Civil Rights Groups Sue State Over 6-Month In-State Residency Requirement for Women in Need of Pre-Natal Care


For Immediate Release: April 24, 2008

SAN FRANCISCO –Maternal and child health advocates and leading public interest law groups have filed a lawsuit against the state of California seeking to end a requirement that low-income working women must be residents of California for six months before they are eligible to receive prenatal and other medical care services through California’s Access for Infants and Mothers (AIM) insurance program. 

Maternal and Child Health Access (MCH Access), a non-profit organization that advocates for health care for pregnant women and children, seeks a court order that will prevent the state from implementing the six-month in-state residency requirement.    

The American Civil Liberties Union of Northern California, Bay Area Legal Aid, the Lawyers’ Committee for Civil Rights, and MCH Access’ lawyers hold that because the requirement discriminates against pregnant women who are new California residents on the basis of how long they have lived in the state, it violates both the California and the United States Constitutions. 

MCH Access points out that time is of the essence in obtaining access to prenatal care, and that prenatal care is especially important to maternal and fetal health in the first trimester.  The sixth-month in-state eligibility requirement means that working poor women who are new residents in California may not be able to obtain timely prenatal care through AIM at all.

“Study after study shows that early access to prenatal care is important for the well-being of the mother and the child,” said Lynn Kersey, Executive Director of MCH Access. “Prenatal health care can help prevent premature delivery and low birth weight. To deny working women health care simply because they are new to the state endangers the health of both the mother and the child.”

In denying a woman AIM coverage, the state also deprives the newborn of healthcare coverage guaranteed if the mother was in the program. This can lead to tremendous costs for families. Studies show that medical bills are one of the nation’s leading causes of bankruptcy for families.  

The legal groups explain that the government requirement is also unconstitutional. “The residency requirement discriminates against new residents in violation of equal protection under the law and impedes the fundamental freedom to travel between states,” said Juniper Lesnik, an attorney at the ACLU-NC. “The U.S. Supreme Court has already struck down durational residency requirements for similar benefits because they are unconstitutional.”

In 2007, the Legislature passed AB 1328, which would have deleted the residency requirement.  The Governor vetoed the bill in October 2007.

The State estimates that 100 women each year are excluded by the six-month requirement in AIM. The lawsuit seeks to clear the way for these women to obtain the prenatal care they need.

Lucy Quacinella, one of the lawyers for MCH Access, added: “With the mounting cost of food, gas, and other basic necessities, not to mention all time high charges for medical care and premiums for private health insurance, many working women find that they cannot afford health care. AIM is a program that is designed to step in and help these women who otherwise might fall through the cracks because they earn too much to qualify for the Medi-Cal program but too little to purchase health insurance.”

Participants in AIM contribute 1.5% of their annual income to the health services they receive.

The program is not only medically vital but cost effective.  According to the federal government’s Institute of Medicine, each dollar spent on providing adequate prenatal care saves $3.38 on medical care that would otherwise be necessary for low birth weight infants during the first year of life.  Other investigators have computed different, even higher, ratios, but virtually all find evidence of cost effectiveness.

To find out more about the AIM program you can call their toll-free number (800) 433-2611. You may also visit the AIM website: 
http://www.mrmib.ca.gov/MRMIB/AIM.shtml