Could a CA bill on tortillas improve maternal health?

California is struggling to provide maternal health for its residents. But as one proposal aims to prevent birth defects, another has received hateful pushback that’s been condemned by both political parties.

As CalMatters health reporter Ana B. Ibarra writes, Assemblymember Joaquin Arambula has introduced a bill that would require corn masa flour makers to add 0.7 milligrams of folic acid per pound of flour. Though federal law requires other grain products, such as cereals, breads and pasta, be fortified with folic acid, corn masa flour is not included. The corn flour is a key ingredient used in many classic Latino foods.

• Arambula, a Fresno Democrat and physician, to CalMatters: “Food is the best way that we can get folic acid into our communities before they’re pregnant. Oftentimes the prenatal vitamins that we give to pregnant people are too late.” 

Research has shown that folic acid, which can be found in prenatal and women’s multi-vitamins, promotes healthy cell growth, and can prevent birth defects when taken before and during the early weeks of pregnancy. Since 1998, when the U.S. Food and Drug Administration handed down the requirement, the proportion of babies born with neural tube defects dropped by 35%.

But between 2017 and 2019, only about 28% of Latinas reported taking folic acid the month before becoming pregnant, compared to 46% of white women. Women on Medi-Cal, the state’s health insurance program for low-income families, are also less likely to take folic acid before pregnancy compared to women on private insurance. 

To learn more about the proposal, read Ana’s story.

Another bill related to maternal health, Assembly Bill 2319, was the subject of a racist letter sent to members of the Health Committee, according to lawmakers.

The measure would require healthcare providers to undergo training for implicit bias, and for the training to include “recognition of intersecting identities.” 

The bill’s co-author, Assemblymember Lori Wilson, said the letter was “vile and hateful.”

Assembly Republicans also said the letter had no place in legislative debate: “While we may not always agree on policy, we are united to strongly condemn racism and the evil ideology behind this letter.”

Wilson, a Suisun City Democrat who is chairperson of the Legislative Black Caucus, vowed to carry on with the measure.

The proposals by Arumbula and Wilson follow state data showing that in 2020 California saw a ten-year high of pregnancy-related deaths. Black expectant mothers are particularly vulnerable: They are three times more likely to die of pregnancy-related complications than others. It’s a point raised by former state Senate leader Toni Atkins in a social media post last week.

Meanwhile, maternity wards across the state are closing, creating “maternity care deserts,” and California midwives treating Medi-Cal patients struggle to keep their businesses afloat. A February report from the state auditor also found that state health departments failed to track the effectiveness of a perinatal care program for Medi-Cal patients.

From CalMatters housing reporter Ben Christopher:

It’s about to get more difficult for local governments to slap construction projects with certain fees — and a bit easier for developers to sue governments when they do. 

That’s thanks to a unanimous ruling the U.S. Supreme Court handed down Friday.

As many court watchers expected, the justices sided with George Sheetz, a septuagenarian retiree who sued El Dorado County over a $23,420 building fee.

Sheetz’s lawyers argued that the county should have had to prove that this five-digit fee matched the cost that his manufactured home actually would inflict on local roads and highways. That requirement was established in a four-decade-old court ruling also out of California.

El Dorado County, with the backing of both the Gov. Gavin Newsom and President Joe Biden administrations, countered that such a high bar is only required of one-off fees levied by regulators, not fees scheduled for all developments and established by elected bodies, like the county board of supervisors.

In its 9-0 ruling, the Supreme Court said that “there is no basis for affording property rights less protection in the hands of legislators than administrators.”

A few possible consequences of the ruling:

• Cities and counties now have to show that impact fees are connected to and “roughly proportionate” to the fiscal impact of a given development. That could have the unintended consequence of slowing down permitting. 
• Developers may now have a powerful new legal tool to challenge fees that they think are too high.

And they are high here. As of 2015, the average impact fee on a single family home in California was more than four times the national average.

But it’s too soon to say exactly how all of this will shake out. That’s because the court stopped short of saying exactly how far governments have to go to justify their fees — or whether El Dorado County already cleared that hurdle in this case. Those questions were left to lower courts.

The State Water Resources Control Board is poised to penalize Kings County groundwater agencies for failing to manage overpumping in the region’s water supply — a move that would set a new precedent.

As CalMatters water reporter Rachel Becker explains, the board on Tuesday is expected to decide whether to put county agencies on probation for unsuccessfully restricting farmers’ overdrafting of the water supply from the Tulare Lake underground basin. If the board decides to crack down, it will be the first time the state imposes penalties under a landmark 2014 law that requires agencies to achieve groundwater sustainability by 2040.

The board’s decision could also signal how the state will approach five other overpumped San Joaquin Valley basins that may face probation as well.

Overpumping in Kings County has caused household and community water wells to dry up and land to sink, which endangers canals, aqueducts and flood-controlling levees. And because wells must reach deeper into the ground to extract water, contaminants such as arsenic are released and cause water contamination levels to rise.

Putting Kings County agencies on probation could mean imposing state fees totaling as much as $10 million a year, according to a CalMatters analysis. It could also lead to state regulators eventually managing the region’s groundwater.

This has small farmers in the region concerned that they’ll be forced out of business due to the state’s steep fees. The basin provides drinking and irrigation water for 146,000 residents and supports a multibillion-dollar agricultural industry.

For more on this issue, read Rachel’s story.

California’s water crisis, explained: CalMatters has a detailed look at how California might increase its water supply, and a dashboard tracking the state’s water situation.