Ensuring California's Future by Insuring California's Undocumented: Why Excluding Undocumented Californians from the Affordable Care Act Hurts All of Us

This report develops the rationale for extending health insurance coverage to undocumented immigrants in the State of California. Undocumented immigrants are excluded from the Affordable Care Act (ACA) and ineligible for private health insurance subsidies, Medicaid expansion, and the Basic Health Program, which impacts up to 1.5 million uninsured in California. Meanwhile, federal funding for hospitals providing care to the uninsured is being reduced. On the state level, California is cutting funding for low-income and uninsured medical services on the county-level in response to the ACA. State Senator Lara has proposed expansion of Medi-Cal and the establishment of a private insurance exchange for undocumented individuals. According to the report, undocumented immigrants are valuable to the California economy as they pay $2.7B in sales and taxes.  Additionally, the 2.6 million undocumented comprise nearly 7 percent of the state's population and work in major industries such as agriculture, construction, personal services, and retail. With a median income of $20,000 for full-time undocumented workers, up to 75 percent of undocumented individuals lack medical insurance. Despite legal fears, evidence shows undocumented individuals would sign up if medical insurance were offered.  Benefits of insurance coverage include: improved health, health care, and quality of life; preventive care; reduced psychological distress; and preventing financial crisis. However, barriers to reaching the undocumented population include: a lack of cultural sensitivity on the part of providers, linguistic and physical accessibility, and fear of deportation. Establishing partnerships with CBO's could help address these problems. Historically, Californians have given bipartisan support to immigration laws favoring undocumented immigrants and state sovereignty in immigrant policy making. (Colin Liebtag, Rutgers Graduate School of Social Work)

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