Medi-Cal For Illegals Cost-Effective
A nominal increase in Medi-Cal spending could potentially make an enormous difference in the ability of California's hundreds of thousands of undocumented residents to access primary and preventative care.
That’s the conclusion of researchers with UC Berkeley's Center for Labor Research and Education and the UCLA Center for Health Policy Research.
The two organizations studied the potentia effects – both fiscal and operational – of pending Senate Bill 1005.
The bill, authored by Sen. Ricardo Lara, D-Bell Gardens, would make undocumented residents eligible for basic Medi-Cal services if they meet the income requirements. Those who earn too much money for Medi-Cal would be allowed to purchase health benefits on a private exchange.
Expanding the Medicaid program under the Affordable Care Act has been contentious. While California was among the first states to expand coverage under the ACA and the federal government has pledged to cover 100% of the costs for the first three years of expansion, only 26 states have done so to date. The remaining 24 states have yet to do so, claiming it would cost too much.
And while some undocumented children are eligible for coverage under the Deferred Action program that was created by the Obama Administration, no states have extended coverage to all undocumented residents and their families.
“California would be the first in the nation to make its health insurance program inclusive of all low-income residents and their families, including those who are undocumented,” said Laurel Lucia, policy analyst at the UC Berkeley Labor Center and one of the study’s co-authors.
The researchers at UC Berkeley and UCLA have indicated that implementing SB 1005 would allow the state's 1.4 million undocumented immigrants access to primary and preventative care at an overall cost between $353 million and $369 million in 2015.
They estimate that between 690,000 and 730,000 undocumented residents would enroll in Medi-Cal if the program was expanded.
Those numbers are based on the $94 monthly cost of providing Medi-Cal managed care coverage to an adult. That sum would grow to between $424 and $436 million by 2024. The entire Medi-Cal program cost about $65 billion to operate in 2013.
The researchers said that expanding coverahge is relatively paltry because 60% of the cost of providing Medi-Cal coverage for emergency and hospital services are already provided under federal guidelines.
The bill is set for a hearing in the Senate Finance Committee on Friday.
“The undocumented don’t get sufficient access to preventive care and often wait as long as possible before seeking care,” said Nadereh Pourat, director of research at the UCLA Center for Health Policy Research.
Pourat and the other researchers concluded that the cost of providing the additional care would mostly be offset by increases in sales tax revenues from managed care organizations that provide Medi-Cal coverage, which pay a 3.93% annual tax based on their enrollment figures. There would also be decreases in spending on the county level to care for the uninsured.
Altogether, extending primary care services to the undocumented population would increase Medi-Cal spending by 2%, while increasing enrollment a total of 7%.
The UCLA and Berkeley researchers have been studying the effects of Medi-Cal expansion on the immigrant population over the past year. It concluded that the population -- which often tries to fly under the radar due to avoid potential detention by federal authorities -- would greatly benefit from obtaining Medi-Cal benefits.
“Providing preventive care helps the undocumented stay healthy and allows them to continue to contribute to California’s economy,” Pourat said.
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