Health Care Access Varies by County for Calif.’s Undocumented
The different ways California counties interpret state law have created disparities in undocumented residents' access to health care, the Los Angeles Times reports.
Background
In California, undocumented immigrants make up the largest portion of uninsured individuals, with about 1.5 million lacking insurance.
Some uninsured undocumented residents have access to limited health care services under a 1933 state law that requires counties to "relieve and support all incompetent poor, indigent persons." However, that access varies by county.
Details of Disparities
According to the Times, the ambiguity of the state law has left it open to interpretation by counties. For example:
- 11 counties offer low-cost medical care to undocumented immigrants, some of which offer such care just to seriously ill patients; and
- 47 counties do not consider the law to apply to undocumented immigrants.
Undocumented immigrants who do not qualify for no-cost or subsidized coverage can seek treatment at emergency departments, according to the Times. However, such care costs the state billions of dollars.
Some experts say that undocumented residents' dependence on EDs could undermine potential savings under the Affordable Care Act. As such, advocates are urging state and county officials to develop plans to improve access to care for undocumented immigrants.
Counties Weigh Changes to Undocumented Care Policies
Some counties that have not offered medical services to undocumented immigrants now are considering changes to their policies.
For example, the Sacramento Board of Supervisors is considering a plan to provide primary and specialty care to about 10,000 of the county's 50,000 undocumented immigrants. The care would be provided on a first-come, first-served basis.
However, others counties -- such as San Bernardino -- have said they do not plan to provide health coverage to undocumented residents, in part because of cost concerns.
Gabrielle Lessard, a health policy attorney at the National Immigration Law Center, said some counties likely would be hesitant to expand health care to undocumented immigrants because of state funding cuts for such services.
According to the Times, the state collected a total of $900 million from counties to help finance parts of the ACA.
Alex Briscoe, director of Alameda County's Health Care Services Agency, said those cuts could result in "one of the unintended consequences" of the ACA: reducing services for the uninsured. He noted that Alameda County lost 80% of its $51 million annual budget for the program (Karlamangla, Los Angeles Times, 6/11).
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