CA opens Affordable Care Act door to unlawful immigrants

 

Covered-California-575x431State Democrats forged ahead with legislation designed to fill out Covered California’s enrollment ranks with unlawful and undocumented immigrants. 

Following the state Senate, the Assembly has “passed a measure that would remove a critical barrier to Covered California and allow all Californians to access the state health insurance marketplace, regardless of immigration status,” as State of Reform noted. The legislation, introduced as Senate Bill 10 by state Sen. Ricardo Lara, D-Bell Gardens, “would authorize the state to apply for a federal waiver that would allow undocumented immigrants to buy unsubsidized health coverage through Covered California.”

“Currently, undocumented immigrants are barred from using the state marketplace under the Affordable Care Act even when using their own money and instead must go directly to a broker or health plan to purchase health insurance. During its April board meeting, a Covered California staff report gave the green light to pursue this waiver from the federal government, and is now awaiting direction from the Legislature and governor.”

Republican rollover

Despite massive Republican resistance to the implementation of Obamacare, with a “repeal and replace” approach adopted by elected officials at the state and federal level, California’s GOP quietly folded in the face of the expansion plan. SB10 sailed through both houses of the Legislature with bipartisan support, as the San Jose Mercury News recalled.

Prior to the vote, key Republicans tried to keep a low profile. Leaders “in both legislative chambers declined to comment on whether the bill has enough support to pass,” according to CALmatters. “But a Republican strategist said the California GOP might be more likely to support the measure than its national counterpart, to avoid ceding the state’s Latino vote to the Democrats.”

The ins and outs of the complex Affordable Care Act have lent some circumstantial evidence to the notion that, despite President Obama’s claims to the contrary, at least some enrollment by the undocumented was envisioned or prepared for. An ACA provision “called the ‘innovation waiver’ allows states like California to change portions of the law as long as the state makes coverage available to more people and as long as the federal government doesn’t get stuck footing the bill,” reported Fox News. And though the impact of that population on Covered California has not been fully estimated, it would be significant: Lara suggested nearly 400,000 unlawful immigrants “would be eligible to receive health insurance,” according to the channel.

Federal hurdles

But the political landscape has become uncertain enough at the federal level to create an extra layer of difficulty — and urgency — for Lara and his allies. “The proposal needs federal approval, an involved bureaucratic process that could be thwarted under a new presidency. So California advocates are acting swiftly to get their application to President Obama before he leaves office, and to do so must win support from at least a few California Republican lawmakers,” Capital Public Radio noted. “Lara put an urgency clause on the bill, which requires a two-thirds majority vote to pass the Legislature. At least one Republican state senator has indicated his support” — Andy Vidak, R-Hanford — “a cherry grower in the Central Valley’s Kings County, which has a 53 percent Latino population.”

Even with adequate Republican support for urgency, however, SB10 could be stymied inside the Beltway. Public comment review requirements left some analysts skeptical that the new rules could be approved before a change in administrations, CALmatters reported. “And even if the proposal works its way through that maze and is reviewed by the Obama administration, he said, it may not be approved because of current federal guidelines. The U.S. Department of Health and Human Services has strict rules for modifying the Affordable Care Act marketplaces. They might have been put in place to avoid creating a precedent that opens the door to future changes the current administration would deem” problematic.



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