Bill for Undocumented Health Coverage Could Cost $740M

A California bill (SB 4) that would extend health care coverage to undocumented immigrants could cost the state more than $700 million annually, according to a fiscal review released Monday, the San Jose Mercury News reports.

A state Senate committee has put the bill on hold pending further review (Seipel, San Jose Mercury News, 5/4).

Details of SB 4

The measure is part of a 10-bill legislative package that aims to expand health coverage, among other protections, to undocumented immigrants.

Specifically, SB 4, by state Sen. Ricardo Lara (D-Bell Gardens), would give undocumented immigrants access to:

• Medi-Cal coverage; and
• Health coverage through California's Health Benefit Exchange.

Medi-Cal is California's Medicaid program.

A similar bill to SB 4 stalled in a legislative committee last session after lawmakers failed to find funding to cover its estimated $1.3 billion annual cost. The legislative package also does not include funding plans for the coverage expansion.

However, Lara has said that the bill has been changed to reduce its cost.

In mid-April, the state Senate Health Committee voted 7-0 to advance the measure (California Healthline, 5/4).

Details of Fiscal Analysis

A state Senate fiscal analysis estimated that SB 4 could cost California as much as $740 million annually, the Los Angeles Times' "PolitiCal" reports.

The analysis calculated the bill's potential costs by reviewing two possible scenarios:

• In the first scenario, about 1.5 million undocumented immigrants in the state would qualify for Medi-Cal, between 50% and 60% of whom would enroll, increasing the program's spending by $280 million to $740 million annually; and
• In the second scenario, about 900,000 Californians would qualify under President Obama's executive order to offer deportation relief to certain undocumented immigrants, making them eligible for Medi-Cal. For those who would not qualify for the relief, extending medical coverage would cost $175 million to $455 million.

The analysis noted that costs for undocumented immigrants who could qualify for coverage under the presidential order would "not be attributable" to SB 4.

In a statement, Lara said that the cost analysis reflected "our ongoing efforts to develop a realistic, cost-effective solution in our pursuit of expanding health care for all Californians, regardless of immigration status" (Mason, "PolitiCal," Los Angeles Times, 5/4).

Committee Postpones Consideration of Bill

On Monday, the California Senate Appropriations Committee referred SB 4 to its suspense file until it can be reviewed against the state fiscal year 2015-2016 budget. The suspense file is for bills that would cost more than $50,000 in state general funds, according to the Mercury News.

A revised budget is expected to be released next week (San Jose Mercury News, 5/4).