EFFECT OF CALIFORNIA PROPOSITION-187 ON THE USE OF PRIMARY-CARE CLINICS

California's ballot proposition 187, passed by the voters in November 1994, threatened to discontinue undocumented immigrants' eligibility f or most health services while mandating that health care professionals report suspected undocumented patients to authorities. Although the p roposition has not been put into practice, reports suggest that its pa ssage was associated with a decline in the use of health services by s ome groups. To assess the effects of the passage of Proposition 187 on the use of primary care services, we surveyed a representative sample of California clinics serving low-income groups (n = 129). Using a ma iled questionnaire and phone interviews with clinic directors, we obta ined qualitative and quantitative data regarding the effects of the pa ssage of the proposition on clinic use. Among primary care clinics sta tewide and clinics serving predominantly Latino patients, we detected no significant decline in total monthly visits following the election. Nevertheless, half of clinic directors (51%) thought that the number of clinic visits declined after the passage of Proposition 187, and ma ny directors thought that the deterrent effects of the election persis ted for weeks to months after the election. Whereas the number of visi ts probably declined at some clinics, only a small minority of patient s at most primary care clinics could have been deterred from seeking c are after the passage of Proposition 187.