California will be the first state to provide free health care to all illegal immigrants, at a cost of $2.7 billion per year.
It is part of the $307.9 trillion operating budget that Gov. Gavin Newsom was expected sign the agreement on Thursday. It promises to make all low-income adults eligible for Medicaid by 2024, regardless their immigration status. This is a long-awaited victory for both health care and immigration activists who have been asking for it for over a decade.
Federal and state governments across the country join forces to provide free healthcare to low-income children and adults through Medicaid. The federal government will not pay for illegal immigrants. California and other states have used some of their tax dollars to pay for a portion the health care costs of low-income immigrants.
California wants to be the one to do it for everyone.
California currently has 92% coverage, which puts it in the middle of the national pack. This will change when the budget is fully implemented. Illegal immigrants make up the largest segment of those without insurance in California.
Anthony Wright, executive director, Health Access California, an advocacy group for consumer health care, stated that this will be the largest expansion of coverage since the Affordable Care Act was implemented in 2014. "Everyone benefits when everyone is covered in California," Wright said.
According to the Kaiser Family Foundation, an international health care organization, illegal immigrants made up about 7 percent of the nation's population in 2020. That is approximately 22.1 million people. They are not eligible to most public benefits programs, even though they have jobs and pay taxes.
Slowly, immigrants have been able to access some health care programs. 18 states offer prenatal care regardless of immigration status. The District of Columbia, California, Illinois and New York all cover children from low-income families, regardless of immigration status. California and Illinois expanded Medicaid to include older adults who are immigrants.
Republicans in California and conservative groups oppose expanding health care for illegal immigrants. Jon Coupal, president and CEO of Howard Jarvis Taxpayers Association said that offering free health care to immigrants will make California "a magnet" for illegal aliens.
Coupal stated, "I think most of us are very sympathetic towards the immigrant population, but we really wish that we had better control over who enters this country and state."
California's Medicaid expansion won't come easy. It is likely that about 40,000 low-income immigrant will lose their coverage in 2023 due to a combination of factors, including slow implementation by the state and the ending of federal pandemic policies. This illustrates the difficulties of trying to navigate the government-run insurance system, which is supposed to make it easier to obtain coverage.
Beatriz Hernandez arrived in the United States as an 11-year-old. When she was a child, California taxpayers paid for her health care costs. Because of her immigration status, she lost this coverage at 19 and was then reinstated in 2020.
Hernandez turned 26 in February. Because of the emergency federal rules that were in place during the pandemic, Hernandez has not lost her coverage. However, these rules could end later in the year. She will be one of approximately 40,000 people who lose temporary coverage when California's new program begins on January 1, 2024. This is according to an analysis done by the nonpartisan Legislative Analyst's Office.
Hernandez is a organizer for the California Immigrant Policy Center and lives in Merced, California's Central Valley. Her mother, who has never had insurance since her move to the U.S., would be the most benefited by the expansion.
Hernandez is concerned that Hernandez's coverage could be cut off and she might lose her access to the medication she uses to treat her depression. She's trying to schedule as many appointments this year as possible, including those for the dermatologist, optometrist, and dentist, in order to avoid losing her coverage.
Hernandez said that California has taken the initiative to set an example for other states. She said that she doesn't have a work permit nor permission to reside in the United States. "I believe we can do better by making certain that people like me, hundreds of others, and thousands of other people, don't lose their health care just because they turn 26.
It took six months to one year to implement previous expansions of California's Medicaid program. The Newsom administration claims it will take a year and half to complete the expansion, as it is larger than any of the previous ones.
Advocates for health care say that the gap in coverage is important for low-income immigrant families who are illegally in the country. They don't have any other options. Losing Medicaid coverage is possible for citizens to purchase coverage through Covered California. They may be eligible for a substantial discount.
"But for this group, that's all. "Medicaid" is the only program that they have access to," stated Sarah Dar, director for health and public benefits policy at the California Immigrant Policy Center.
The state Legislature's Democrats say that they are working with Newsom to speed up the process.
"We are doing everything we can. "We're talking with the administration, talking with the leadership at the (California Department of Health), to make sure we do it as quickly as possible and that no one loses it in between," stated Democratic Senator Maria Elena Durazo. It doesn't make any sense to lose them, then bring them back in.
