Legislators were skeptical, and some reporters thought it was a trick. We were proposing progressive social policy to help farmworkers get health care that would actually subsidize the state’s general fund, not the other way around.
But with Senate Bill 145, we proved the impossible was possible. And Gov. Jerry Brown has signed the legislation into law for the next five years.
The Affordable Care Act permanently excludes undocumented immigrants from using their own money to purchase insurance on health exchanges. That means hundreds of thousands of farmworkers have access only to subsidized health care when they go to emergency rooms, where care is very expensive.
We found a solution that works for California, building on the Robert F. Kennedy Farm Worker Health Plan that Cesar Chavez created 46 years ago. The plan is governed by a board of farmers and farmworkers, and both groups contribute money for every hour worked. The trust fund then pays the medical bills for 13,000 farmworker family members, a total of $25 million last year.
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The not-for-profit plan’s 5 percent administrative overhead beats any standard in America. But operating on a lean budget also meant the plan didn’t build up large enough reserves to pay for some catastrophic bills. The Affordable Care Act requires all health insurance coverage to be unlimited, but obligation would put the RFK plan into bankruptcy without more time to build reserves.
Farmers and farmworkers agreed to a series of self-help steps. They agreed to increase their contributions, plan administrators re-engineered benefits and the state helped the plan purchase stop-loss insurance to reduce the risks of catastrophic illnesses or injuries.
Over the past 15 months, these steps worked. The RFK plan is growing stronger by the month. More farmworkers are covered, more health care providers are lowering costs and the state general fund savings have materialized.
SB 145 caps state costs at $3 million for the next four years while securing continued farmer and farmworker contributions of no less than $25 million per year.
The end result will be an unprecedented success story. California will save $30 million in its general fund, farmworkers and their families will have $125 million in health care. And all of this will happen without waiting for any changes from Washington, D.C.
Richard Pan, a Sacramento Democrat, represents the state’s 6th Senate District. Arturo S. Rodriguez is president of the United Farm Workers of America.