California Bill Would Extend Health Coverage To All Residents


In a push to cover immigrants excluded from the nation’s health reform law, a California state senator has proposed legislation that would offer health insurance for all Californians, including those living here illegally.

The bill would extend state-funded Medi-Cal to low-income immigrants who, because they are in the country without permission,  are now eligible only for emergency and pregnancy coverage. It would also create a marketplace similar to Covered California to offer insurance policies to higher income immigrants who lack legal status.

Sen. Ricardo Lara, a Democrat who represents Long Beach and Southeast Los Angeles, announced the proposed legislation at a press conference Friday. He said immigrants  contribute to the California economy and deserve to have access to health insurance.

“While we’ve made enormous strides to reduce California’s uninsured population with the implementation of the Affordable Care Act, we won’t have a truly healthy state until everyone has access to quality, affordable coverage,” he said in a statement.

An estimated 2.3 to 2.6 million immigrants live in California illegally – more than in any other state. About 1 million are believed to be uninsured, while many of the others purchase their own policies or are covered through employer plans.

Currently, those who are uninsured can receive medical care at community and free clinics and in some counties, through public hospitals and health facilities.

Ira Mehlman, spokesman for the Federation for American Immigration Reform, a group that opposes illegal immigration, said the proposed legislation is clearly an end-run around what Congress intended under the health law. But Mehlman said the effort didn’t surprise him: The proposal comes just months after the California legislature approved special driver’s licenses for those living here without legal permission.

“There isn’t anything [the California legislature] is not going to give people who are in the country illegally,” he said.

Most of the state’s Medi-Cal recipients receive services paid for by a combination of federal and state funds. The new proposal would be paid for entirely by the state.

Diana Dooley, secretary of the state’s Health and Human Services Agency, has said that California health officials are aware of the need to cover immigrants who lack legal status.  But she said the priority for now is covering people who are eligible for coverage under the Affordable Care Act.

It’s not clear how much the new coverage would cost or how the state would fund it. That would depend on how many people came forward. Fear of deportation often keeps people from seeking public services, advocates for immigrants’ rights said.

These advocates and other activists argue that the legislation would lower health care spending in California by enabling immigrants to receive regular check-ups, reducing their reliance on emergency rooms.

They also argue that it could help the state by bringing more families of mixed immigration status out of the shadows.

“Opening the door to all Californians means it’s more likely that those already eligible take advantage of the benefits, bringing more federal dollars into California,” said Anthony Wright, executive director of the consumer group Health Access California.

agorman@kff.org