All Californians regardless of immigration status deserve the fundamental right to health care. Such is the notion driving Senate Bill 4, introduced by Senator Ricardo Lara, D-Bell Gardens. Also known as the Health for All Act, the legislation aims to provide access to health care coverage to undocumented individuals who are not covered under the Affordable Care Act. It would expand Medi-Cal to low-income undocumented individuals and create a private insurance exchange option for those with higher incomes.
Denying individuals the opportunity to purchase coverage when they are willing to buy into the market does not make sense.
Recent political strides at the national level focus on immigration policy. At the end of 2014, President Barack Obama took executive action to provide temporary protection against deportation to millions of undocumented individuals. The order has been temporarily blocked by the federal court. Despite this, the undocumented community continues to work and contribute to California’s economy. They produce about $131.5 billion of the state’s gross domestic and make up 9% of the labor force.
Yet over 1.4 million undocumented individuals remain uninsured. They are ineligible for comprehensive federal health care coverage, unable to purchase private insurance in California’s health insurance exchange, and ineligible for tax credits or lower co-payments. Such restrictions negatively impact undocumented individuals as well as the community at large in the form of costly health care expenditures and poor public health. Although emergency care under federal law and health services at safety-net hospitals and clinics are helpful, they are also more costly. When emergency medical costs rise, all taxpayers are impacted. Providing preventive care through coverage access would not only improve public health but also help stabilize California’s economy and taxpayers’ pockets.
Denying individuals the opportunity to purchase coverage when they are willing to buy into the market does not make sense. While SB 4 would expand Medi-Cal to cover low-income undocumented individuals, it would not subsidize health plans for those with higher incomes. Rather undocumented individuals with higher incomes will be granted the opportunity to buy into a private insurance exchange option. Including undocumented individuals in the insurance pool would be cost effective for everyone involved. Risk sharing would add to the success of health coverage and benefit all taxpayers.
After the bill was unanimously cleared by the California Senate Health Committee, the Senate Appropriations Committee placed it on the suspense file due to costs. A fiscal analysis of SB 4 suggests that expanding Medi-Cal to cover undocumented individuals would cost anywhere from $175 million to $740 million, depending on the outcome of President Obama’s executive action. While opponents focus on such costs, proponents highlight that California’s current budget relies heavily on the back breaking work and contributions of those they are excluding.
The legislation is on hold until the end of the month, when it will be reviewed against California’s revised state budget. If the bill passes out of the suspense file, it would need to win a vote on the Senate floor followed by the Assembly before reaching Governor Brown. Although SB 4 faces a challenging road ahead, Californians need to be open-minded and inform themselves of the holistic political, social and economic implications of such legislation.
It is critical that lawmakers continue to push forward to make healthcare accessible for all Californians. Investing in the undocumented today can lead to savings and benefits tomorrow. The future of our state depends on the boldness of our leadership and our commitment to the wellbeing of all Californians. California lawmakers have the opportunity to set a precedent for the rest of the nation. We urge them to continue to stand with undocumented Californians to build on their progress and success.
Ed’s Note: Daisy Ramirez and Cecilia Gonzalez are graduate students at the University of Southern California pursuing a master’s degree in social work.