By Matthew McGiffen, Brenda Miranda,
Jason Paris, and Aryriana 
Alexander, California State University, San Bernardino
On February 13, 2014, Senator Ricardo Lara (District-33) introduced the Health for All Act (SB 1005) which would extend health care benefits provided through the Federal Medicaid Program to undocumented and/or illegal aliens residing in California.
Currently, policies governing the federal Medicaid program prohibit payments to states for provision of medical services to illegal aliens. The Patient Protection and Affordable Care Act (PPACA) requires each state to establish an American Health Benefit Exchange (an accountable and transparent health care insurance market) and specifies that “an individual who is not a citizen or national of the United States shall not be treated as a qualified individual and may not be covered under a qualified health plan offered through an exchange” (SB 1005, 2014).
This proposed expansion of the Medicaid program would require the executive board governing the California Health Benefit exchange to provide the same subsidies and cost-sharing reductions extended to eligible individuals to the estimated 2.3 million untaxed, illegal and/or undocumented entities within Californian jurisdiction (Russ, 2014).
While the rights and privileges afforded to American citizens are undermined by the proposed Health for All Act, the more immediate and far-reaching question posed is how this bill is to be funded. CalWatchDog reports estimate the state’s annual incurred fiscal debt at over 1.1 trillion dollars including a $27.8 billion “Wall of Debt”; $383 billion in state, county and city government, school districts, redevelopment agencies and special interest districts appropriations; $265.1 billion in California public employee pensions and health care; and $200.3 billion in unfunded pension liability expenditure (Russ, 2014). We project that Senator Lara’s Health for All Bill will increase taxes and cut funding for many more worthy programs.
Here are a few facts concerning SB 1005:
The debt created by the bill would place an immense burden on California taxpayers.
The emergency health care currently available to illegal immigrants is paid for by the federal government (Galewitz, 2013).
If this policy is implemented, the cost added to Medi-Cal will be paid for entirely by California taxpayers unless the federal government offers to assist (California Health Care Foundation, 2009). In order to provide regulated health care to illegal immigrants, California would have to refuse to enforce national immigration law.
By providing new benefits to illegal immigration while unofficially refusing to impose consequences of illegal immigration by ignoring the immigration status of service recipients, Health Care for All would encourage additional illegal immigration.
Providing health care to illegal immigrants would increase future illegal immigration, so ethical concerns relating to illegal immigration in general relate to SB 1005. Encouraging illegal immigration means discrimination against non-Mexican immigrants.
The U.S. takes roughly 1 million legal immigrants each year (Department of Homeland Security, 2014). More than 13 million individuals and families applied for the green card lottery in 2010, but only 50,000 green card lottery applicants each year are accepted (US Bureau of Consular Affairs, 2010). Mexico is already the majority supplier of legal immigrants with 15 percent of all legal immigration into the U.S.; the next highest is China with only 7 percent (Department of Homeland Security, 2014).
To implement the Health Care for All Act, California would have to willfully refuse to carry out national immigration law. Since immigration is a national issue and national law supersedes state law, this bill represents a willful attempt by California lawmakers to subvert the national democratic process.
To address the issue of providing adequate health care for illegal aliens, legislation which is both in the interest of Californians while extending emergency assistance to undocumented persons is needed. However, state expenditures for entities under non-national or illegal status could only be, by definition, frivolous and thus a misappropriation. Challenging the necessity of Senator Lara’s “Health Care for All” bill, more viable options to this legislation should be pursued which can alternatively expand and improve upon existing federal and state supported health care systems.
Author Note:
Matthew McGiffen, Brenda Miranda, Jason Paris, and Aryriana Alexander, Department: Master of Social Work. All contributors are currently participants in CSUSB MSW program. Correspondence concerning this project should be addressed to Allan G. Rawland MSW, ACSW, Department of Social Work, California State University San Bernardino, 5500 University Parkway, San Bernardino, CA 92407-2318
References
Bureau of Consular Affairs. (2010). Diversity Visa Program 2007-2013 registrant entry tables. travel.state.gov/content/dam/visas/DV_Applicant_Entrants_by_Country_2007-2013.pdf.
California HealthCare Foundation. (2009). California Health Care Spending: California Health Care Almanac Quick Reference Guide. www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/H/PDF%20HealthCareCosts12CAQRG.pdf.
California State Legislature. (2014). SB -1005 Health care coverage: Immigration status (S. hrg. 100530-100541). U.S. Senate, Regular Session, (2013-2014).
Department of Homeland Security Office of Immigration Statistics. (2014). Yearbook of Immigration Statistics. www.dhs.gov/immigration-statistics.
Galewitz, Phil. (2013). Medicaid Helps Hospitals Pay for Illegal Immigrants’ Care. Kaiser Health News.www.kaiserhealthnews.org/stories/2013/february/13/medicaid-illegal-immigrant-emergency-care.aspx.
Russ, Katharine. (2014). California senator offers controversial bill to cover heathcare cost for illegals not covered by ACA. City Watch. 12(15). www.citywatchla.com/recent-posts-lead-stories/6478-california-senator-offers-controversial-bill-to-cover-healthcare-costs-for-illegals-not-covered-by-aca.
