Consumer groups and immigration advocates want state and federal government to allow undocumented immigrants to buy health insurance through the Covered California health exchange.
Those families and individuals would have to pay full price for the coverage – without a taxpayer subsidy.
Covered California is the state-run exchange for health insurance under the Affordable Care Act. Four insurers – Kaiser Permanente, Blue Cross, Blue Shield and Health Net – have offered a variety of “Obamacare” health plans to residents in the Northern San Joaquin Valley since 2014.
The proposal to sell such health care plans to undocumented people, at full price, was analyzed in a report this week from Covered California staff members.
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So far, there are no good estimates on how many undocumented state residents would purchase Covered California plans without a subsidy to lower their premiums. Consumers who are legal residents have gone to the state exchange because they don’t have health coverage or find it difficult to afford insurance without a break on premiums.
In the San Joaquin Valley, more than 90 percent of those who participate in Obamacare receive assistance that lowers their monthly premium.
Workers with no legal status can purchase coverage from a broker or directly from an insurer.
“There are some people who are undocumented who have coverage,” said Anthony Wright, executive director of Health Access, a leading supporter of the ACA in California. “This would at least provide (those without insurance) an opportunity to buy coverage from Covered California, even though it does not provide the affordability assistance.”
Wright said it could also simplify matters for hundreds of thousands of people in families with mixed legal status. Those families could buy a single health plan, giving them access to the same network of health care providers, with full premiums for some members and subsidized rates for the rest.
The state would need a federal waiver to get around an ACA provision that excludes undocumented workers.
Under the ACA, states can apply for waivers to modify rules of the nationwide program, and the changes can take effective as early as January 2017. The federal government won’t approve any waivers that change the affordability and coverage goals of Obamacare or would increase the federal deficit.
Wright said a staff report (http://board.coveredca.com/meetings/2016/4-07/1332_wavier_options_analysis_04-07-16_FINAL.pdf) presented to Covered California’s board of directors Thursday concluded that offering coverage for undocumented immigrants was doable and feasible. A state bill needs to be passed and signed by the governor to request the waiver from the federal Department of Health and Human Services.
Advocates say the rules excluding undocumented workers are counterproductive.
“This exclusion discourages a crucial part of our economy and society from taking responsibility for their health and finances,” Wright said.
Under the insurance quotes for 2016, a 40-year-old undocumented adult from Modesto would pay from $321 to $403 a month for the standard coverage through Covered California. For a family of four, the most popular coverage would cost between $956 and $1,200 per month.
Covered California staff reports on the innovation waivers can be viewed under item “V.” at http://board.coveredca.com/meetings/2016/4-07/index.shtml.
Ken Carlson: 209-578-2321, @KenCarlson16