More than 100,000 undocumented adult immigrants in California would be eligible for state-subsidized health coverage under a major budget push announced by Assembly Democrats on Monday.
Lawmakers are asking Gov. Jerry Brown for $1 billion, a large portion of which would fund a major expansion of Medi-Cal, the state's low-income health care program. Roughly a quarter of the request – $250 million – would extend Medi-Cal to undocumented immigrant adults who are ineligible for coverage.
"We are California. We don't follow, we lead," said Assemblyman Joaquin Arambula, D-Frenso, author of Assembly Bill 2965, which would qualify all undocumented adults for Medi-Cal.
There are an estimated 1.8 million undocumented adult immigrants in California who are uninsured. Roughly 1.2 million of them are low-income and thus would qualify for Medi-Cal, according to state projections. Most rely on expensive emergency room care for routine doctor visits.
The $250 million would cover 11 percent of the uninsured undocumented adults whose incomes are low enough to qualify for Medi-Cal – about 114,000 people, according to lawmakers.
Lawmakers also are asking for millions of dollars to fund premium assistance for low- and middle-income people who struggle with the costs of insurance purchased through the Covered California exchange, to extend Medi-Cal to low-income seniors and disabled people and to expand the ranks of primary care doctors in rural parts of California and other underserved communities.
The move is the first major financial request tied to Democratic-led efforts to expand universal health coverage in California. Lawmakers argued their efforts will help not only the uninsured but also the overall health care system, as rising costs associated with uncompensated care decline.
"It is important that ... we ensure some day that we get to say in the state of California that health care truly is a right," said Assemblyman David Chiu, D-San Francisco.
The money would come from California's $6.1 billion budget surplus, said Assemblyman Phil Ting, D-San Francisco, chairman of the Assembly budget committee.
Brown, in his last year in office, remains a major hurdle.
Brown has warned of a looming recession and has expressed skepticism over making any additional major investments in ongoing spending. He has also already outlined how he intends to spend the surplus. His January budget proposal sets aside $3.5 billion in the state's rainy day fund, with additional spending on voting system upgrades, mental health and an earthquake early warning system.
In recent years, Brown has made major investments to expand health care for low-income uninsured Californians. His office declined to comment specifically on the Assembly budget ask.
"The governor will send his revised budget to the Legislature in the coming week and will provide any updates to his health care proposals at that time," Department of Finance spokesman H.D. Palmer said.
Past efforts to expand health insurance to undocumented adults have failed, including a 2014 bill from state Sen. Ricardo Lara. Spending estimates at the time estimated it would cost up to $900 million a year to cover all undocumented adults. Undocumented children are already eligible for Medi-Cal coverage.
Lara has an identical bill to Arambula's this year.