SB10 was 'the first California casualty of the Trump administration,' says the law's author.
This story originally appeared in California Healthfax.
A California lawmaker has withdrawn a bill that would have allowed undocumented immigrants to buy health plans on Covered California, citing concerns about a potential overreach by the federal government.
Senate Bill 10 was authored by Sen. Ricardo Lara (D-Bell Gardens). The bill instructed Covered California, the state's health insurance marketplace, to request that federal officials allow undocumented immigrants to buy health plans on Covered California, albeit without federal subsidies.
Gov. Jerry Brown signed the bill into law on January 10. However, Lara subsequently withdrew the bill, calling it "the first California casualty of the Trump administration."
"I take Trump at his word that anyone is subject to deportation at any time, and California will not be part of a wasteful and inhumane campaign against immigrants who are working hard and playing by the rules," said Lara.
"We will continue to seek ways to expand health coverage even as Republicans in Washington move to take it away."
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SB10 would have had a minimal impact on enrollment. Covered California officials estimate the waiver would have boosted enrollment by about 17,000 on an exchange that has more than 1.3 million enrollees.
Other Challenges
California is already bracing for an immigration battle with the Trump administration on other fronts.
State Sen. Kevin De Leon (D-Los Angeles) introduced a bill that would establish hospitals, schools, and courthouses as 'safe zones' for undocumented immigrants.
De Leon said Senate Bill 54, dubbed the California Values Act, would ensure that undocumented immigrants have access to hospitals and healthcare in the event federal officials enact an "over-reaching mass deportation policy."
State legislators and healthcare providers are still awaiting clarity on Republican efforts to repeal the Affordable Care Act (ACA).
Trump signed an executive order on January 20 that purports to allow the federal government to withhold funding for some provisions of the ACA, but the order does not specify what programs could be defunded or how.
Trump's First Order Has Strong Words On Health. Actual Impact May Be Weak.
More than 3.7 million state residents have gained coverage under the ACA through Medicaid expansion. The UCLA Center for Health Policy Research on January 20 released a study that detailed the impact Medicaid expansion has had on the state's poorest counties.
The study estimates that several California counties had more than 10% of their residents enroll for coverage under Medicaid expansion, which made Medi-Cal available to people with incomes up to 138% of the poverty level.
In addition, the study estimates that 13.9% of residents living in Humboldt and Mendocino counties gained healthcare coverage under Medicaid expansion. In Trinity County, an estimated 13.6% of residents gained coverage, as did about 12% of residents in Fresno County.
Overall, more than half of all residents in five counties are now covered under Medi-Cal. Leading the way is Tulare County at 55%, followed by Merced County at 51.5%.
Unaffordable Care
A rollback of Medicaid expansion would not eliminate coverage for all residents who gained coverage under the ACA but would likely make it unaffordable.
"Not every person who gained coverage under Medicaid expansion would become uninsured," said Laurel Lucia, a healthcare program manager at the UC Berkeley Labor Center.
"Some could find coverage through employer-based plans or buy plans on the commercial market, though privately purchased coverage would probably be unaffordable for most people."