New Initiatives Set to Increase Health Coverage for Undocumented Immigrants in California

President Obama’s executive action on immigration, announced last month, could potentially come with a much sweeter – and healthier – deal for undocumented immigrants in California than in the rest of the country.

While undocumented immigrants in the U.S. do not qualify for coverage under the Affordable Care Act, California law allows “certain lawfully present immigrants” to be covered by Medi-Cal, the state’s low-income health program. Immigration experts say they expect that provision to apply to the new Deferred Action for Parental Accountability program announced by the president, which allows undocumented people who have a child who is a U.S. citizen or lawful, permanent-resident to apply for a work permit and deportation protection if the applicant has been in the U.S. since Jan. 1, 2010.

Over four million people in the U.S. are likely to qualify for the program beginning in 2015, and over a million of those live in California, according to the National Immigration Law Center in Los Angeles. That means more than a million Californians could be newly eligible for Medi-Cal, if their incomes are low enough to qualify.

Other programs will offer insurance opportunities

The president’s executive action also expands the Deferred Action for Childhood Arrivals program, which allows some people who came to the U.S. before their 16th birthday — with some other conditions — to apply for deportation protection.

And those applying for the protection may also be eligible for Medi-Cal, depending on income. A new provision in the executive order eliminates the deferred action upper age limit, currently set at age 31, and could extend coverage to 300,000 people, including tens of thousands in California, said Alvaro M. Huerta, a staff attorney for the National Immigration Law Center. Both deferred action programs can be renewed after three years, although the process is not automatic.

Other health insurance opportunities opened up by the president’s executive action include the possibility that immigrants who qualify for deportation protection may be able to apply for employer-based coverage, if their work offers it.

New policy may dispel worry

Ronald Coleman, manager of government affairs at the California Immigrant Policy Center, said immigration experts also expect to see more insurance sign ups from people who previously qualified but didn’t enroll out of fear that personal information on application forms would draw attention to family members who are undocumented. Those undocumented family members may now be eligible to apply for deportation protection, allaying some concerns.

Covered California has spent close to $100 million on advertising that seeks to dispel the worry that signing up will trigger deportations. Citizens and lawfully present immigrants who are still uninsured can sign up for coverage through February 15 for health insurance that will begin within weeks of paying the premiums. Medi-Cal enrollment is year round.

Lillian Saldana, 23, of Covina, was born in the U.S. and therefore eligible for coverage under Covered California. But she didn’t sign up last year, out of fear that her parents, who are undocumented, might be identified and deported.

But this year, in light of the new legislation, Saldana finally signed up for coverage beginning in 2015, which will help her address some health concerns she has.

Saldana said that although her parents will not qualify for a change in status under the president’s executive action, her family is excited for family friends who will.

However, Saldana, who works at the CIRCLE Project, an immigrant empowerment program, said she doesn’t think many people who might qualify for deportation protection realize that the status could come with health coverage.

“There will need to be a lot of education about that, and we should start now,” she said.

Bill calls for coverage for all

While not part of the president’s executive action, a California bill introduced earlier this month could offer health coverage by fall 2015 to undocumented immigrants who have no other options.

The bill, Health for All, was first introduced last year by State Sen. Ricardo Lara, (D-Bell Gardens) and was reintroduced on Dec. 1. Lara’s parents were once undocumented immigrants.

Lawrence Cooper, a legislative consultant for Lara, said the bill has broad support and could be more likely to pass this time because the federal Affordable Care Act has lowered the cost of covering the uninsured, since more residents are insured now.

A study earlier this year on the bill by researchers at the UC Berkeley Center for Labor Research and Education and the UCLA Center for Health Policy Research projected that the law would add only two cents per health care dollar currently spent by the state.

“California would be the first in the nation to make its health-insurance program inclusive of all low-income residents and their families, including those who are undocumented,” said Laurel Lucia, policy analyst at the UC Berkeley Center.

According to the report, the new spending would be offset by an increase in state tax revenue from managed-care insurance plans as well as savings from reduced county spending on care for the uninsured.

Aides to Lara say they expect the bill to come up for a vote in the spring and are hopeful that Gov. Jerry Brown will sign it by the fall of 2015.

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