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Thread: California Looks to Cover Illegal Immigrants Under Obamacare

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  1. #1
    Senior Member lorrie's Avatar
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    California Looks to Cover Illegal Immigrants Under Obamacare

    California Looks to Cover Illegal Immigrants Under Obamacare

    Leah Jessen @_LeahKay_ / April 29, 2016

    In an unprecedented move, California legislators look to extend Obamacare health coverage to the state’s estimated 2.6 million illegal immigrant population.

    If passed and signed into law, California would be the first state in the nation to request illegal immigrants be covered through a state exchange, the Los Angeles Times reported.

    It is against the law for California to allow illegal immigrants to enroll in Covered California, the state’s Obamacare health insurance exchange, Sally C. Pipes, president and CEO of the pro-free-market Pacific Research Institute, told The Daily Signal in an emailed response.

    “The law does not allow illegals to enroll in the state exchanges or the federal exchange,” Pipes said.

    California state Sen. Ricardo Lara, D-Bell Gardens, authored legislation, SB 10, that requests the federal government give Covered California permission to cover illegal immigrants.

    Under the Affordable Care Act, commonly known as Obamacare, health care exchanges cannot allow illegal immigrants to receive exchange tax credits and cost-sharing subsidies.

    State government can make requests for federal government consideration to modify Obamacare to extend health coverage in their state, ThinkProgress reported.

    “This bill would require the Secretary of California Health and Human Services to apply to the United States Department of Health and Human Services for a waiver to allow individuals who are not eligible to obtain health coverage because of their immigration status to obtain coverage from the Exchange,” text from California SB 10, amended April 13 in the California Assembly, says.

    Illegal immigrants would be required to pay for the health insurance plans themselves.

    The bill was approved in the Senate last year. The Assembly Committee on Health passed the bill this week, referring the bill to the Assembly’s appropriations committee.

    If the bill makes it through the legislature, it would head to the desk of Gov. Jerry Brown, a Democrat.

    Brown already signed a bill that will allow illegal immigrant children to receive Medi-Cal, the state’s Medicaid welfare program for low-income individuals. Coverage will take effect in May.

    United States Code prohibits an unqualified illegal immigrant from receiving federal public benefits, or “any retirement, welfare, health, disability, public or assisted housing, postsecondary education, food assistance, unemployment benefit, or any other similar benefit for which payments or assistance are provided to an individual, household, or family eligibility unit by an agency of the United States or by appropriated funds of the United States.”

    Legislation proposed
    last fall by Rep. Luis Gutiérrez, D-Ill., in the United States House of Representatives also aims to extend Obamacare health coverage to illegal immigrants.

    Data from the Centers for Medicare and Medicaid Services show that 2015 Obamacare enrollment did not meet the Obama administration’s projected 11.7 million enrollees.

    “The reason that the 2015 enrollment number went down from 11.7 to 9.5 million was because they did not pay the premium or could not prove citizenship,” Pacific Research Institute’s Pipes said.

    Recently, a U.S. Senate report found that up to $750 million in Obamacare tax credits may have gone to illegal immigrants.

    Pipes added of California: “Perhaps a taxpayer could sue the state over standing.”
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  2. #2
    Senior Member lorrie's Avatar
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    California Takes A Step Further Toward Immigrant Integration

    by Stephen A. Nuño
    May 2 2016, 9:27 am ET

    The Supreme Court seems divided over President Obama's Deferred Action for Childhood Arrivals program (DACA), giving a temporary reprieve to young undocumented immigrants, and Congress has made little progress in ending the gridlock over immigration reform.

    Despite the standstill in Washington D.C., some states, especially California, are taking a different approach. California just began extending health care benefits to undocumented immigrant children in May, a move that points to the state's evolving attitude toward immigrant integration in marked contrast to the contentious fight over immigration two decades ago.

    Under a new law passed in September of 2015 and signed by Governor Jerry Brown, "an individual who is under 19 years of age and who does not have satisfactory immigration status or is unable to establish satisfactory immigration status - shall be eligible for the full scope of Medi-Cal benefits".

    The bill's primary sponsor is state Senator Ricardo Lara, from the Southeast part of Los Angeles.

    Medi-Cal is California's managed health care plan, which is partially funded by the federal government's Medicaid program. Federal law generally does not allow eligibility for undocumented immigrants to receive Medicaid coverage, with the exception of emergency care and some qualified non-citizens who entered the country prior to 1996.

    Health care benefits to undocumented immigrants continue to be a hotly contested issue across the nation. The Affordable Care Act, known as Obamacare, does not extend coverage to undocumented immigrants, but does extend coverage to immigrants who are "lawfully present" in the country.

