In 1994, the California legislature passed a law with the hope of coercing poor mothers into having fewer children. Legislators evidently felt that the $122 a month that mothers received on average in welfare support for an additional child was encouraging poor mothers to have more children. The Maximum Family Grant Rule (also known as a family cap law) stripped these mothers, who were largely women of color, of this so-called incentive.

The Maximum Family Grant Rule added an exclusion to CalWORKs, California’s version of the federal Temporary Assistance for Needy Families program (commonly referred to as TANF), which provides poor expectant and recent mothers with cash support. It bars families who are already receiving CalWORKs assistance from obtaining additional support for a new child; the amount that a family receives thus remains unchanged. Similar family cap laws have been repealed in a handful of other states, but more than a dozen still have them on the books.

In California, a bill heading through the state legislature, SB 23, could soon repeal the Maximum Family Grant Rule after more than two decades. The California Senate passed SB 23 two weeks ago, and it is currently under consideration in the assembly. This is the third recent attempt to rescind the law; previous attempts have passed the assembly before dying in the senate. Since SB 23 has passed the senate it seems that a major hurdle has been overcome.

California’s Maximum Grant rule should be repealed first and foremost because of its discriminatory nature and demonization of poor women, particularly women of color, for having children and for requiring help from the government. The use of cash to attempt to influence parental birth decisions is also disturbing. However, there is a further argument to be made against the law: one of public health.

Family cap laws became popular during welfare reform in the 1990s, spurred by racist depictions of poor Black mothers as feckless parents and welfare queens who had children for the sole purpose of receiving government money. Family cap laws were intended to discourage families on welfare from having more children, with low-income Black women the primary targets. This rationale is still cited in support of them, even though research has found these policies have no such deterrent effect on the number of children individuals have.

Under the Maximum Family Grant Rule, mothers remain eligible for additional assistance only in the case of reported rape, incest, or contraceptive failures, although the accepted forms of contraception in this case are limited to an intrauterine device, a contraceptive shot or implant, or sterilization. (In other words, families with children conceived from the failures of birth control pills or condoms would not be eligible for more assistance.) These exceptions are themselves an issue: Many instances of rape and incest go unreported, and considering the history of sterilization of people of color in the United States and particularly in California, this pressuring of mothers into long-term contraception is problematic.

Research—and common sense—demonstrates that these laws worsen child poverty. Nationwide, the cap has led to a 13.1 percent increase in deep poverty rates among children of single mothers and a 12.5 percent increase among single mothers. Its repeal would open additional support for more than 130,000 children in desperate need across California. This would have a significant effect on public health, as there is a clear correlation between childhood poverty and poor health outcomes, including obesity and diabetes, child mortality, and low birth weight. The impacts of childhood poverty continue into adolescence and adulthood, limiting children’s abilities to do well in school and increasing their risk of chronic disease in later life.

Lacking sufficient resources, many families are unable to buy the healthy foods they need, instead turning to cheaper, high-calorie but low-nutrition foods to keep them full. This increases chances of childhood obesity, diabetes, and other chronic diseases. Obesity rates are 1.7 times higher among poor children and teens, and while obesity rates have increased by 10 percent among all children age 10-to-17, obesity rates among low-income children have increased by 23 percent. A California study found that poverty is significantly associated with children being overweight, and, similarly, diabetes rates are highest in poorest communities.

Common consequences of poverty, including poor nutrition, high stress, and limited access to prenatal care, also increase the risk of child mortality and low birth weight. Low birth weight, in addition to increasing the likelihood of health problems among newborns, is associated with higher risks for obesity, diabetes, heart disease, and other chronic health conditions later in life. This is another avenue through which CalWORKs benefits could aid growing families: Small amounts of cash assistance to new and expecting mothers can help them pay for such essentials as prenatal visits that will have a lasting effect on their infants.

Solutions aimed at prevention are not only the ethical approach, but also the fiscally smart approach. From an economic perspective, increases in poor child health have significant cost implications for taxpayers. The annual cost of medical care for a child with diabetes is six times that of a child without the disease, and the average cost of Medicaid care for a child with obesity is $6,730 compared to $2,446 for all children.

The link between poverty and poor health is unambiguous. While public health advocates have focused on policies to expand access to food stamp programs and healthy foods, cash-based programs are also important. Much more can be done to back solutions that explicitly address poverty and inequality. Repealing the Maximum Family Grant Rule should be a priority, along with efforts such as raising the minimum wage and guaranteeing paid parental leave. The public health basis for supporting these campaigns is clear. By leveraging the science linking poverty with poor health and chronic disease, public health and human rights advocates can advance the case for poverty-reduction programs and effectively push for policy change—including the passage of SB 23.