Immigration Reform Plans Could Affect Health Access in California

Federal immigration reform plans would gradually provide health care benefits for undocumented immigrants in California and other states, the Ventura County Star reports (Gonzales, Ventura County Star, 3/23).

Background

Under the Affordable Care Act, undocumented immigrants are excluded from new coverage opportunities, including state health insurance exchanges and Medicaid expansions. Lawful immigrants who have lived in the U.S. for less than five years may participate in health insurance exchanges and obtain subsidies if income-qualified, but in many states they do not qualify for Medicaid.

California officials and health care providers are considering different strategies for treating immigrants who will remain uninsured after implementation of the ACA (California Healthline, 3/13).

Details of Federal Immigration Reform Plans

Under an immigration reform plan developed by President Obama, undocumented immigrants would be required to wait at least eight years before they qualify for federal health care benefits.

Meanwhile, a plan by GOP Sens. Marco Rubio (Fla.) and John McCain (Ariz.) would require that undocumented immigrants wait at least 10 years before qualifying for such benefits.

Reaction to Plans

Certain groups, such as the California Endowment, argue that immigration reform plans should not require undocumented immigrants wait several years for coverage. They say that undocumented immigrants should immediately be able to receive benefits under the ACA.

In addition, some experts say that denying ACA benefits to undocumented immigrants could cause problems.

Ignatious Bau -- a San Francisco-based health policy consultant -- said, "We're going to create a two-tiered system of health, as well as perpetuate disparities in health." Bau said that those with health insurance will continue to absorb the cost of undocumented immigrants without insurance.

However, Rubio said that he would withdraw his support for immigration reform if undocumented immigrants were given immediate access to health reform benefits.

Certain health care providers say that the gradual approach proposed in federal immigrant reform plans is the best way to accommodate the large number of undocumented immigrants who will seek care, especially in states like California.

Martin Serota -- chief medical officer of AltaMed, a California network of health care clinics -- said, "From a pure numbers point of view, it would allow the system to ramp up to accept these folks."

He added that the health care system also needs time to train immigrants as caregivers and staff bilingual, bicultural medical workers.

The article was produced by the California HealthCare Foundation Center for Health Reporting. The center is supported by a grant from CHCF, which publishes California Healthline (Ventura County Star, 3/23).