California Sen. Ricardo Lara (D) is pushing a bill through the statehouse that seems to promise the impossible: Making California the first state in the nation to allow undocumented immigrants to get covered under Obamacare.
Lara’s bill — which was passed by the Senate last year — faces the state’s Committee of Health on Tuesday. Policy experts say this bill has a good chance of landing on Gov. Jerry Brown’s desk.
The bill represents a stepping stone toward allowing immigrants to purchase insurance through Obamacare’s state health exchanges. Essentially, it asks the federal government to allow the state the right to open its exchange (Covered California, in California’s case) to undocumented immigrants — which is currently illegal under the Affordable Care Act.
We are talking about our neighbors and our families who are denied basic health care in the richest state of this union
Asking the government to change a major law may seem like a long shot, but this right is actually written into the ACA itself. The health care law welcomes “innovation waivers,” or requests by state governments to modify the ACA in their state in order to expand insurance coverage. Lara’s request falls directly into this category.
To Lara, the son of an undocumented immigrant, this bill isn’t just about expansion.
“We are talking about our friends. We are talking about our neighbors and our families who are denied basic health care in the richest state of this union,” Lara said last June during Senate negotiations.
To gain state support, he’s pointed to the ACA loophole allowing Medicaid to cover undocumented patients if they come through the emergency room. This means many immigrants rely on ER visits for health issues that could have easily been avoided with regular primary medical care — a luxury they aren’t allowed. By expanding undocumented immigrants’ access to insurance plans that cover preventative care, Lara said the government will see a significant decrease in spendy ER bills.
ER visits for undocumented immigrants add up to a yearly $1.7 billion in state costs, according to California Assemblyman Rob Bonta.
“We are providing care in California at taxpayer cost for undocumented Californians today,” he Bonta said, according to IB Times. “The emergency room is one of the most expensive points of healthcare delivery in the entire system. That’s not efficient.”
Lara has yet to request any state funding to back this bill. While this approach could help it land Gov. Brown’s signature, opponents fear it also could render it pointless. To qualify for the ACA’s “innovation waiver” provision, a state cannot rely on any additional federal health care funding. That means that unlike documented immigrants, those without papers will have no access to the subsidies that make Covered California so affordable.
In a state where a staggering 80 percent of all households occupied by undocumented people live in poverty, the likelihood that they’d opt into the unsubsidized exchange is slim. However, proponents say that this bill is just the first phase in California’s push to give all residents access to affordable health care. This first stage may be more a symbol of progress toward this end goal.
If Lara’s bill becomes law, California will be the first state to legally allow undocumented residents to purchase Obamacare plans. However, some states have already funded their own programs to break down the barriers to affordable health care. As of June 2015, 18 states offered subsidies for prenatal care for undocumented women and health insurance for all undocumented children.
Counties in California and other states have introduced smaller-scale efforts to keep their communities healthy — and ER costs down. At least 20 of the 25 counties that host the largest percent of undocumented immigrants have county-funded programs providing free or subsidized preventative health care for undocumented people. In California, 48 counties offer this kind of care. County officials argue that this strengthens the entire health of the population.
“Consider the implications of half the people on the [local] rail lines and buses carrying them to work being denied flu shots,” Clay Jenkins, the chief elected official for Dallas County, Texas, told the Wall Street Journal. “There are 2.5 million people that live here, and they’re all important and they’re all deserving of respect and medical care.”
This post originally referred to California’s state health exchange as Medi-Cal, when it is actually called Covered California.