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State urges feds to OK immigrants’ health coverage

A physician flanked by the California flag. (Illustration: Niyazz, via Shutterstock).

Hundreds of thousands of undocumented immigrants in California would be able to buy insurance through the state healthcare coverage marketplace if the federal government accepts a newly signed state law to exempt them from the federal rule.

Federal law prohibits illegal immigrants from buying health insurance through Covered California, the state health insurance exchange – the first one in the nation — created by the federal Affordable Care Act, or ACA. The complex system includes a sliding scale of costs and subsidies pegged to income.

“Our health care system is stronger when more are included. It seems odd to continue to maintain this exclusion.”

But on June 10, Gov. Jerry Brown signed legislation requiring Covered California to ask the federal government for a waiver to let an estimated 390,000 undocumented immigrants buy health insurance – as long as they do it with their own money.

The ACA, which provided $40 million for California to start up its health exchange, included a provision specifically barring undocumented immigrants from buying insurance through its program.

“The current policy disallowing immigrants from purchasing care with their own money is both discriminatory and outdated,” state Sen. Ricardo Lara, D-Bell Gardens, the author of the bill, SB 10, said in a written statement.  He urged the federal government to “remove barriers to health insurance access that discriminates against some of our residents on the basis of their documentation status.”

California would apply for an “innovation waiver” under a provision of the ACA that lets states “implement innovative ways” to provide healthcare that has at least the same coverage as ACA, would cover the same amount of people and would not add to the federal deficit.

Lara’s bill prohibits undocumented immigrants from receiving any federal assistance to pay for the insurance, unlike citizens and others who are legally in California who may get subsidies to help meet the cost of coverage.

There was no formal opposition, although 20 Assembly Republicans and 10 Senate Republicans voted against the measure.

While undocumented immigrants currently can buy health insurance through a broker, they are excluded from buying through the Covered California system, said Anthony Wright, executive director of Health Access California, which advocates for the expansion of quality health care.

“It’s not just unfair, but counter-productive,” he said. “We recognize that because without subsidies there will be very significant affordability burden for many if not most.”

But there is a “relatively small number who could take advantage … Our health care system is stronger when more are included,” he added. “It seems odd to continue to maintain this exclusion.”

Supporters of SB 10 also say eliminating the exclusion would make it easier for the 70 percent of families of mixed immigration status to have health insurance. Children 18 years or younger became eligible for full-scope Medi-Cal services on May 16. Medi-Cal is a huge program providing medical services to low-income people, children and the disabled. Nearly 13 million people, about a third of California’s population, receive Medi-Cal services.

According to the bill’s document package, there was no formal opposition, although 20 Assembly Republicans and 10 Senate Republicans voted against the measure.

But, SB 10 ultimately passed with bi-partisan support.

“SB 10 allows individuals to purchase health coverage without a government subsidy, rather than seeking healthcare through emergency rooms, which ends up costing the taxpayers,” Senator Andy Vidak, R-Hanford, said in a statement.

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