Analysts estimate that 11 million people are living in the country illegally, about a quarter of them in California. Those with low incomes aren't eligible for state or federal insurance programs, so they typically rely on a hodgepodge of free clinics, basic health services in selected counties and emergency rooms. That's an expensive and inefficient way to provide healthcare, given that the uninsured tend to delay treatment until minor problems become major ones.
Lara has a proposal to extend subsidized insurance to poor Californians here illegally, but that's on hold until next year at least. This month the Legislature is considering a far more modest Lara bill, SB 4, seeking federal permission to let any resident buy unsubsidized health coverage through Covered California. The federal
SB 4 would help just a fraction of those without coverage. People living in the country illegally are already able to buy policies from private insurers directly or through agents, and any policy that's offered inside Covered California is available outside it as well. The main beneficiaries of the bill would be the tens of thousands of adult immigrants living in families that are a mix of citizens and noncitizens, who would gain the ability to buy coverage for their entire family — some of it subsidized, some of it not — from one place.
Just as important, though, opening Covered California to all residents would send the message that the exchange has something to offer everyone. Extending insurance to all is part of the effort to control healthcare costs, a task that requires more preventive and efficient care — changes that are hard to bring to the uninsured. That's why the Legislature should pass SB 4.