California is set to become the biggest U.S. state to provide taxpayer-financed health care to children of undocumented immigrants, taking on a $132 million annual burden as Congress blocks federal reform.
The decision to cover about 142,500 immigrant children under Medi-Cal, the state’s version of the federal Medicaid health-care plan for the poor, comes at a time when the program’s rolls are swelling from a mandated expansion under Obamacare.
“This is now becoming in a sense the implementation of immigration reform, even bigger immigration reform than they’re considering in Washington,” said Raphael Sonenshein, executive director of the Edmund G. “Pat” Brown Institute for Public Affairs at California State University, Los Angeles. “One out of eight Americans live in California, so it’s by definition a trailblazer.”
As Republicans block the Obama administration’s efforts to advance immigration reforms in Congress, the state that’s home to a quarter of the undocumented immigrants in the U.S. is taking the lead in implementing its own changes, including extending driver’s licenses and college financial aid to the 2.8 million Californians who are in the state illegally.
“While Washington dithers because they can’t get things done, we need immigration reform,” Senate President Pro Tem Kevin de Leon, a Democrat from Los Angeles, said last week at a Sacramento news conference announcing a budget agreement with the governor. “The reality is many of these children require some type of health care and often they receive it in the emergency room and we end up paying for it nonetheless.”
The health funding is part of a $115.4 billion general-fund budget Brown, a 77-year-old Democrat, signed into law on Wednesday. It adds $1.9 billion to the state’s rainy-day fund, spends $380 million on an earned-income tax credit for the poor and steers an additional $14.3 billion to the K-12 school system and community colleges.
A third of the state’s population is already enrolled in Medi-Cal, according to the California Department of Health Care Services.
Republican lawmakers opposed the additional assistance, saying there aren’t enough doctors available to cover those people.
“There are 12.4 million Californians who depend on Medi-Cal right now that have difficulty accessing doctors and services because our reimbursement rates are too low,” Senate Republican leader Bob Huff said during a budget debate on June 19.
New York, Massachusetts, Washington, Illinois and the District of Columbia already provide health coverage to undocumented children, said Gabrielle Lessard, health policy attorney at the National Immigration Law Center in Los Angeles.
“It’s a recognition that these are people who are very well integrated into our communities,” Lessard said. “We can’t continue to treat them as others and not members of our community.”
California is among 10 states, including Nevada and Colorado, that issue driver’s licenses regardless of immigration status, according to the law center.
California was the most active in enacting immigration measures in 2014, approving 26 of the 171 laws passed by U.S. state legislatures, according to the Denver-based National Conference of State Legislatures.
It was the first state along with Texas to enact legislation in 2001 to extend in-state tuition to undocumented students, according to NCSL. At least 18 states now offer the benefit.
California’s municipal lawmakers are also weighing in. The San Francisco Board of Supervisors last year agreed to provide $2.1 million for lawyers to represent undocumented immigrant children facing deportation after crossing the U.S. border to escape violence in Central America.
In Los Angeles, Mayor Eric Garcetti said last year the city’s police department would stop honoring some federal requests to detain arrested undocumented immigrants and turn them over to federal agents.
California has about 250,000 undocumented children, said Mark Lopez, director of Hispanic research at the Pew Research Center in Washington.
“These are people who often times have grown up in the United States and are, like any other young American, tied to the U.S.,” Lopez said. “Through circumstances beyond their control, they have an undocumented status.”