
1987 injunction, which was reversed by the May 22 court
ruling.
The only government health programs remaining for the
undocumented in this state are Child Health Plus, a
state-financed sliding-scale insurance for children, and care
at hospital emergency rooms. Uninsured citizens and
documented residents also depend on these programs to access
health care.
While a lower court decides how to implement the court's
ruling, prenatal care for undocumented women under PCAP will
continue. State legislators are also considering ways of
providing prenatal care even without federal assistance.
In deciding whether or not to appeal the federal court
decision, Legal Aid lawyers must consider the danger that
such an appeal could allow the Supreme Court to re-open Roe
v. Wade, the 1973 decision that made abortion legal by ruling
that a fetus is not a person protected by the
Constitution.
The Second Circuit referred to the landmark abortion
ruling, stating, "if a fetus lacks constitutional protection
to be born, we see no basis for according it constitutional
protection to assure it enhanced prospects of good health
after birth."
It is interesting to note that so far none of the
so-called "pro-life," that is, anti-abortion, groups have
come forward to defend prenatal care, although they claim to
be champions of the "unborn child."
This article is copyright under a Creative
Commons License.
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