A California plan to expand health insurance to undocumented immigrants is creating a political stir. Already approved by the state Senate, the proposed legislation would allow los indocumentados (as they are known in Spanish) to buy private insurance on the state’s insurance exchange. However, even if the Assembly and Governor pass the law, it will still be subject to federal review and couldn’t be implemented at the earliest until 2017.
The 2010 federal health care law bans undocumented immigrants from buying into Obamacare plans even if they can afford to do so with their own money and don’t need subsidies. The California law wants to change that. The legislators supporting the bill and immigration advocates say that it makes no sense to bar those who can afford to buy health insurance from doing so just because they are undocumented. Under California law, undocumented immigrants can already buy private health plans not sold through the Obama exchanges.
If the new law passes, the next step is federal review. California would seek a waiver from the federal Department of Health and Human Services to enroll undocumented immigrants on its exchange. However, even if the waiver is granted, it couldn’t start until 2017 under federal law. Whether such a waiver would be granted by the federal government is also unclear, and obviously depends on the outcome of the next national election cycle. A Clinton administration would no doubt take a very different view of waiver request compared to a Trump administration.
Not surprisingly, there is a lot of opposition to the California proposal. Although the law would not allow undocumented immigrants to enroll in Medicaid or receive subsidies to cover the cost of the insurance, opponents see this as moving in that direction. Already under California (and New York) law, state funds are used to cover certain undocumented immigrants who were protected from deportation under the 2012 deferred action program. Other states are also funding coverage in limited cases. Anti-immigration forces fear the California plan will start to weaken existing federal law that prohibits the federal government from paying for health insurance for undocumented immigrants.
If the federal government does approve the CA plan, other liberal states like New York are likely to follow with their own versions.