SACRAMENTO – Gov. Jerry Brown signed a bill earlier this month empowering state agencies to seek a waiver that would allow all immigrants, regardless of status, to buy health insurance plans through the state’s exchange.
Gabrielle Lessard, a health policy attorney for the National Immigration Law Center, said the bill lets the state ask the U.S. Department of Health and Human Services and the Internal Revenue Service to waive parts of the Affordable Care Act.
“It’s a step toward getting access to health care,” Lessard told the Northern California Record. “The objective of that waiver would be to allow people in California who are considered not lawfully present under the Affordable Care Act to buy policies through Covered California. I say considered not lawfully present because, in addition to people who are undocumented, the Affordable Care Act treats recipients of deferred action for childhood arrival (DACA) as not lawfully present. They are excluded from being able to being able to purchase policies through the exchanges.”
The decision to exclude those people was made by the Department of Health and Human Services, she said, and could be reversed without any action by Congress.
If the state does get waivers, it isn’t clear how many more people would be able to actually buy health insurance, because even if the plans are available, federal law prevents the state from offering subsidies to make them more affordable.
“Since undocumented residents are among the poorest members of our society, a number of people will simply not be able to afford the plans,” Lessard said. “We're hoping that DACA recipients who are employed, people who are small business owners, and particularly people in mixed-status families – where they have spouses of children who are citizens or have their lawfully present status – will be able to go to Covered California, use the shop and compare tool, select plans that work for the entire family, and then enroll the eligible members into the Covered California plan, and enroll the undocumented family members into the comparable plan all at one time.”
The bill was originally more expansive, but the state legislature amended it, reducing its scope, she said.
“The legislation that led to SB 10 began as SB 1005, and that legislation would have opened up MediCal to all immigrants who were income eligible, regardless of their immigration status, as well as creating a parallel exchange for people who were above the MediCal income eligibility threshold,” Lessard said. “That legislation was amended and ultimately resulted in all children who were income eligible being eligible for MediCal regardless of income status. We are working on a continuing effort to ensure that everybody has access to health care.”
Ensuring access is key, she said, because of the dangers those without access to affordable care face.
“It's well-documented that people who are uninsured or don't have access to affordable care, they have a tendency to defer seeking care until they are in a situation where they are just in unbearable pain or have some other kind of disabling physical condition that they can't ignore,” she said. “So the result of that is that people who have conditions that don't exhibit symptoms, like diabetes or high blood pressure or cancer, tend to get a diagnosis when the condition is well advanced. And even if people do have a diagnosis, they aren't able to get the medical assistance they need to manage conditions like high blood pressure, and so they do have consequences. There was person who came and spoke at a number of our rallies over the past few years who had gotten a diagnosis of cancer at stage IV, and understood that it was too late for her, but she wanted to get access to health care for other people. And unfortunately she passed away earlier this year.”