    California has been at the forefront of the debate over benefits for undocumented immigrants.

    In 1994, California voters approved Proposition 187, named the "Save Our State" initiative. In part, the controversial legislation required health care providers to verify the immigration status of anyone seeking health care services. Implementation of Prop 187 was blocked by a federal judge almost in its entirety.

    Former Republican Governor Pete Wilson, the main proponent of Prop 187, who made immigration the centerpiece of his campaign for Governor, appealed the court's decision, but the appeal was withdrawn by Democrat Gray Davis when he became the newly elected Governor, effectively killing the bill. During this time, the legislation mobilized Latinos and others in the state, and it has been widely seen as one of the catalysts of the states' Democratic dominance.

    Karthick Ramakrishnan, a professor at UC Riverside and an expert on immigration, points to a divergence in approach for California compared to other states since the Prop 187 debate.
    With the growth of the state's Latino population, which is now close to 40 percent, opposition to anti-immigrant bills has waned. Republicans now find themselves struggling to capture an audience in California, with SB-04 passing easily through the State House and Senate.

    A recent survey sponsored by the California Program on Access to Care (CPAC) from the University of California at Berkeley and conducted by the polling firm Latino Decisions, found that California voters are also supportive of expanding health care coverage to undocumented children, with 62 percent saying they approve of the bill.

    Voters were supportive of providing health care benefits to undocumented immigrants who have temporary work permits, as well, with 68 percent saying they approve. However, California voters in the poll showed limitations to their support in further expanding health care, with only 42 percent saying they support expanding access to all undocumented immigrants and 48 percent saying they disapprove.

    Despite limitations, California has taken an integrative approach to the immigrant population while reform continues to stall in Congress. California continues to extend benefits to undocumented immigrants, says Ramakrishnan, pointing to driver's licenses and college financial aid as important policies which allow immigrants to get to work and go to college.

    "After more than a decade of policy gridlock on immigration in Washington, DC, California began to embark on a series of pro-integration policies that have accumulated over time, forming what we call the California Package of immigration reform," says Ramakrishnan.

    This approach acknowledges the important role immigrants play in the California economy and provides a patchwork of benefits that allows them to continue their contribution with as little friction as possible. For example, professional licenses and low-cost auto insurance are among the policies which allow immigrants to function in California's economy.

    The Senate bill states that "no child in California should endure suffering and pain due to a lack of access to health care services", which Ramakrishnan points out should not be seen as a benefit exclusively enjoyed by the Hispanic population.

    "Undocumented immigration is not just about Mexican immigrants, or even Latinos. Asian Americans account for about 1 out of every 7 undocumented immigrants in California and national reports show that the Asian share of the unauthorized population has grown rapidly in the last decade," says Ramakrishnan. "Expanding health care access to children will make an enormous difference for Asian American communities."

    José Huizar, a member of the Los Angeles City Council, praised the expansion of health care resources to undocumented children and encourages going even further and covering adult undocumented immigrants.

    While strongly supportive of the Affordable Care Act, Huizar said in a statement to NBC that the ACA "will fall short of its promise if we do not utilize it to cover all segments of our population, including undocumented immigrants and their families".

    José Huizar's city council district is over 70 percent Hispanic and includes Boyle Heights, a traditional gateway community for immigrants.

    "The hardworking immigrant communities that I represent need access to quality preventative healthcare and I support Sen. Lara's bill. It represents a first step in full access and health coverage for all Californians", stated Huizar.

    But for Huizar and others who support the new law, covering undocumented children is an important start.

  3. #3
    Senior Member lorrie's Avatar
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    Medi-Cal will soon cover children in the U.S. illegally.
    The real battle? Getting adults insured

    izeth Gallegos, 14, with her mother, Carolina Moran, in their Canoga Park apartment. Lizeth will be getting
    Medi-Cal health coverage. (Rick Loomis / Los Angeles Times)

    Soumya Karlamangla

    Ever since Obamacare took effect two years ago, many California legislators have been fighting to get health insurance for those it left out — the quarter of all immigrants in the country illegally who live within the state's borders.

    Next month, California will make a sizable dent in that effort when immigrants younger than 19 who are here without papers begin receiving free health coverage through Medi-Cal, the state's low-income health program. State officials estimate that 170,000 residents will be eligible.

    But insuring children is an easy battle to win, experts say, because of kids' emotional appeal and their low medical expenses. California isn't blazing the way here. Massachusetts, Illinois, New York, Washington and Washington, D.C., already have extended coverage to children in the country illegally.

