Hundreds of thousands could gain health insurance, but many will remain uncovered.
Between 360,000 and 500,000 immigrants living in California would become eligible for Medi-Cal if they receive temporary protection from deportation and permission to work as a result of recent executive actions by President Barack Obama. Up to 57 percent of immigrants in California who are eligible under the executive actions are low-income and lack private health insurance, according to a study by UC Berkeley’s Center for Labor Research and Education and the UCLA Center for Health Policy Research.
In November, Obama announced the expansion of the Deferred Action for Childhood Arrivals program, or DACA, which was established in 2012, and the creation of Deferred Action for Parents of U.S. Citizens and Lawful Permanent Residents, or DAPA. Applications continue for the original DACA program. Application processes for the new programs have been placed on hold under a court order, but immigration policy experts predict that the new programs will ultimately be implemented.
Although immigrants approved under the DACA and DAPA programs are not eligible for health coverage options under the Affordable Care Act, they are eligible for Medi-Cal under California state policy if they are in families earning less than a certain amount.
“We have left behind millions of undocumented workers and students who are excluded from health coverage options under the Affordable Care Act,” said Laurel Lucia, a policy analyst at the UC Berkeley Labor Center and lead author of the brief. “California is leading among states by providing comprehensive health care services to low-income residents granted DACA and DAPA, which is an important step toward closing the state’s largest eligibility gap.”
The researchers estimated that 66 percent of DACA- and DAPA-eligible adults are working.
“The only way we can improve overall health and efficiencies in expenditures is by providing important preventive and primary care services to everyone, not just those lucky enough to afford coverage,” said Nadereh Pourat, director of research at the UCLA Center for Health Policy Research and co-author of the brief. “Insurance coverage is the essential requirement for getting care when it is needed, and most undocumented working in low-income jobs fall through the cracks.”
New cost per person likely to be low
The researchers found that Californians eligible for DACA and DAPA are relatively young: 92 percent are under the age of 45, which would likely mean that their insurance premiums would be lower than the current statewide average.
Providing comprehensive coverage would also build upon federal and state funds already spent. Previous research by the authors found that 60 percent of the cost per adult of comprehensive Medi-Cal coverage is already paid for by the federal and state government through restricted scope Medi-Cal, which covers emergency and pregnancy-related services.
Many undocumented will remain uncovered
Even after expanded DACA and DAPA are implemented, many undocumented Californians would be expected to remain uninsured because they are not eligible for the programs, face barriers in signing up for deferred action or enrolling in Medi-Cal, or are not income-eligible for Medi-Cal.
This brief comes as the California Legislature considers the Health for All Act, or Senate Bill 4, proposed by state Sen. Ricardo Lara. The bill would expand eligibility for comprehensive Medi-Cal to all low-income Californians, regardless of their immigration status, and broaden undocumented Californians’ options for purchasing private insurance.
The health coverage and demographic estimates use data from the 2013 Current Population Survey, conducted by the U.S. Bureau of Labor Statistics and Census Bureau. The estimates are applied to the Pew Research Center’s estimate that 1.25 million Californians are potentially eligible for DACA and DAPA.
“This report gives us an important new insight on how many people are still locked out of health coverage. Now that we’ve seen these numbers, we can all work together to make sure everyone gets enrolled,” said Daniel Zingale, a senior vice president at The California Endowment, which funded the research. “People shouldn’t suffer or die because of their immigration status. The president’s executive action brings us a step closer to securing a healthier future for everyone, but even still, there will be others who are locked out of affordable coverage, and California needs to finish the job.”