Immigrant healthcare

Farm laborer Javier Carreon talks to Dr. Luis Martinez during an exam at Clinica Sierra Vista in Fresno last year. Carreon is one of the many immigrants who delay care because they are poor, uninsured and in the country without legal status. (Mark Crosse / MCT / April 1, 2013)

State Sen. Ricardo Lara (D-Bell Gardens) introduced legislation Friday that would allow immigrants without legal status to receive or buy health insurance through the state.

Such immigrants are the single-largest group of people who remain uninsured under the Affordable Care Act. The national law explicitly bars immigrants without legal status from receiving any kind of federal money, which means that in California, they can't buy insurance through the Covered California exchange, or qualify for the state's low-income health plan, Medi-Cal. 

"Healthcare for everyone should mean everyone," Lara said at a news conference Friday in Los Angeles. "Only when we include everyone can we truly have a healthy California." 

Lara's bill, SB 1005, proposes that California use state money to expand Medi-Cal eligibility to those who meet the financial requirements -- an annual income of about $15,000 or less for one person -- but have not been able to qualify because of their immigration status.

The bill, which Lara calls "Health for All," also proposes setting up an exchange that would be run by Covered California officials through which immigrants without legal status could purchase insurance. The exchange would also provide the same premium assistance and cost-sharing that Covered California does, but paid for with state money.

Lara said the state spends about $1.4 billion annually providing expensive emergency care to people without insurance. He said that he expects his plan to cost a bit less, or the same as that amount, but it would provide insurance instead of just one-time visits.

"It's better care, and it'll cost us less," he said. 

California is home to more than 2 million immigrants who lack legal status, the largest population of any state. Experts predict that five years from now, between 3 million and 4 million Californians will be uninsured, and a quarter of them will be immigrants without papers. 

Imelda Plascencia, 28, described her experience trying to get healthcare services at Friday's event. Her family moved to the United States from Mexico when she was 5. 

"I've been living with gallstones since 2008," she said. She has spent hours waiting in emergency rooms to get care, and has been in pain for years, she said.

Healthcare advocates worry that infrastructure that in the past has supported people without insurance, many of whom lacked documents, will not be as strong in the future as more people get insurance under the Affordable Care Act. 

"The situation for the undocumented is not improving under the Affordable Care Act and it's possible it will even get worse," said Dr. Steven Wallace of the UCLA School of Public Health.  

In Los Angeles County, between 980,000 and 1.3 million people will remain uninsured, according to Dr. Mitchell Katz, director of the county Department of Health Services.

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soumya.karlamangla@latimes.com
Twitter: @skarlamangla