    The remaining frontier — covering adults — will be a much tougher sell — and a more significant test of California's larger push to provide additional services to those here illegally.

    "The next steps are harder, the air gets thinner, the angles get tougher to ascend," said Anthony Wright, executive director of Sacramento-based advocacy group Health Access.

    The children's coverage came at a high cost, in a last-minute budget deal. To make it happen, Gov. Jerry Brown pledged $20 million in state funds to provide coverage from May through the end of the fiscal year, and $143 million in the upcoming fiscal year, said Medi-Cal spokesman Tony Cava.

    The state had to foot the entire bill. Even though Medi-Cal traditionally is funded with a mix of state and federal money, the Affordable Care Act prohibits the use of federal money to pay for covering immigrants in the country illegally.

    Some young people here illegally are already eligible to receive healthcare through county programs, such as My Health LA in Los Angeles County.

    Approximately 115,000 youths also get coverage for emergencies through Medi-Cal, according to state officials. They will be rolled into the newly expanded program on May 16, but will be covered retroactively from May 1, Cava said.

    As many as 27,500 children who have not yet been signed up for Medi-Cal are expected to enroll in the first year, Cava said. For minors to qualify, a family must earn less than 266% of the federal poverty level — or less than $53,626 for a family of three or $75,650 for a family of five.

    Maria Graciela, who lives in South El Monte, plans to get her 14-year-old daughter Ingrid's eyes examined as soon as her Medi-Cal coverage kicks in.

    "I just feel so fortunate," said Graciela, who cleans houses and hasn't been able to afford to take her daughter to the ophthalmologist or the dentist in years.

    Sonya Schwartz, a research fellow at Georgetown University Health Policy Institute's Center for Children and Families, said offering health insurance to kids is a smart investment, because research shows that children with access to Medicaid have fewer emergency room visits and lower blood pressure as adults. They also are more likely to graduate from college than those who do not have health coverage.

    "It's kind of penny-wise and pound-foolish not to cover these kids," Schwartz said.

    Even with the expanded coverage, UC Berkeley researchers estimate that as many as 1.5 million of the 2.67 million immigrants who are in the state illegally will remain uninsured by 2019. They would make up roughly half of California's anticipated uninsured population.

    "The big piece of unfinished business around health coverage is undocumented adults," said Daniel Zingale, senior vice president of The California Endowment, which leads a statewide campaign called Health4All.
    The government already prohibits anyone who turns up in an emergency room from being refused treatment, regardless of immigration status. Zingale said it makes more sense to invest taxpayer money in cheaper, preventive care to stave off serious problems that generate big emergency room bills down the road.

    Last year, a bill that would have covered all those here illegally made it through the state Senate but was whittled down to only children during budget deliberations. The original proposal could have cost as much as $1 billion annually.

    Opponents of expanding Medi-Cal say it is misguided to spend money on those here illegally when services for Californians lawfully in the country are being cut. They also cite studies that conclude that increasing access to medical care increases use and expenses, instead of lowering costs.

    Now, advocates for those here illegally are trying another, less expensive approach.

    Sen. Ricardo Lara (D-Bell Gardens) recently introduced a bill in Sacramento that would ask the federal government for permission to allow unauthorized immigrants to buy insurance from the state's health exchange, Covered California. California would be the first state in the nation to do this, but the move would be mostly symbolic, because immigrants still wouldn't get subsidies to help them afford coverage.

    The new proposal, combined with the rollout of coverage for those under 19, "will bring us closer to providing coverage to all Californians, regardless of where they were born," Lara said in a statement to The Times.

    State officials also are following a Supreme Court case that concerns President Obama's executive actions on immigration. An unusual policy in California allows those granted temporary relief from deportation to sign up for Medi-Cal, and researchers estimate that up to half a million Californians could apply for Medi-Cal if the executive actions being challenged in court are upheld.

    Even as advocates fight for more coverage, some who are eligible — whether they are here legally or not — aren't signing up, they say. That's partly because of confusion surrounding the patchwork of coverage.

    When the Dolores Huerta Foundation led an effort to knock on thousands of doors in the Central Valley to spread the word about the upcoming Medi-Cal expansion, many people told the advocates they were worried they would endanger themselves or family members in the country illegally by giving information to the government, said Yesenia Contreras, the foundation's civic engagement coordinator.

    President Obama has said that immigration officials will not have access to personal information submitted during health insurance sign-ups. But assuaging those fears, and getting eligible immigrants to enroll, remains difficult, Zingale said.

    "What most undocumented Californians know about Obamacare is that it excluded them," he said.

