Proposed legislation in California would allow as many as 390,000 adult undocumented immigrants to purchase health coverage through the state’s Obamacare insurance marketplace, dubbed Covered California.
Based on the Golden State’s other recent successful efforts to expand healthcare to its 2.4-million strong undocumented population, the bill is expected to pass. But it would require a final sign-off from President Obama’s administration since the Affordable Care Act specifically prohibits undocumented immigrants from accessing the health law’s marketplaces. It is the first such bill of its kind to be proposed in the U.S.
The legislation, SB 10, was last amended in the state Senate on Wednesday and centers on the sizable pool of California’s undocumented adult immigrants who earn too much money to be able to qualify for Medi-Cal (the state’s Medicaid healthcare program for the poor).
The effort blends the toxic politics of two of the most controversial policy arenas of Obama’s presidency—healthcare and immigration—and has already drawn sharp rebukes from critics who say it will exacerbate an unsustainable influx of undocumented immigration.
But the lawmakers behind the bill hope that its provisions requiring the immigrants to pay for their own coverage without any federal or state assistance will spur Governor Jerry Brown (D) to sign a final bill (if passed) and the federal Department of Health and Human Services (HHS) to grant California a waiver to pursue the proposed program.
California took the first major step towards expanding healthcare coverage to undocumented immigrants last year when it became the largest state to ensure Medi-Cal access to children regardless of immigration status.
Beyond compassion-based arguments, supporters of the latest legislation argue that Americans already pay for undocumented immigrants’ healthcare since these people can’t be turned away from more costly and inefficient emergency rooms.
Undocumented immigrants also tend to be younger (and, by extension, usually healthier) than other uninsured populations, meaning their entry into the health insurance risk pool could potentially mitigate Obamacare’s current problems with sicker-than-expected enrollees.