Allowing Undocumented Immigrants to Buy Obamacare: California Moving Toward Health Care Controversy

Combustible issues of Obamacare & Immigration could reignite battles Texas Insider Report: WASHINGTON D.C. Congressional Republicans never trusted Democrats repeated assurances that the ObamaCare Affordable Care Act would never cover undocumented immigrants if it became law. That built up to South Carolina Congressman Joe Wilsons infamous You lie!" moment in 2009. But California lawmakers (and activists) are making progress on a first-in-the-nation plan to let undocumented immigrants buy Obamacare Health Insurance.   And just last month Gov. Brown agreed to spend millions in state dollars to provide health care to undocumented children mirroring similar efforts in a handful of other liberal states. The bill Brown signed last month will provide Medicaid coverage to roughly 170000 undocumented children at an estimated cost of $132 million per year. Supporters say the California proposal which would need federal approval and couldnt start until 2017 is the next logical step in expanding health insurance to a population that was intentionally excluded from the presidents health-care law. Supporters are hoping submit the plan for federal review in 2016 to avoid the uncertainty that would come with a new president the following year. California Gov. Jerry Brown isnt commenting on the legislation. And theres no guarantee the California bill still winding through the states legislature will succeed even though Democrats control the California statehouse the governors mansion and the White House. But uniting the two highly combustible issues of Obamacare and immigration could reignite a fierce health-care reform controversy. The California bill wouldnt immediately open the states exchange to undocumented immigrants who are primarily Latino. Instead it would direct California to seek permission from the federal Department of Health & Human Services through an Obamacare waiver program that allows states to shape their own health care reforms. National anti-immigration forces are taking note of the bill in California home to the countrys largest population of undocumented immigrants.

A bill like this is a camels nose" said Dan Stein president of the Federation for American Immigration Reform If you see a camels nose under the tent its not too long before the whole camel will be in the tent. Or the tent will be on the ground."

Stein believes the California proposal signals a weakening in enforcement of immigration laws. The bills sponsor state Sen. Ricardo Lara acknowledges the political risk. But he remains optimistic that the Obama administration if given the chance to review Californias proposal would see it as an opportunity to move immigration reform forward before its second term wraps up.

We are trying to come up with sensible progressive policies that help to integrate every Californian" Lara said. It just makes common sense."

The 2010 health care law bans undocumented immigrants from enrolling in Medicaid. And not only are they barred from getting subsidies to buy private insurance on the health insurance exchanges they cant buy the Obamacare plans with just their money. That prohibition especially riles immigrant advocates who say theres no reason to ban people from purchasing exchange plans if they can afford it on their own. Not allowing certain types of immigrants to pay into the exchange of the ACA is coming back to haunt us fiscally" California Senate President pro Tempore Kevin de Len said referring to the Affordable Care Act. The issue is already making its way into 2016 presidential politics. Democratic presidential hopeful Martin OMalley a former Maryland governor proposed an immigration reform plan last month that would provide health care including Obamacare subsidies to some undocumented immigrants. Would simply saying theres not a legal barrier to you buying it make people want to do it?" said Nancy Berlinger a Hastings Center scholar who has studied undocumented immigrants access to health care. Its important symbolically to be more welcoming of families to enter the health system" said Anthony Wright executive director of Health Access California. However the administration hasnt spelled out the guidelines for the state innovation waivers" program which doesnt start until 2017 and its unclear whether the White House would rethink its Obamacare coverage ban for undocumented immigrants. An HHS spokesperson said the department hasnt discussed the California proposal with state officials and declined to comment on the bill. Cost would still be a struggle supporters of the effort acknowledge. But they still see a clear benefit. Opening the states exchange to everyone could boost insurance sign-ups. But even for those Latinos who can get coverage their experience under the health care law has been mixed. Whether allowing Obamacare coverage for undocumented immigrants would boost enrollment depends on the outreach effort from Californias insurance marketplace and advocates said Laurel Lucia a health care policy expert at the University of California  Berkeley Center for Labor Research and Education. An estimated 320000 undocumented immigrants are expected to purchase individual health plans in four years according to Lucias projections. Californias Medicaid program like New Yorks uses state money to cover so-called DREAMers" the young undocumented immigrants who were protected from deportation under the White Houses 2012 deferred action program. Massachusetts Illinois and Washington also already use state money to cover undocumented children while the District of Columbia funds coverage for undocumented children and adults.