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Benefits
Appeals court affirms Congress’s right to deny assistance to pregnant undocumented aliens even though the babies will be U.S. citizens
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• U.S. Immigration Issues
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• U.S. Immigration Law
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• Prenatal Care at a Glance
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• Immigrant Prenatal Care Jeopardized (AP)
• The ruling (Lewis v. Grinker, 2nd Cir., May 22, 2001)
Dateline: 05/29/01
In a case that seems to highlight
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governmental foolishness, if not irrationality, the U.S. 2nd Circuit Court of Appeals in New York has ruled that Congress can seek to deter alien women from illegally entering the United States by denying them benefits for prenatal care, even though the children, once born, will be U.S. citizens with automatic eligibility for Medicare.
The court so ruled even though it accepted the fact that the cost of medical treatment for conditions created by lack of prenatal care greatly exceeds the cost of prenatal care.
The ruling last week in Lewis v. Grinker (2nd Cir., May 22, 2001), ends a long-standing lower court order requiring the government to provide prenatal care to undocumented aliens while requiring assistance to the same mothers’ children once they are born in the U.S. to the same extent as any other U.S. citizen.
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The court relied on the famous Roe v. Wade abortion decision from 1973 to establish that the unborn fetuses could not have the rights associated with citizens, even if when born they will instantly and automatically gain citizenship by virtue of being born in the U.S., because Roe established that fetuses cannot be considered “persons” within the meaning of the constitution. As such, the denial of benefits by Congress would be upheld if the law met a mere “rational basis” test on review, as opposed to a higher standard (presumably, a “compelling state interest”) applied to citizens claiming lack of equal treatment under the Fourteenth Amendment.
The government proposed three reasons in support of rationality. First, it claimed that denying benefits to illegal immigrants would deter further illegal immigration. Second, that it encouraged, relatively speaking, more self-sufficient immigrants (presumably those that would not apply for medical assistance). Third, the government proposed that denying prenatal benefits to these undocumented women would save money.
The court agreed with the first theory. Barely. It said:
Although the record discloses no evidence that a prospective illegal immigrant considers the unavailability of prenatal care in deliberating whether to illegally enter the country, such evidence is not required to satisfy rational basis analysis. … It is sufficient that this proposition be “reasonably conceivable,” … and it is reasonable for Congress to believe that some aliens would be less likely to hazard the trip to this country if they understood that they would not receive government benefits upon arrival … Although it seems likely that many alien women will illegally immigrate to obtain the benefit of citizenship for their children, undeterred by ineligibility for prenatal care in the event of pregnancy, Congress is entitled to suppose that the denial of care will deter some of them. In the realm of immigration, where congressional discretion is extremely broad, this supposition, even if dubious, satisfies rational basis review.
Because this was sufficient to uphold the restrictive welfare law, the court did not even address the second proposed justification, that of encouraging self-reliance. As to the cost factor, however, the court added in a footnote:
The latter rationale [cost savings] would seem to press the limits of even “rational speculation;” … it requires a belief that the welfare costs that would have been spent on the alien women (and their families) who are deterred by the denial of benefits would exceed the added costs of providing extensive medical services, for the rest of their lives, to the citizen children of those who come anyway.
One might wonder how this court can see any difference in rationality between the theory of deterrence - indeed, it called the deterrence theory, “dubious” - when women will know that if they can bear their children in the U.S., the children will be automatic U.S. citizens and entitled to all the privileges and immunities of citizens, just because they will not be able to get free prenatal care during pregnancy, while at the same time having no problem suggesting that the proposed dollar savings rationale is bogus.
In other words, if "Congress is entitled to suppose that the denial of care will deter some of them [from illegally immigrating],‘’ why is not Congress entitled to suppose that the government would save money by not paying benefits to those who are deterred from ever coming to the U.S., or entitled to suppose that those that do come anyway will generally find prenatal care some other way? Conversely, if the court says that the evidence doesn’t support the cost savings rationale, how then can it apply mere speculation to support the deterrence rationale?
In any event, it ultimately falls to Congress to take another look at the mess with which the courts must wrestle over the lack of minimal prenatal care and, as they say, “do the right thing.”
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