In a move called both symbolic and practical, the Covered California board took the first step Thursday toward allowing undocumented residents to purchase health plans – with no state or federal subsidies – through California’s Obamacare marketplace.
The board can’t officially enact that change, which requires state legislation and federal permission, but Covered California officials indicated they were ready to lend support if California lawmakers ask them to.
“The ball is in their court,” said Peter Lee, director of Covered California, who said there is no guarantee that permission would be granted by federal health care officials.
Currently, undocumented residents can purchase a health insurance plan in California through private insurance brokers, but cannot use the Covered California marketplace.
It’s not clear how many undocumented residents would be interested in purchasing plans through the exchange. One estimate, according to a Covered California report, said the potential enrollment is 50,000 individuals.
The move to seek a federal waiver was endorsed by numerous advocacy groups.
“This could potentially benefit tens of thousands of (immigrant) Californians,” said Anthony Wright, executive director of Health Access California, a consumer advocacy group. “Beyond the symbolism of inclusion, this will provide practical benefits. It’s allowing people to take on the financial responsibility of getting covered and having health care security. Even folks who disagree with immigration policy can agree that it’s a good thing.”
The board’s analysis Thursday also noted the potential impact on families of “mixed immigration status,” such as when a parent or grandparent is undocumented, and a child or mother is a legal resident. For those families, obtaining health insurance often means different types of policies, public programs and coverage.
If a federal waiver is granted, “it allows (undocumented residents) to purchase a health plan with their own money. It’s a one-door opportunity to get health care as a family,” said Betzabel Estudillo, health policy coordinator for the California Immigrant Policy Center in Los Angeles.
Under the Affordable Care Act, states are allowed to seek federal permission – known as a 1332 waiver – to enact changes, such as covering undocumented residents. The waivers cannot add costs to the federal budget and require state legislation.
In California, that legislation is already underway. Senate Bill 10, by state Sen. Ricardo Lara, D-Bell Gardens, seeks a federal waiver to allow undocumented residents to purchase Covered California policies. It passed the Senate last year.
It “underlines a common-sense belief. If someone can afford to buy insurance, they should be allowed to do so, regardless of their immigration status,” Lara said in an email Thursday. His bill is expected to be taken up by the Assembly Rules Committee in the next few weeks, according to his staff.