Dispute Imperils California Family Planning Program For The Poor

Dispute imperils California family planning program for the poor

The state could incur millions in costs because of dispute with Bush administration over how it counts illegal immigrants in the successful service.

By Jordan Rau
Los Angeles Times Staff Writer
October 3, 2008

SACRAMENTO — California is locked in a dispute with Washington that state officials say has imperiled a successful family planning program for the poor.

The program saves federal and state taxpayers more than $1.4 billion annually, the officials say, by helping low-income women avoid unwanted pregnancies. The Bush administration wants the state to change the way it counts the illegal immigrants who use the service.

If not resolved in California's favor, the disagreement could create a new hole of at least $262 million in the state budget that just went into effect, the state officials say.

“We are . . . potentially dismantling a program that everybody believes has been highly effective,” said Stan Rosenstein, who runs Medi-Cal, California's healthcare program for the poor.

Californias Family Planning, Access Care and Treatment Program, or Family PACT, provides counseling, education and birth-control services to nearly 1.7 million low-income Californians each year, including prenatal services, annual exams and education about sexually transmitted diseases. It does not provide abortion counseling.

The federal government pays $315 million of the program's $432-million annual cost. Because those federal funds can be spent only on legal residents, California picks up the tab for the services to undocumented immigrants.

Officials say the services cost far less than the state would pay in maternity care for the 170,000 women who avoid unplanned pregnancies through the program. Avoiding those births also saves the state welfare and public schooling costs.

Since it began receiving Medicaid money in 1998, the state has used a statistical method to estimate the number of illegal immigrants in the Family PACT program, currently calculated at 14%. But the Bush administration, which has been objecting to this method since 2004, last month told California it had 30 days to begin vetting every participant to determine if each is in the country legally, or lose all federal funding.

It is not clear why the ultimatum was issued now, just months before President Bush leaves office.

Gov. Arnold Schwarzenegger and congressional Democrats have strenuously objected to the demand. They say it would require the state to hire 2,800 more workers — essentially doubling the staff of the Department of Health Care Services.

Vetting each program applicant would increase the state's costs by 40%, state officials said.

“It makes no fiscal sense whatsoever,” said Kathy Kneer, president of Planned Parenthood Affiliates of California. “It undermines the whole cost-effectiveness of the program.”

California officials fear that if they have to determine the immigration status of each participant in Family PACT, it will scare away many who are not in the country legally. The state offered to increase its estimate of illegal immigrants to 17.8% of total participants, but that was rejected, Rosenstein said.

Federal officials declined to discuss the issue with The Times.

In a Sept. 3 letter, Washington gave the Schwarzenegger administration a month to agree to the new terms or give up the federal money. It extended that deadline by two weeks after Schwarzenegger complained in a letter to U.S. Health and Human Services Secretary Mike Leavitt: “Frankly, I am disappointed by this abrupt action and the lack of personal consultation.”

Still, starting today, California will begin forfeiting 5% of the federal money until it agrees to the new rules.

Schwarzenegger and legislative leaders have been lobbying House Speaker Nancy Pelosi (D-San Francisco) to either intervene with the Bush administration or overrule it.

“We strongly urge your support in reversing the recent directive,” said a letter to Pelosi signed by Schwarzenegger, state Senate President Pro Tem Don Perata (D-Oakland) and Assembly Speaker Karen Bass (D-Los Angeles).

Pelosi and other members of the California congressional delegation have written to Leavitt asking for reconsideration.

But California officials fear the issue will not be resolved before Congress, consumed lately by the national financial crisis, adjourns for the year. They hope to at least postpone the new rules until next year, when Congress is back in session and there is a new administration in Washington to reconsider them.

“The clock is running,” Rosenstein said.