Undocumented Californians One Step Closer to #Health4All

On Friday, Gov. Jerry Brown signed in to law a historic piece of legislation that will allow undocumented immigrants access health insurance plans through Covered California – the state Affordable Care Act (ACA) marketplace.

California’s SB 10 requires the state to apply for a federal waiver under Section 1332 of the Affordable Care Act in order to expand health coverage through the state health care marketplace. The waiver will allow undocumented immigrants and Deferred Action for Childhood Arrivals (DACA) recipients to buy health insurance policies through the Covered California exchange for the first time.

Children and families that may have been here for their entire lives can obtain only emergency care under California’s current rules. But a lack of preventative care leads to a cycle of sickness for thousands of families.

In fiscal year 2014/15, California spent approximately $1.3 billion on emergency and maternity treatment for undocumented immigrants.

Though adult non-citizens would not qualify for financial assistance in paying their health care costs, as most Americans on ACA plans do, this expansion of the law would allow mixed-citizenship families to shop and apply for coverage in the same place at the same time.

But many of these of mixed-status families are eligible for financial assistance in other ways.

Last year, California expanded Medi-Cal (Medicaid) coverage to thousands of financially needy children under 19 years old, regardless of their citizenship status. The plan (last year’s SB 4) went into effect in May, and is estimated to bring low-or-no cost health care coverage to 170,000 undocumented children not covered by Obamacare. California is only the fifth state to expand health coverage to undocumented children, but the neediest kids in the state with the highest undocumented immigrant population in the country now have access to preventative care, dental, and mental health services they would have not qualified for previously.

California Senator Ricardo Lara, the original sponsor of both bills (and himself the son of undocumented immigrants), estimated that this would result in approximately 390,000 new users of the Covered California marketplace.

The ACA provides greater access to private health insurance and Medicaid– but there are still millions across the country without access to affordable healthcare. And in California somewhere between 2.7 and 3.4 million people are still uninsured – approximately 1.4 million of which are undocumented and would still be unable to afford insurance under new rules of SB 10.

Immigrant families contribute over $3 billion per year to state and local taxes in California, and reap very few of the benefits.

SB 10 would not ensure healthcare as a right for immigrants – it will simply give them the ability to buy coverage in an increasingly expensive insurance market.

You may recall that in September 2009, when the debate over the ACA was at its peak, the very question of whether the ACA would benefit undocumented immigrants caused fireworks during a joint session of Congress. However inflammatory the debate was at the time, it was impossible for President Obama to foretell how states like California might modify future coverage for its residents.

Section 1332 of the ACA allows any state to use an “innovation waiver” to expand healthcare access to more of its residents – whomever they may be – so long as the state did not require additional funding from the federal government.

And in a state like California, an expansion toward inclusiveness is indispensable.

California is also working to advance legislation to expand Medi-Cal access to all qualifying adults, regardless of citizenship status – to bring us closer to true healthcare for all.

By bringing thousands of undocumented workers in to the marketplaces that serves the rest of their families, we are removing barriers to healthier lives for all Californians.

Over two thousand Public Citizen activists in California joined in demanding #Health4All – and they thank you, Governor Brown.

Keira Thompson is the online advocacy organizer for Public Citizen’s Congress Watch division.