New Health Care Agenda for California Bolsters Obamacare, Eyes Single- Payer
During his first weeks on the job, California’s new governor, Gavin Newsom, restated his intent to turn his state into a single-payer health care system, provide “state-based support” for illegal immigrants ages 19 to 26, expand insurance subsidies and re
Newsom requested Transformational Cost and Universal Coverage Waivers from the Trump administration to reach his goals, stating in a letter to President Donald Trump and congressional leaders, he wants to “build on the successes of the Affordable Care Act (ACA)” and prevent changes that “erode” Obamacare.
The waivers would give California more control over how it spends federal health care money.
Says Plan Will Be Costly
Devon M. Herrick, a health economist and policy advisor to The Heartland Institute, which publishes Health Care News, says expanding Medicaid to illegal aliens is unlikely.
“I know Gov. Newsom would like to expand Medicaid in California, but with all the wildfires they’ve had, recovery takes priority, plus the state is out of money anyway,” Herrick said. “It would be a very difficult push because they would have to get a divided U.S. Congress to sign off on it.”
Current federal law precludes undocumented immigrants from getting Medicaid, except in emergencies, says Herrick. Medicaid is available to “qualified” immigrants who complete a five year waiting period.
“If you showed up in labor at a hospital, they would deliver the baby,” said Herrick. “They’re not going to turn you away. Even if you show up at the ER for a heart attack, they’re going to treat you and stabilize you.
“But illegal immigrants don’t qualify for federal assistance until they’ve been in the United States for five years,” Herrick said. “I don’t think California could get matching funds from the feds to expand Medicaid for noncitizens. They could go it alone, but they could not get matching funds to cover undocumented workers or illegal aliens. I don’t think this is something Health and Human Services would approve, or else it would have already been done by President Obama.”
Questions Cost Estimates
The plan would cost far more than expected, Herrick says.
“Hispanics, more than any other ethnic group, tend to be the least insured across the United States,” Herrick said. “A lot of people buy into the notion that they don’t want to pay for a health care plan or health insurance because it’s something they think they don’t need or will ever use.”
As a result, if California offers “free” health care to the uninsured, the ones most likely to sign up will be those who have health problems, says Herrick.
“What this means is you would not be getting a lot of healthy people buying premiums to offset the cost of the unhealthy folks, but you would get a lot of new expenses coming in as the unhealthy folks signed up for Medicaid,” said Herrick. “It would not be cheap.”
Play, No Pay
Adding illegal aliens to Medicaid will further erode the viability and quality of already troubled government insurance programs, says John Dunn, a physician, lawyer, and policy advisor for The Heartland Institute.
“Right now, we have a situation where access to health care is compromised for people who are insured with Medicaid,” Dunn said. “This is also true for people insured through Medicare, which also has a reimbursement rate which, in some cases, is not very friendly to providers. So in effect a lot of people are getting taken out of Medicare because the reimbursement system is so unattractive, despite the demand being so high.”
Newsom’s plan makes the situation even worse by adding a new category of people who will use the system without paying into it.
“Part of California’s program is to ignore the fact that illegal aliens are coming in to take advantage of the benefits of being an American citizen without becoming citizens.
“There isn’t anything about Medicaid expansion that I can describe as being a good development,” Dunn said.
Driving Taxes Higher
Sally C. Pipes, president and chief executive officer of the Pacific Research Institute, a San Francisco-based think tank, says extending Medicaid benefits to the illegal alien population between the ages of 19 and 26 is a radical idea that will drive people out of the state.
“First of all, illegal immigrants aren’t even covered under the Affordable Care Act (ACA), so why should people who are here illegally receive support from people who are here legally and paying taxes for health care?” Pipes said.
“They will be getting health care through Medi-Cal, which is California’s version of Medicaid, and the cost is about $200 million to do this,” Pipes said. “More and more people are going to leave California if the income taxes are increased, because the incentive to stay in California will just not be there because our taxes are so high. Our state tax, with the millionaire’s tax, is the highest state tax, at 13 percent.”
Pipes says many illegal immigrants are already seeking treatment at costly emergency rooms.
“This will increase as more and more come to California for free health care, but they won’t be able to find doctors, and this will further increase ER use,” Pipes said. “ER is the most expensive form of care.”
Kenneth Artz(firstname.lastname@example.org)writes from Dallas, Texas.
Gov. Gavin Newsom, Letter to President Trump Requesting Health Care Waivers: https://www.gov.ca.gov/wp-content/uploads/2019/01/1.7.19-Letter-to-the-White-House-and-Congress.pdf
Eligibility for Non-Citizens in Medicaid and CHIP, Centers for Medicare and MedicaidServices: https://www.medicaid.gov/medicaid/outreach-and-enrollment/downloads/overview-of-eligibility-for-non-citizens-in-medicaid-and-chip.pdf
California Gov. Gavin Newsom: https://govapps.gov.ca.gov/gov40mail/