On a 5-2 vote, the California Senate Appropriations Committee on Thursday approved a first-of-its-kind bill in the nation that will provide health care for everyone in the state, regardless of immigration status. This year’s bill comes with a lower price tag than a similar bill that stalled last year in the Appropriations Committee over budgetary concerns.
The dissenting votes on Thursday came from the two Republicans on the committee, Senators Jim Nielsen, R-Gerber, and Patricia Bates, R-Santa Ana.
“Today’s vote represents a historic step forward on the path towards achieving health for all,” said Sen. Ricardo Lara, D-Bell Gardens, the chief sponsor of SB 4, the Health for All bill. “The amendments reflect two things: what we can realistically achieve now, and what we hope to achieve in the near future. Ensuring that everyone in California is healthy is what’s right for our state.”
The amendments Lara was referring to were made by the Senate Appropriations Committee to address cost concerns, but the intent of the bill was preserved, according to a press release from his office.
Some of the key provisions in the bill will:
• Allow undocumented Californians to buy health insurance with their own money on Covered California, the state’s online exchange set up under the Affordable Care Act. But the state must first get a federal waiver to do this.
• Allow children 19 and under to enroll in full-scope Medi-Cal (California’s name for Medicaid), regardless of whether they are documented or not.
• Expand access to Medi-Cal to adults 19 and older, by establishing a capped enrollment program that will provide services as funding is made available.
“It’s a huge step forward,” said Anthony Wright, executive director of Health Access California, a statewide health consumer advocacy coalition.
“We are thrilled that all children and some adults will now have the opportunity for basic health care coverage, which is a basic human right,” said Ronald Coleman, government affairs manager at the California Immigrant Policy Center (CIPC). “And at the same time, we know there are many more steps to travel on this road, and much more work to protect many more lives.”
The 2010 landmark Affordable Care Act, designed to make health care affordable to all U.S. residents, barred undocumented immigrants from enrolling in Medicaid, the health insurance program for low-income people funded by the federal and state governments. It also barred undocumented residents from buying health insurance on the exchanges that every state was required to have. That left millions of immigrants uninsured and dependent on fraying safety nets provided by county hospitals.
President Obama’s 2014 executive action to expand the Deferred Action for Childhood Arrivals (DACA) program, and to initiate the Deferred Action for Parents of Americans (DAPA) program is likely to significantly reduce the cost of providing Medi-Cal under SB 4, estimated by health care advocates at between $100 million and $300 million per year. UCLA health policy researchers however put the figure at between $353 million and $369 million annually.
The deferred action program, currently on hold while it is being challenged in a federal court, is expected to cut in half the state’s undocumented, uninsured population of around 1.5 million, the most of any state in the nation.
Just last week, the California Senate Budget Sub-Committee added $40 million in spending to its Medi-Cal budget, currently at $19 billion a year.
The dissenting votes cast Thursday in the Appropriations Committee by Senator Nielsen, R-Gerber, and in the Senate Health Committee last month by Sen. Janet Nguyen, R-Garden Grove, should come as no surprise. A MapLight analysis of campaign contributions to the candidate-controlled committees associated with the two lawmakers shows that Nguyen raised $2,292,505 for the November 2014 general election ballot from groups opposing Obamacare. Sen. Nielsen, who also voted against SB 4 in the Senate Health Committee, raised $7,784 from groups opposing the ACA.
SB 4 is slated to go before the full Senate on June 5. Health care advocates expect that all 25 Democrats and possibly some of the 15 Republicans on the Senate will support it, said CIPC’s Coleman.
It will then go before the health and appropriations committees in the Assembly before it goes to the Assembly floor, where Coleman expects the bill will have an easy passage. Assembly Health Committee chair Rob Bonta, who describes himself as the “principal supporter” of the bill, is campaigning for it.
In the meantime, CIPC and other health advocacy groups are continuing to “educate” the fiscally conservative Governor Brown, letting him know that it makes economic sense to sign the bill and provide health care for all of the state’s residents.
A 50-state study released last month by the Institute on Taxation and Economic Policy finds that the 3.1 million undocumented immigrants currently living in California collectively paid $3.2 billion in state and local taxes in 2012. This represents a $500 million increase over a similar report two years ago.
“We know that from here, we will only go forward,” Coleman said. “We renew our commitment to keep working until not a single Californian suffers or dies from a treatable condition, no matter where they were born.”
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