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Study finds modest investment could expand Medi-Cal to undocumented residents of California

May 21, 2014

  • UCLA Center for Health Policy Research

Approximately 690,000 to 730,000 undocumented Californians could gain access to routine and preventive health care in 2015 with just a 2 percent increase in state Medi-Cal spending – estimated at between $353 to $369 million – according to a joint study by the University of California, Berkeley’s Center for Labor Research and Education and the UCLA Center for Health Policy Research.  

The study looks at certain provisions of the proposed Health for All Act, or Senate Bill 1005, proposed by state Sen. Ricardo Lara (D- Huntington Park/ Long Beach) and under consideration in the state Legislature, that will make all low-income Californians who are excluded from federal health reform, including undocumented immigrants, eligible for Medi-Cal.

More than 1.4 million undocumented Californians are uninsured because they are not eligible for Affordable Care Act coverage programs due to their immigration status.

“California would be the first in the nation to make its health insurance program inclusive of all low-income residents and their families, including those who are undocumented,” said Laurel Lucia, policy analyst at the UC Berkeley Labor Center.

The proposed policy would complement the state’s recent lead role in expanding immigrants’ rights in the absence of federal immigration reform, following moves to provide driver’s licenses to all residents and extend financial aid to undocumented college students who arrived in the United States as children, said Lucia.

The proposed change would move California from a system of disjointed emergency care to more rational and comprehensive care at a relatively low cost per person, according to the study authors, because some 60 percent of health care costs for California's low-income, undocumented adults are already paid under long-standing federal policy. Matching dollars are provided by the federal government to the state for emergency and pregnancy-related services already available to all low-income Californians, regardless of immigration status.

But undocumented immigrants, who make up 9 percent of California’s workforce, often lack access to health-promoting, cost-effective preventive and routine services.

“The undocumented don’t get sufficient access to preventive care and often wait as long as possible before seeking care,” said Nadereh Pourat, director of research at the UCLA Center for Health Policy Research. “Providing preventive care helps the undocumented stay healthy and allows them to continue to contribute to California’s economy.”

The new spending would be substantially offset by an increase in state sales tax revenue from managed care insurance plans, in addition to savings from reduced county spending for providing care to the uninsured, according to the report.

These offsets are included in the estimate that net state spending would be predicted to increase by between $353 and $369 million in 2015 in order to cover between 690,000 and 730,000 Californians. By 2019, the proposed policy would be predicted to increase net state spending by between $424 and $436 million in order to cover to between 750,000 and 790,000 Californians.

The report’s enrollment and cost projections were primarily made using the California Simulation of Insurance Markets (CalSIM) model, a microsimulation developed by researchers at the two UC centers. CalSIM uses a range of official data sources, including the California Health Interview Survey, to estimate the coverage impact of policy changes in California. The analysis also uses and makes comparisons with enrollment and cost data from the state Department of Health Care Services.

 
The UCLA Center for Health Policy Research is one of the nation’s leading health policy research centers and the premier source of health-related information on Californians.

The UC Berkeley Center for Labor Research and Education was founded in 1964 to conduct research and educate on issues related to labor and employment, such as job quality and workforce development.