New law expands health coverage for undocumented children

For the first time in their lives, hundreds of kids in Contra Costa County have health insurance.

Senate Bill 75 (SB 75), which was passed last year and covers health care for undocumented immigrants under the age of 19, expanded coverage for almost 2,000 Contra Costa children and covered an additional 744 children for the first time, according to reports released last month. The bill makes California one of only a handful of states that provides health care benefits to undocumented residents.

Previously, undocumented children in California only had access to restricted-scope Medi-Cal, which covers only emergency and prenatal care. For primary care visits or specialty treatments such as chemotherapy, parents and guardians had to pay out of pocket—or let children go without.

Now, anyone under the age of 19 is eligible for full-scope Medi-Cal regardless of documentation status.

“It almost sounds too good to be true sometimes,” said Roxane Foster, lead division manager for the Work Force Services Bureau at the Contra Costa County Employment and Human Services Department, whose responsibilities include managing the Medi-Cal and Cal-Fresh service center and the health care access center.

Although 744 newly insured children may not sound like a lot, she said, “for each of those kids it’s a big deal.”

The bill was signed into law by Governor Jerry Brown in June 2015 and went into effect in May of this year. Foster said the bill was implemented quickly, with all children covered by insurance within the first few months.

“The transition has actually been very smooth,” she said.

It is “a crucial piece of legislation,” said Nancy Berlinger, Research Scholar at The Hastings Center, an independent bioethics research institute. “It closed an important gap in access to health care for immigrant children.”

The bill was sponsored in the state senate by Sen. Ricardo Lara (D-CA-33), and supported by the California Immigrant Policy Center and Health Access California.

“This was a step forward for both the immigrant rights movement, and the health reform movement,” said Anthony Wright, Executive Director of Health Access California, an advocacy coalition that promotes quality and affordable health care for all Californians.

The children SB 75 covers, he said, “in many cases don’t know a home other than America and California.”

“When you look at kids,” said Wright, “there’s certainly a recognition that this is our future.”

Although the bill passed the state senate 28 to 12, with two Republican senators voting against their party, the majority of Republican Senators voted against the bill.

However, a representative for Senator Jeff Stone (R-CA-28), who opposed the bill, said via e-mail that Stone’s opposition “had more to do with the lack of transparency than the substance of the bill.”

Stone was worried, according to his website, that the bill would be nothing more than a way to hide back-room changes to the 2015 state budget.

Anti-immigration groups, including the Federation for American Immigration Reform, also opposed the bill.

Berlinger said that even in states that are unwelcoming to immigrants, “that still doesn’t mean that people don’t get sick, or have babies, or fall off ladders.”

“The problem is still going to play out at that local level,” she said. Which means that when medical issues arise, the state or local hospitals will have to foot the bill for those without health insurance.

Moreover, said Berlinger, undocumented immigrants typically pay into the health care system and receive no benefits in return. She pointed to a 2015 study in the Journal of General Internal Medicine that found that from 2000 to 2011, undocumented immigrants annually contributed $2.2 to $3.8 billion more than they withdrew from the Medicare Trust Fund—delaying the Fund’s insolvency by at least a year.

For many professionals in California’s health system, SB 75 is one crucial step towards statewide universal health care.

“We believe the health care system is stronger when everybody is included,” said Wright. “Covering more people, especially with primary and preventative care, makes for a more efficient and effective health care system.”

For Andres Abarra, patient services advocate and outreach worker at LifeLong Medical Center, which received a $2 million state grant through SB 75, the biggest drawback of the bill is that it ends coverage for undocumented immigrants at age 19.

“Usually health care follows you,” he said, “but with this bill, it drops you.”

Abarra said that, like Wright, he used to be hopeful that SB 75 would pave the way to Medi-Cal benefits for undocumented adults as well. Yet after the election of President-elect Donald Trump, he does not think it will.

“He’s definitely not a champion for undocumented citizens,” said Abarra.

“It was looking up,” he sighed, “but today, I don’t know. I just don’t know.”