830,000 May Lose Medi-Cal, Study Says

An estimated 830,000 immigrants living in California, predominantly Latino women and children, would lose Medi-Cal health care benefits under immigration changes being considered in Congress, according to a UCLA study being released today.

The UCLA study provides the first comprehensive look at how the changes, almost certain to gain final passage, would affect health care for California’s poor.

Among other effects, the new restrictions would boost the ranks of those without health insurance to 7.4 million--more than 25% of the state’s non-elderly population, the study says.

The immigrants would lose Medi-Cal coverage under the legislation because it would create a new financial means test, requiring noncitizens to include the income of their sponsors along with their own in determining whether they fall within the income threshold to qualify for the program.

Currently, 1.1 million immigrants under the age of 65 receive Medi-Cal, the study said.

Los Angeles County, with the largest population of legal and illegal immigrants in the state, would be heavily affected by the proposed changes in Medi-Cal eligibility.

The House and Senate have passed separate bills that would cut a range of public services provided to both legal and illegal immigrants, including public education, health care and welfare. Congressional leaders are working out a compromise between the two bills.

President Clinton strongly supports the legislation, though the administration is against proposed cuts in public education for immigrants and generally opposed to health care cutbacks.

But whether Clinton would veto a high-profile bill that his administration backs remains unclear. A White House spokeswoman said Sunday that the administration had not seen the UCLA study and had no comment on it.

Under existing law, legal immigrants are treated the same as citizens in qualifying for Medicaid or Medi-Cal, the California version of the federal program of health care for the poor. Undocumented immigrants may obtain only emergency health care and prenatal care in California.

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The new legislation would tighten rules to qualify for Medicaid, requiring immigrants to include the income of their sponsors for up to 10 years after their arrival in the United States. The technical term for this change is called “deeming,” an issue that drew opposition from the Clinton administration in a statement issued April 15.

The bills would allow deportation of legal immigrants if they are found violating the new qualification rules. Undocumented immigrants already face deportation if caught under almost any circumstances.

Sean Walsh, press secretary to California Gov. Pete Wilson, said Sunday that the governor’s office has not seen the UCLA study and would refrain from commenting on it. However, Walsh said the governor believes that “there is a legitimate and serious concern in Congress and in the state about the sponsorship of immigrants and the lack of [financial] accountability on the part of sponsors when the immigrant arrives in this country.”

Although the final bill has not been written, Wilson fully supports aspects of the legislation that would require the federal government to pay for incarcerating illegal immigrants in California’s prison system as well as provisions that would cut off education benefits to illegal immigrants. “Should the House version pass, this will essentially provide congressional intent on illegal immigration and should make it much easier to enforce Proposition 187 through the courts,” Walsh said.

Critics of the legislation say that it goes too far, reducing such benefits as job training, child-care and college loans that are afforded to American working families because they are intended to help pull the poor up the economic ladder.

White House Chief of Staff Leon Panetta, speaking Sunday on “Face the Nation,” cited these concerns in stating the administration’s narrow opposition to barring illegal immigrants’ access to public education.

“If you don’t provide education for these kids, you are basically turning these kids over to drug warlords, to gangs, to criminals,” Panetta said. “It is wrong to do that.”

In the case of health care, E. Richard Brown, a principal author of the UCLA report, said the cutbacks would jeopardize the health and safety of the general public as well as poor Latinos in California.

Without poor immigrants having access to health care, California “will have people walking around with infectious diseases longer and infecting others before getting into treatment,” Brown said.

Concerned about the legislation’s potential effects, Los Angeles County Supervisor Gloria Molina is planning to go to Washington this week to lobby Clinton administration officials and members of the House-Senate conference committee negotiating the immigration measure.

“This is bad policy,” Molina’s spokesman, Michael Bustamante, said Sunday. “It will hurt legal immigrants who have been here for years and played by the rules.”

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Molina’s legislative deputy, Miguel Santana, said there is no doubt that the requirement that the income of legal immigrants’ sponsors be considered in determining Medi-Cal eligibility “is going to have a negative impact on the county.”

Bustamante said Molina opposes other provisions of the bill that would require the county to verify citizenship status when treating patients in hospital emergency rooms. “They are looking to us to become agents of the INS,” he said.

Molina is adamantly opposed to provisions--like those in Proposition 187--that would deny education benefits to illegal immigrants.

Bustamante said that cutting off education benefits would leave “tens of thousands of children to roam the streets” and aggravate gang, drug and crime problems.

However, Molina does support part of the complicated immigration measure that would require the federal government to pay the costs of incarcerating illegal immigrants in the county’s overburdened jail system.

The UCLA study was conducted by the university’s Center for Health Policy Research, based on an analysis of data from the Census Bureau’s March 1995 current population survey.

The study does not indicate how many of the 830,000 immigrants facing loss of their Medi-Cal benefits are legal residents. Brown said the census data would not disclose whether individuals are residing here illegally, but believes that the majority of those who would be affected are legal residents. Under Medi-Cal rules, illegal immigrants are not supposed to get routine benefits in the first place.

Brown is director of the UCLA center and president of the American Public Health Assn. The report was written with seven other UCLA researchers and faculty members.

The study assumed that noncitizens now qualifying for Medi-Cal would become uninsured after the changes were implemented unless they met one of two criteria: They worked at least 20 hours a week and resided in the United States for 10 years, or had retired or left a job for health reasons.

The study reports that 2.7 million of California’s 6.1 million noncitizen immigrants are already uninsured--a disproportionately high rate compared with citizens. While 62% of citizens in California have insurance at their jobs, just 31% of Latinos and 40% of Asians do.

Not surprisingly, Latinos would be hit hardest by the proposed changes, accounting for about 500,000 of those who will lose benefits. Asian noncitizens account for 220,000 more and other nationalities 107,000.

The impact might be offset if many noncitizens become citizens. Using congressional budget office assumptions, as many as one-third of the 830,000 who lose benefits might regain them by becoming citizens.

Vartabedian and Rosenblatt reported from Washington; Rabin reported from Los Angeles.