A proposal to expand health care to Californians in the country illegally cleared the Senate on Tuesday, passing on a 28-11 vote and heading to the Assembly.
Senate Bill 4 would allow undocumented immigrants to purchase health insurance on the state exchange, pending a federal waiver, and enroll eligible children under the age of 19 in Medi-Cal, the state’s insurance program for the poor. A capped number of undocumented adults would also be allowed participate, if additional funding is appropriated in the state budget.
“We are talking about our friends, we are talking about our neighbors and our families who are denied basic health care in the richest state of this union,” said Sen. Ricardo Lara, D-Bell Gardens, the measure’s author. “Ensuring that every child in California grows up healthy and with an opportunity to thrive and succeed is simply the right thing to do.”
The debate frequently turned to other intersecting issues, including Medi-Cal reimbursement rates. An effort to reverse a 10 percent cut to the payments from 2011 has been front and center at the Capitol during final budget negotiations, with many lawmakers arguing that doctors simply cannot afford to accept new Medi-Cal patients.
“If this were bill were to be signed into law, it would only serve to exacerbate the problem and not fix it,” Sen. Jeff Stone, R-Temecula, said. “This bill would only add hundreds of thousands of more patients to the roll with no one to care for them.”
As the discussion shifted to stalled federal efforts to overhaul the country’s immigration laws, it got increasingly feisty. Sen. Isadore Hall, D-Los Angeles, baited his Republican colleagues – who supported a resolution in April calling for comprehensive immigration reform – to vote for SB 4, calling their “excuses” to oppose the measure “tools of the weak and incompetent.”
“If excuses are the tools of the weak and incompetent, then we have a weak and incompetent president,” retorted Sen. Bob Huff, R-Diamond Bar.
Republican Sens. Andy Vidak of Hanford and Anthony Cannella of Ceres, who both represent swing agricultural districts, joined Democrats in voting yes on the bill.
“Taxpayers are already paying high health care costs for the undocumented Californians when they show up in our emergency rooms,” Vidak said.
While support for SB 4 is strong in the Assembly, a signature from Gov. Jerry Brown is not guaranteed. Brown has expressed skepticism over the bill because of its cost, which was estimated to be as much as $740 million annually in an earlier incarnation.
Lara scaled back the bill last week to help it get past the Senate Appropriations Committee, where a similar proposal was held last year. In addition to limiting the Medi-Cal enrollment guarantee to children only, the amendments eliminated a proposal to establish a secondary insurance market for undocumented immigrants if the federal waiver is not approved.
Because SB 4 aims to expand the scope of the federal Affordable Care Act, which prohibited undocumented immigrants from participating in any of the health insurance exchanges it established, California would be required to apply for a waiver allowing individuals to buy plans on the state exchange regardless of immigration status, though they would not be eligible for subsidies to help pay for the coverage.