California Moves to Cover Some Undocumented Immigrants

June 17, 2019

What the move could mean for patient outcomes.

The California state Senate has moved along a bill that would offer health benefits to some resident undocumented immigrants. This is the first state to make this move.

This could potentially come at a cost of $1 billion, according to the Times of San Diego.

Introduced by Democratic Sen. Maria Durazo, Senate Bill 29 passed Wednesday 24-11 and expands the funding for healthcare services to those aged 19 to 25 who currently qualify for partial coverage under the state’s Medi-Cal program.

"California is attempting to reduce its number of uninsured by covering a segment of its population that is largely ignored by the rest of the country," says Don Hall, principal at DeltaSigma a healthcare consulting firm and Managed Healthcare Executive editorial advisor. "It's important to understand that the reality of this action is to provide a mechanism for paying providers who care for these and in many cases have previously cared for them without reimbursement."

“This push to expand coverage to all, documented or undocumented residents, should help provide these individuals with the wherewithal to seek out appropriate treatment,” says Annette Bechtold, SVP of regulatory affairs and reform initiatives at OneDigital, a company headquartered in Atlanta that focused on employee benefits and human resources.

Related article: Medicare for All: Four Things Health Executives Should Know

“If coupled with education and encouragement of preventive care and early treatment, this program could help individuals improve their health and outcomes,” Bechtold says. “This, in turn, promotes healthier individuals in the community and lower costs to the overall healthcare system.” 

Financing healthcare is a challenge, says Bechtold. “The cost of medical goods and services continues to escalate. For many, these costs prevent them from seeking the treatment they need,” she says. “This delay in treatment often results in more expensive treatment at the later stages of an illness or injury.

“I think we can all agree that early access to healthcare is important. It provides the individual with diagnosis and treatment, enabling earlier management of illness or injury, thereby lessening the frequency and cost of care. This helps the individual, the community, and the overall healthcare system,” Bechtold continues.  

Insurance coverage is the most popular way to pay for healthcare services, she says. “Individuals without a healthy bank account, or access to good health insurance coverage, lack the funds and direction necessary for early treatment,” Bechtold says. 

While some worry how this will affect employers, Jamie Webb-Akasaka, VP legal counsel, HR Consulting, OneDigital, says there most likely won’t be any direct impact.

“Generally, there does not appear to be a direct impact on employers as a result of the pending California budget,” Webb-Akasaka says. “However, the bill may encourage more employees to enroll in employer-sponsored benefits so as to avoid individual mandate penalties, or to enroll in the individual marketplace thereby decreasing overall prices. The level of each employer’s benefit sponsorship will determine whether increased employee enrollment will result in any added cost to employers. It is unclear if other states will follow suit because they each implemented ACA policies differently.”

The impact on health plans will probably be minimal as the plans that cover Medi-Cal members are already geared up to handle language and other barriers face by immigrants, adds Hall.

However, Mario Anglada, CEO at Hoy Health, an organization dedicated to providing access to bilingual English and Spanish speaking healthcare professionals, says other states will soon adopt similar laws. 

"I think many states will take a wait-and-see-response but, ultimately, they will adopt similar laws," says Anglada. "Aside from the belief that many of us share, that health is a fundamental right for all people, let’s look at the economics. Right now, anyone who walks into an emergency department must be offered care. Individuals living in California who don’t have insurance and who can’t pay their medical bills end up costing taxpayers more in the long run.

"Many executives are beginning to recognize that such changes are needed. Hispanics have the highest uninsured rates of any racial or ethnic group within the United States, making culturally relevant care more critical than ever. We’re already seeing a trend toward innovative health products designed to close gaps in care for underinsured, uninsured and underserved popula-tions, such as California’s growing Hispanic population. These individuals require greater access to quality affordable care that is attuned to their culture and language, as well as medications that they can afford.

"It’s up to executives and legislators to recognize the health and economic benefits of making it easier for these vulnerable populations to access affordable primary care and avoid the crippling costs of emergency department utilization that hamstrings the entire economy."