Influencers Opinion

All immigrants need access to affordable health care. But how is that accomplished?

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In other parts of the country, they’re fighting about whether to build a border wall or whether to deport asylum seekers. But here in California we’re having an entirely different type of debate.

When Gov. Gavin Newsom’s budget proposed expanding health coverage to all undocumented immigrants up to age 26, his fiercest criticism came from those who felt his proposal was not nearly ambitious enough.

So it shouldn’t be surprising that most of our California Influencers support providing health insurance to larger numbers of low-income immigrants, citing a range of public health, economic and humanitarian concerns.

Mark Ghaly, Newsom’s secretary of Health and Human Services, cited federal requirements to provide emergency services to all uninsured patients and suggested that it would not make sense to withhold other types of care to undocumented immigrants.

“The question should be, what should California do given our clearly defined minimum obligation under federal law,” Ghaly asked. “Should we stop there or should we take it a relatively small step further by ensuring the full benefits of a health care system built on the backbone of primary and preventive care rather than emergency and hospital care? I vote the latter.”

Robin Swanson, founder of Swanson Communications, was emphatic in answering Ghaly’s question.

“Studies have shown that high rates of uninsured result in considerable financial burdens for hospital systems, which are charged with providing care whether or not a patient who walks in the door is insured,” she said. “We can either address the issue upfront and provide basic preventative care, or we can wait until health problems become a very expensive crisis.”

Santa Cruz County Supervisor Zach Friend agreed.

“There is a real and direct cost, especially at the local level, to not providing adequate health care and coverage to undocumented immigrants,” Friend said. “In our county, we see the costs from those that aren’t insured – from poorer health outcomes to decreased worker productivity.”

Le Ondra Clark Harvey, director of Policy and Legislative Affairs for the California Council of Community Behavioral Health Agencies, was even more specific.

“Poor healthcare infrastructure for undocumented immigrants can result in a lack of preventative care, overcrowded emergency rooms, an over-reliance on county indigent care and safety net system,” Clark Harvey said. “And poor health outcomes impact more than the individual and their family – these outcomes also impact the community they reside in and … the education and criminal justice systems.”

Former AARP President Jeanine English added that undocumented immigrants are also part of the community

“They are the mothers, fathers and grandparents of our citizens,” English said. “Regardless of parentage, the babies that we deliver in our hospitals are citizens, and it is important that they become healthy children who have the best chance of becoming productive and contributing members of our community.”

Assembly Republican leader Marie Waldron did not contest the humanitarian issues raised by her fellow Influencers, but called for the need to first address shortcomings in current state health programs.

“The question should be: How do we distribute our limited resources to make sure they’re doing the most good? ...It’s clear that we need to ensure our safety net health care programs are serving current enrollees before we expand the programs any further,” said Waldron, who pointed to low rates of services for low-income children. “Low payments to providers and other barriers to accessing care need to be addressed before we add thousands of additional people to Medi-Cal. Until then, it just doesn’t make sense to expand a program that’s not doing a good job at its current size.”

Other Influencers pointed to the impracticalities of differentiating care according to documentation.

“The reality is that major epidemic illnesses like the flu, measles, or tuberculosis don’t check residency status,” said Bruce Chernof, president and CEO of The SCAN Foundation. “Chronic diseases are far more expensive seen in the emergency room than managed appropriately in an outpatient setting. Our health… is shaped by all those living in our communities.”

Dustin Corcoran, CEO of the California Medical Association, echoed those sentiments.

“Physicians should not be concerned with a patient’s immigration status when that patient needs health care,” Corcoran said.

Kassy Perry, president of Perry Communications Group, pointed out that the solution would need to come from Washington not Sacramento.

“The real responsibility here rests with Congress, whose inability to reach across the aisle… for the good of the nation is appalling,” she said. “Our challenge is how do we move Congress to pay for the care provided to those living and working in California without legal status.”

Dan Schnur, a veteran analyst and longtime participant in California politics, is director of the California Influencers series for McClatchy.
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