DESPITE California leading the nation in expanding healthcare insurance to include everybody, nearly 1.8 million of its residents remain uninsured. According to research from teams at University of California, Los Angeles and UC Berkeley, about 1.5 million undocumented Californians would qualify for health programs under the Affordable Care Act, which remains off-limits to undocumented immigrants.
Senate Bill 4, known as the “Health for All” Act, is the formal legislation that would change that. The bill, introduced last December by 33rd District Senator Ricardo Lara (D-Bell Gardens), made progress when it passed in the Senate Health Committee on a unanimous vote last month.
If signed into law, the bill would allow more than a million undocumented immigrants to qualify for Medi-Cal, California’s health program for lower-income individuals and families.
“In California, a state built by immigrants, there have been many efforts to implement healthcare reform to include everyone,” Sen. Lara said in a press call with the media on Monday, May 11. “It’s time to end the deliberate exclusion of undocumented immigrants from the program.”
“We have an opportunity to demonstrate visual leadership, to provide a pathway to healthcare coverage to include everyone in the state,” he added.
Overall, the Health for All bill seeks a way for the federal government to expand Medi-Cal coverage to undocumented immigrants, as well as for higher-income immigrants to purchase their own healthcare through Covered California.
The projected increase in Medi-Cal spending would range from $280 million to $740 million annually, according to research, and between 50-60 percent of eligible immigrants would enroll in the healthcare program.
“[SB 4] creates a merit exchange program under Covered California to allow undocumented Californians to purchase insurance offered through the exchange, just like every other citizen,” Lara said.
Undocumented immigrants comprise 10 percent of the state workforce, Lara mentioned. Polling data from the UC Berkeley Labor Center also found that about one-third of immigrants have incomes above the medical insurance threshold, and can pay for their own insurance if they qualified.
53 percent of all undocumented immigrants in California fell below the medical eligibility threshold and lacked private health insurance through their employer.
“The state has already provided unlimited care coverage, and 1.1 billion dollars is spent annually providing coverage for California,” Lara said. “But we need to provide coverage for everyone in California.”
Lara added that the measure would be a “significant cut” from a similar, costlier proposal he made last year (SB 1005), which was stalled in the Appropriations Committee, and SB 4 is a “realistic, cost-effective solution” to the issue.
“Enrollment [in healthcare programs] is not only a more humanitarian approach, but also a more cost-effective and ensures access to necessary health and wellness programs,” he said confidently. “But we will cut the state subsidies from the exchange, reducing significant costs from implementing the bill.”
The state is already spending about $1.7 billion on its Emergency Medi-Cal population, according to the California Immigrant Policy Center’s government affairs manager, Ronald Coleman. “Under Lara’s bill, it would only be spending an additional 2 cents on every dollar it spends to provide comprehensive Medi-Cal,” Coleman said.
Anthony Wright, executive director of Health Access, a coalition of over 200 groups that advocates for quality, affordable and equal healthcare for all, also commented on the importance of the Act.
“Being uninsured means you live sicker, you die younger, you are one emergency away from a higher risk of something unexpected—it leads to financial consequences for families and the larger community,” Wright said. “Our healthcare system is stronger with immigrants—we recognize that we are all better off if everyone is licensed, trained, and insured; if everyone is included.”
“If we really want to make the long-awaited reform in healthcare and the economy, this is the way,” he added. “It’s really hard to steer a ship if there are still people hanging off the sides.”
This time around, said Wright, there is more momentum around the bill—more members of the Senate voting and co-authoring, more legislative leaders supporting healthcare as an important issue that affects not just the immigrant community, but everyone.
And the cost of this year’s proposal was just a fraction of last year’s, he added.
Both Senator Lara and Wright also supported President Obama’s proposed executive actions for immigrant reform, currently on hold from a court order. If the order is upheld, around 900,000 immigrants in the state would qualify for Medi-Cal and other state programs. Deferred action for at least 5 million undocumented immigrants would “bring even more momentum to the issue, reduce costs, and give more citizens access to healthcare,” Wright said. “This is the next step towards having a humane system.”
The hearing for the Appropriations Committee to decide when SB 4 will go to the full Senate floor for budget negotiations and a final vote is scheduled for the last week of May or early June.
“California has to be the leader, because what happens here will hopefully cascade from west to east,” said Sen. Lara. “We have to embrace this opportunity to be decisive and make a historic move to expand healthcare, and to make a real difference in the lives of thousands of hard-working immigrant families.”
“We must really achieve the dream of a healthy California.”
(With reports from Los Angeles Times)
(LA Midweek May 13-15, 2015 Sec. A pg.1)