Immigration proposal could affect California health safety net

Making immigrants ineligible for public health benefits -- at least initially -- under proposed immigration law changes would push the costs of healthcare from the federal government to states and counties, said Sonal Ambegaokar, a health policy attorney at the National Immigration Law Center.

And those costs could be sizable in a state like California, where there are an estimated 2.5 million illegal immigrants.

“It is the federal government telling the states they have to take care of these immigrants,” she said.

Nationwide, almost 60% of the 11 million immigrants here illegally lack health insurance, according to a recent article in Health Affairs. About 1 million of those immigrants are children.

The proposal could affect safety net providers in California, straining their services even further, said Michael Fix, senior vice president of the Migration Policy Institute.

Excluding immigrants could also make healthcare more expensive for everybody else, according to experts and advocates. Typically, immigrants are younger and healthier – the type of patients insurers want, especially when everybody is required to get insurance next year under the federal healthcare overhaul, Ambegaokar said.

“The concept of excluding immigrants who are on a road to citizenship is shortsighted,” she said. “While they are waiting, you want them to be healthy, you want them to be productive.”

When the immigrants do finally become eligible for public health benefits -- such as Medicaid or subsidies under health insurance exchanges, they could be in worse health and require more costly care, Fix said.

“By not having insurance for such a sustained period of time, it could lead to lower levels of health for this population,” he said.

Fix said he wouldn’t be surprised to see California legislators come forward with an alternative proposal to cover immigrants who could be eligible for citizenship.

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