New California law could help undocumented immigrants buy health insurance

California Gov. Jerry Brown has signed legislation that could ultimately allow undocumented immigrants to purchase health insurance plans through Covered California, the state’s health insurance exchange.

Many undocumented immigrants are expected to decline the opportunity, unable to afford the premiums and out-of-pocket costs for plans available through the exchange. Undocumented immigrants will not be offered Covered California subsidies available to U.S. citizens.

But health care advocates said the success of the legislation is a symbolic step toward making more health insurance options available to undocumented immigrants.

“California’s health system and California families are stronger when everyone is included and has an opportunity to purchase health coverage,” said Suzie Shupe, CEO of the Redwood Community Health Coalition, a multi-county consortium of community health clinics. Shupe said undocumented immigrants will be able to buy a plan through Covered California, though without the government subsidies that make the plans more affordable.

Shupe said the federal government must first approve a waiver under President Obama’s Affordable Care Act, or Obamacare, before the state is allowed to sell exchange health plans to undocumented immigrants. Obamacare prohibits the sale of health exchange plans to those in the country illegally.

“If the federal government approves the waiver required by SB 10, this would make California the first state in the country to expand its health exchange to undocumented immigrants.”

Vijay Das, a health care policy advocate for Public Citizen, a national nonprofit public interest group, said no other state in the country is pursuing a policy that would allow their undocumented populations to purchase unsubsidized plans through health exchanges.

Das also said the move was largely symbolic in that it helped remove the “shame hanging over people’s heads.”

“The biggest thing is for undocumented immigrants to not feel like they are shunned,” he said.

Das said it could be up to the next administration to decide whether to grant the waiver.

“If Trump wins, the effort is for not,” he said. “If Hillary wins, there’s a good chance she’ll sign off... If it were up to President Obama, it would happen right now.”

The pool of potential purchasers across the state is estimated to be between 320,000 and 400,000 undocumented immigrants, said Das.

Shupe said it’s unclear how many undocumented immigrants in Sonoma County would take advantage of the opportunity. The cost of unsubsidized Covered California health plans could be a major deterrent, she said.

She pointed out that undocumented immigrants may currently purchase coverage through the private health insurance market, but that not many of them do so because of the high cost.

There are nearly 39,000 undocumented immigrants in Sonoma County, according to the latest estimates from the nonpartisan Public Policy Institute of California. But some undocumented immigrants get health coverage through their employers and up to 4,300 children countywide are eligible for comprehensive coverage through Medi-Cal, the state’s Medicaid program.

The governor’s signature comes a little more than a month after the state began offering comprehensive Medi-Cal health insurance to undocumented children in California.

The county has estimated that there are about 20,000 uninsured county residents, many of whom are presumed to be undocumented.

SB 10 was sponsored by Sen. Ricardo Lara, D-Bell Gardens. The federal government must approve the waiver before the state can go forward with selling Covered California plans to state residents who are in the country illegally.

“This is a critical first step to expand health care access. It’s imperative that the federal government approve this waiver,” Das said in a statement.

Das and other advocates say that many undocumented immigrants will still not be able to afford the insurance premiums and out-of-pocket expenses of health plans sold through Covered California.

Advocates are also pushing for the state to expand subsidized Medi-Cal insurance for adult undocumented immigrants, as it has for undocumented children.

You can reach Staff Writer Martin Espinoza at (707) 521-5213 or martin.espinoza@pressdemocrat.com. On Twitter @renofish.