    For the moment, such exclusion still is being felt even in families about to get at least some health coverage.

    Carolina Moran, who lives in Canoga Park, is looking forward to taking her 14-year-old daughter Lizeth to the dentist when the Medi-Cal extension starts. She thinks Lizeth has five unfilled cavities.

    As for herself, the mother of five will remain without medical care. Her chronic kidney condition, she says, takes her to the emergency room every few months when she is too sick to go on.

  4. #4
    Senior Member lorrie's Avatar
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    Redondo Beach, California
    Under Obamacare, Medi-Cal ballooned to cover 1 in 3 Californians

    Californians brave long lines in the city of Commerce in 2014 to sign up for health coverage under the Affordable
    Care Act. (Al Seib / Los Angeles Times)

    By:Soumya Karlamangla

    alifornia officials never anticipated how many people would sign up for state-run health insurance under Obamacare.The state's health plan for the poor, known as Medi-Cal, now covers 12.7 million people, 1 of every 3 Californians.

    If Medi-Cal were a state of its own, it would be the nation's seventh-biggest by population; its $91-billion budget would be the country's fourth-largest, trailing only those of California, New York and Texas.

    "When the final numbers started coming out, where a third of the population was on Medi-Cal, it went way past anyone's expectations," said state Sen. Ed Hernandez (D-West Covina), who chairs the Senate Health Committee.

    Expanding Medi-Cal was a key part of the Affordable Care Act, the national law that overhauled the healthcare system and required nearly all Americans to have insurance starting in 2014. Under the law, Medi-Cal — historically a health program for poor families and the disabled — was opened to all low-income Californians starting two years ago, with the federal government paying for those new enrollments.

    Though a surprise, the high Medi-Cal enrollment is generally hailed as a success. California's uninsured population has been cut in half since Obamacare, in large part because so many Californians signed up for Medi-Cal, which is free for beneficiaries.

    "The Medi-Cal program continues to grow at a very substantial rate, which is great. We are very happy that we're able to provide healthcare to getting close to 13 million Californians," said Mari Cantwell, chief deputy director at the state Department of Health Care Services, at a hearing in downtown L.A. this month. But, Cantwell added: "Obviously with that comes cost."

    The question California officials now face is how — and on days with a gloomier economic outlook, if — the massive health program can be sustained. Already, Medi-Cal is seen by many as underfunded, with patients struggling to find doctors and sometimes receiving low quality of care. A group of activists and others recently filed a federal civil rights complaint alleging that Latinos are being denied access to healthcare because the program does not pay doctors enough.

    In many ways, how the program fares will be an important test for the Affordable Care Act.

    Medi-Cal is California's version of Medicaid, a joint federal-state program that exists in every state and has historically provided free health coverage to those considered too poor to afford needed medical care.

    With Medi-Cal, "a lot of people enrolled quickly and stayed in, and that's a really big part of the ACA's success," said Sonya Schwartz, a research fellow at Georgetown University Health Policy Institute's Center for Children and Families.

    The Affordable Care Act allowed states to open up Medicaid to anyone making less than 138% of the federal poverty level — for a single person, a couple or a four-person family, that means an annual income of less than $16,243, $21,983 and $33,465, respectively.

    In California, officials predicted that fewer than 1.5 million people would have enrolled by now. Instead, more than 4 million Californians have signed up.

    Sara Hayden, 52, joined Medi-Cal in early 2014. She has rheumatoid arthritis and other diseases that require expensive medicines and frequent doctor visits.

    "It's just been a godsend for me," said Hayden, who lives in Half Moon Bay near San Francisco. She is unemployed and can't afford private insurance.

    The record number of people like Hayden who have signed up led to big cost increases for the program. Its price tag has jumped from $59 billion to $91 billion.

    The program's enrollment probably will continue to swell, though at a much slower pace, as healthcare prices keep growing nationwide.

    "I'm certain we're going to get close to cracking that $100-billion budget for the Medi-Cal," Cantwell said.

    The federal government promised to initially pay costs of enrollees newly eligible under Obamacare. So while the federal government's annual Medi-Cal payments have increased by $28 billion since 2013, the state's have gone up less than $4 billion.

    Starting in 2017, however, the state will be required to chip in more. Instead of the federal government paying 100% for newly eligible enrollees, the state will have to begin paying 5%. By 2020, the state will be paying 10% of the costs.

    However, experts say that is a relatively small increase.

    "That's a really great deal for California," said Scott Graves, research director at the California Budget & Policy Center. "You don't find that anywhere else."

    Advocates say the expansion, with the huge infusion of federal money, should in fact eventually yield savings for states, possibly enough to make up for the costs.

