Despite the successful implementation of the Affordable Care Act two years ago, over one million individuals remain uninsured in California simply because of their immigration status. But that number could change shortly thanks to unprecedented momentum in favor of health for all in the state. Two weeks ago, the California State Senate made history with a 28-11 vote in favor of a bill that would be the first step to ensure health coverage options to undocumented immigrant residents. With ayes from both sides of the aisle, the bill now moves on to the Assembly. And last week, the California legislative budget conference committee voted to provide $40 million to extend Medi-Cal to undocumented children. Now, the question is whether the legislative leadership will hold firm and send the bill and the budget with this funding to the Governor—and whether the Governor will sign them.
SB 4, authored by California Senator Ricardo Lara, would allow undocumented immigrants to purchase health insurance through the state’s health care marketplace (with a section 1332 waiver from the federal government) as well as provide coverage for low-income children through Medi-Cal, California’s Medicaid program. Low-income adults can also qualify for Medi-Cal, but enrollment is capped based on available funds. An estimated 170,000 undocumented California children could receive comprehensive care as a result.
By offering affordable insurance options to immigrant family members, the whole family is more likely to enroll, including their citizen and lawfully present children who already qualify but are not yet enrolled in coverage. One in six kids in California has an undocumented parent locked out of health coverage, and the majority of these children are citizens. When parents get health coverage, their children are much more likely to be enrolled and to get preventive care.
More and more, leaders are recognizing that investing in the health of hardworking immigrant parents and their children has substantial long-term impacts that benefit all Californians. States already provide emergency care coverage for undocumented immigrant residents, even though preventive care and early treatment are far superior and much more cost effective. A growing body of research shows that if every single parent and child had preventive and ongoing care, we could reduce overall health care costs, avoid preventable emergency room visits, and foster more productive communities. Providing full-scope Medi-Cal coverage would cost less than Medi-Cal emergency services coverage the state is currently providing for undocumented immigrant children.
A study of local programs that extended health care to low-income children estimated that 6,324 childhood hospitalizations were prevented over a five-year period, resulting in approximately $6.7 million in savings to the health care system. Moreover, children need regular checkups to assess healthy childhood development and identify and treat problems early.
When children have health coverage, they are considerably more likely to graduate from high school and complete college. Children newly enrolled in health coverage pay closer attention in class, resulting in a 63 percent improvement in school performance. Expanding health care to undocumented immigrants truly is the remaining piece in ensuring all of our kids are healthy and ready to learn.
The recent Senate vote reflects the opinion of the vast majority of Californians across the political, geographic, and demographic spectrum—undocumented immigrant children should have access to affordable health coverage options. A majority of Californianssupport affordable health options for all low-income undocumented immigrant residents. The broad and diverse coalition of Californians—from business leaders, churches, health care providers, workers, and families across the State—will be watching and urging our policy makers to support options for the remaining uninsured. If SB 4 is enacted into law, California will continue to demonstrate its leadership in laying the foundation needed to extend health care coverage to all. We hope California finishes the job and brings health coverage to all Californians and that other states shortly follow suit. Extending coverage to all children and families is not only cost effective—it’s the right thing to do.