CA Assembly Health Committee to Vote on Bill to Open up Covered California Regardless of Immigration Status, as New Report Details Need for Coverage for All

Despite recent #Health4All Medi-Cal expansions, including the full removal of immigration-based exclusions in January 2024, over 520,000 undocumented Californians will remain ineligible for Medi-Cal and uninsured

AB 4 (Arambula), up in Assembly Health Committee Today, seeks to remove immigration status as a barrier to buying a health plan through Covered California

SACRAMENTO – To continue California’s efforts towards universal coverage, today the Assembly Health Committee will hear for the first time Assembly Bill 4 by Assemblymember Arambula, which will allow access to Covered California health plans for all Californians, regardless of immigration status. Ahead of this hearing, the UC Berkeley Labor Center and UCLA Center for Health Policy Research released a new report: California’s Uninsured in 2024: Medi-Cal expands to all low-income adults, but half a million undocumented Californians lack affordable coverage options to highlight the ongoing need to provide health coverage for all.

Over the last several years, the #Health4All campaign of over 70 health and immigrant rights groups have worked with the California Legislature and Governor Newsom to make historic progress in removing immigration status as an exclusion for eligibility in Medi-Cal. Income-eligible children under the age of 18, young adults ages 19 to 25, and older adults ages 50 and above are now eligible for Medi-Cal, regardless of immigration status. Beginning January 1, 2024, adults ages 26-49—the final group of ineligible undocumented Californians—will be able to access health care coverage under Medi-Cal. That’s nearly one million Californians to be insured, which helps keep families and communities healthy and prevents greater financial strain in a health emergency.

Yet even after this expansion, 520,000 Californians remain ineligible for Medi-Cal and uninsured, simply due to their immigration status. Another 110,000 undocumented Californians are purchasing health plans on their own at full price. These 630,000 Californians would benefit from the ability to access our state’s health care marketplace, Covered California. Undocumented Californians have been explicitly and unjustly excluded from accessing and purchasing these health care plans since they were established under the federal Affordable Care Act (ACA) in 2009.

According to the new UCB/UCLA report, undocumented Californians are nearly four times more likely to be uninsured than the rest of the population, which puts their physical and financial health at risk. Two-thirds of uninsured and undocumented Californians who are ineligible for Medi-Cal earn below 400% of the federal poverty limit, which is just $54,360 for an individual. One in three in this population live in Los Angeles, an already high-cost of living area.

AB 4 by Assemblymember Arambula and principally co-authored by Senator Durazo, would direct Covered California to apply for a federal waiver under section 1332 of the ACA to waive the specific section that explicitly prevents undocumented individuals from purchasing coverage in Covered California. Such a waiver would allow undocumented Californians, over 70% of which are in mixed-status families, to purchase coverage in Covered California with their own money—without subsidies, at least for now.

“California should continue its good progress to tear down harmful barriers to coverage, which has resulted in over a million more Californians insured, and no longer living sicker and one emergency away from financial ruin. Even with our state’s progress, we cannot get to a truly universal, efficient, and equitable system until everyone has access to care regardless of their income or immigration status,” said Jose Torres Casillas, Legislative Advocate for Health Access California, a co-chair of the #Health4All campaign with the California Immigrant Policy Center. “AB 4 would make it easier for over half a million Californians to get coverage, which would provide health and financial benefits not just to them and their families, but the health system and state as a whole.”

“Our communities and our state are stronger when everyone has affordable, quality health care. All Californians, regardless of where they were born, deserve the same access to that care, said Sarah Dar, Policy Director, Health & Public Benefits for California Immigrant Policy Center, a co-chair of the #Health4All campaign. “Despite huge strides over the past few years to ensure health care coverage for our undocumented neighbors, too many people remain ineligible for Medi-Cal due to their income and Covered California due to their immigration status. We must close this gap in services to make our state more equitable, inclusive, and healthy for all who call California home.”

Additional statements from campaign leaders:

“We and our partners throughout the state that provide Medi-Cal and Covered California enrollment support are regularly confronted with the painful necessity to inform clients that their income is just barely too high to qualify for Medi-Cal, but that they also cannot access Covered California due to their immigration status. Without an affordable health coverage option available, this makes healthcare all but unattainable. Our collective experience tells us that there is a vital gap in support services for the most vulnerable Californians which must be addressed by opening Covered California to all, regardless of immigration status.” – Victoria (Nikki) Dominguez, Policy Director, Asian Americans Advancing Justice Southern California (AJSOCAL)

“Over the last 8 years, communities from all regions in the state have mobilized for access to health care without barriers. All Californians regardless of their immigration status should have opportunities to obtain quality health care and seek medical treatment without pause. CPEHN is proud to stand in solidarity with the Health4All Campaign as we look to expand access to Covered California to all communities, regardless of immigration or income status, so we may truly begin to achieve health equity.” – Andrea Rivera, Senior Legislative Advocate, California Pan-Ethnic Health Network

“California leads the nation with its commitment to provide Medi-Cal to all, regardless of immigration status. These policy decisions have real and direct impact in our communities. And there is still work to be done to ensure all who need healthcare can access it, affordably and regardless of immigration status. Opening up access to our state’s Covered California Marketplace moves us in this direction and towards greater equity in our healthcare system.” – Rita Medina, Deputy Director of State Policy and Advocacy, Coalition for Humane Immigrant Rights (CHIRLA)

“AB 4 would take the necessary next step in the fight to achieve coverage for ALL Californians. While we celebrate the achievements of the Health4All campaign in ensuring Medi-Cal access to all – access to coverage for undocumented community members who do not qualify for Medi-Cal, remains an issue. California Latinxs continue to face the highest rate of uninsurance (16%), compared to other racial/ethnic groups (4%-6%) and are less likely to have access to health insurance through employers. The success of AB 4 will ensure the advancement of life-saving access to coverage, allowing our state to keep its promise of ensuring ALL Californians lead long and healthy lives.” – Dr. Seciah Aquino, Executive Director, Latino Coalition for a Healthy California (LCHC)

“At Western Center on Law and Poverty, we believe very strongly that health care is a human right so we work to preserve and expand equitable health care for all Californians. We strongly support the goal of AB 4 to remove immigration status as barrier to eligibility within Covered California. This bill will take the state another step closer to meeting the goal of achieving a truly equitable health system in California providing quality care for everyone regardless of their immigration status.” – Sandra Poole, Health Policy Advocate, Western Center on Law & Poverty

AB 4 is set to be heard in the Assembly Health Committee today, Tuesday, April 11, at 1:30pm. The hearing will be livestreamed here.