    UC researchers calculated that each new federal dollar brought to California by Medi-Cal will generate 5.4 cents in tax revenue for the state, which would mean several billion dollars. That's because the money creates jobs in healthcare, which creates income and sales tax.

    Civil rights complaint filed against Medi-Cal

    Experts predict other savings as well. Medi-Cal can be a boon to the personal finances of Californians who previously went without insurance or struggled to pay for it.

    Before signing up for Medi-Cal, Hayden, who can't work because of her illnesses, was quickly draining her bank account by paying a $900 monthly premium for private insurance.
    "I have depleted my savings, my 401(k)," she said. Since joining Medi-Cal, she hasn't paid a penny.

    Many experts also say the state will save money on services that can now be accessed through Medi-Cal, such as mental health services and substance abuse treatment.

    Plus, many ongoing efforts to improve care for patients are also intended to lower costs, said Chris Perrone with the California HealthCare Foundation. A big one is moving all Medi-Cal beneficiaries onto managed care, a system to better coordinate medical care, with the intent of reducing overlap, delays and costs.

    However, with so many new initiatives, it's difficult to determine the financial effects of the expansion on the state because savings can be realized in several different departments, and may not be caused by Medi-Cal, experts say.

    Also watching are the 20 mostly Republican-led states that didn't open up their Medicaid programs. Advocates there hope that seeing savings in states that did expand will encourage their legislators to follow suit.

    In California, state officials are discussing how they'll afford the program next year. Gov. Jerry Brown called a special legislative session this year to address funding for Medi-Cal.

    "It's a strained system," said Hernandez, "and I really believe we need to figure out how to resolve this because we need to make sure that these people have access to care."

  5. #5
    Moderator Beezer's Avatar
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    Apr 2016
    Maybe we should start claiming 20 dependents now, have less taken out of our checks...then not file our 2016 taxes next April...then file an extension to October 2017 and send the message to DC that we will not pay for illegals in our country anymore!
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  6. #6
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    Healthcare Subsidies for Illegal Aliens Could Cost California Up to $2 Billion Annually

    June 9, 2016 By Spencer Raley 17 Comments

    California lawmakers are using a loophole in the Affordable Care Act (ACA) in an attempt to offer healthcare to illegal aliens. While the ACA expressly bans those living in the country illegally from applying for healthcare through the federal marketplace, it allows states to apply for an “innovation waiver” to expand coverage so long as they pay for any additional costs. The measure, which passed the legislature last week, awaits the governor’s signature before being sent to the amnesty-friendly Obama administration for final approval of the waiver request.

    The bill’s sponsors estimate that approximately 390,000 of California’s more than 2.5 million illegal aliens would immediately become eligible to apply for healthcare through the state-run ACA marketplace.

    What is still questionable is whether these immigrants will receive the same subsidies that citizens are given. Considering illegal alien households earn 28 percent less than American families on average, it is doubtful that many can afford full-price insurance. Given the California Legislature’s track record, it is likely that subsequent legislation would grant state assistance to illegal aliens who purchase insurance through the state-run exchange.

    The average ACA subsidy doled out by the federal government amounts to approximately $3,300, which would make the price tag to cover illegal aliens approximately $1.3 billion annually. Because the law, known as SB 10, expressly prohibits illegal aliens from receiving federal subsidies to pay for healthcare under the state exchange, someone (California taxpayers, probably) will need to pick up the tab to make up the difference. Some estimates regarding the subsidy California provides to residents, especially for lower-income families, average closer to $5,200. This could raise the taxpayer burden to more than $2 billion annually.

    Already bearing an oppressive debt load, Democratic governor Jerry Brown issued a press release last month admitting that the state is unable to cover its current commitments, much less pay off any of the $430 billion already owed to creditors. Covering the insurance bill for illegal aliens would further increase the high-tax state’s liabilities. The governor’s office already projects a $4 billion budget deficit by 2019.

    In addition to creating a substantial amount of new debt, offering healthcare benefits to illegal aliens – subsidized or unsubsidized – only encourages more illegal immigration. Either way the taxpayer burden will become heavier in the future as projections are altered to incorporate a rising number of new beneficiaries.

    For a state with a faltering economy, voluntarily aggravating the illegal alien problem is the exact opposite of sound policy. Undocumented immigrants already cost Californians $22 billion annually and it is projected that an additional $1.2 billion will be necessary to hire more than 17,000 bilingual teachers by 2018 to keep up with the influx of students with limited English proficiency. If these unsustainable costs remain unchecked, California will face an unprecedented economic disaster.

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