Republican fight over undocumented health care illustrates California’s changing politics

Republican fight over undocumented health care illustrates California’s changing politics

Two California lawmakers publicly sparred with each other earlier this month, causing uproar over an issue that has long divided the state’s elected leaders: whether and how much to provide government-subsidized health benefits to undocumented residents.

In one corner, Corona Congressman Bill Essayli declared that he wanted a new law to provide subsidized health insurance to undocumented immigrants.

On the other hand, Congressman Devon Mathis of Visalia supports health care expansion, arguing that it will help the state lower health care costs in the long term and help working families that are critical to the state’s economy.

Both are Republicans, members of the party who pushed for Proposition 187 in 1994 to deny all non-emergency health care to undocumented immigrants, underscoring the state’s political debate that has shifted sharply left over the course of five governors. .

Just 20 years ago, “in the early 2000s, the idea of ​​offering this benefit was considered political suicide for both Democrats and Republicans,” said Attu, faculty research director at the Institute for Latino Policy and Politics at UCLA. Arturo Vargas Bustamante said.

The shift unfolded as a generation of Latino leaders took power in the Capitol, fueled by Proposition 187. Former Gov. Jerry Brown signed a law in 2015 making undocumented children eligible for Medi-Cal.

Then, a state budget surplus and Democratic dominance in the Capitol opened the way for Gov. Gavin Newsom to sign a law providing Medicaid to income-eligible undocumented residents of any age. The law, which takes effect on Jan. 1, makes California the largest state to offer government-subsidized health insurance to low-income undocumented residents of all ages.

Mattis, a Republican, is now citing public health data to justify extending Medicaid to undocumented residents as a “fiscally conservative” move for the state.

The new law actually goes against Proposition 187, the so-called “Save Our State” ballot initiative that denied public services to Californians without legal status. It passed with the support of then-Gov. Pete Wilson, a Republican, did not take effect due to legal challenges.

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On November 7, 1994, hundreds of protesters gathered at Los Angeles City Hall to protest the so-called “Save Our State” proposal, also known as Proposition 187.Photography: Nick Ut, AP Photo

For lawmakers on both sides of the aisle, the topic still carries some political risk. California is expected to face a $38 billion deficit that could worsen and force lawmakers to seek budget cuts. Former President Donald Trump, who has criticized left-leaning states for providing services to immigrants without legal status, may return to office.

Polls also show some concern among California voters about their views on immigration. A poll released earlier this month by the UC Berkeley Institute of Government found that four in 10 California voters believe illegal immigration is a “major burden” on the country. Another 30% considered them a “minor burden.”

But for now, Newsom and lawmakers who advocate for Medicaid expansion insist they won’t go back.

“I’m committed to this,” Newsom said at a news conference earlier this month.

Trump, COVID-19 and money

A potential second Trump administration may appear to jeopardize California’s policy of providing health benefits to the undocumented, but the former president may actually have influenced some of the benefits currently offered, UCLA’s Bustamante said .

Bustamante said California Democrats were angered by Trump’s disparaging remarks about immigrants and his failed attempts to roll back Obamacare. For example, California filed a lawsuit when the Trump administration sought to repeal the Affordable Care Act and eliminate federal subsidies that help millions of people afford insurance.

As the federal government proposes penalizing immigrants for using public benefits, California has another proposal. In fact, the state has sued the Trump administration more than 100 times.

The COVID-19 pandemic also prompted California Democrats to continue expanding health insurance coverage for undocumented immigrants, Bustamante said. It emphasizes the importance of health insurance and highlights health inequities, particularly among Latino, Black and low-income populations.

The rollout of these benefits has been slow. During the Brown administration, memories of the Great Recession tempered expectations for expensive government programs. Still, Brown signed a law by former state Sen. Ricardo Lara to open Medi-Cal to undocumented children.

By contrast, until recently, money was no object for Newsom. The state has received more federal funding for its Medi-Cal program and achieved a historic budget surplus during the pandemic. Newsom supports expanding Medicaid for adults, as does Sen. Maria Elena Durazo, D-Los Angeles, and others.

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On September 10, 2019, Senator Maria Elena Durazo championed legislation that would expand Medi-Cal health insurance to more undocumented immigrants.Photo by Anne Wernikoff for CalMatters

Garry South’s career as a Democratic consultant dates back to a time when liberals faced serious political risks if they supported services for undocumented immigrants. He managed the campaign of former Gov. Gray Davis.

“Not long ago, California was quite competitive politically, but that’s not the case now,” Nan said. “Yes, there were districts where Republicans won congressional seats, Senate seats, Assembly seats, but they were marginalized to the point of irrelevance, so most Democrats running in most places in California didn’t have to worry about being defeated by A Republican. They’re more worried about a runoff with another Democrat.”

He compared expanding Medi-Cal to undocumented immigrants being allowed by states to obtain driver’s licenses. It took years and multiple failed attempts, he said, but lawmakers and a majority of Californians ultimately decided it was safer for everyone to get these drivers licensed and insured.

Central Valley Republicans back Medi-Cal expansion

With the exception of Essaly, most elected California Republicans have remained silent on the state’s new benefits for undocumented residents. Republican political consultant Tim Rosales said supporting expansion wouldn’t necessarily hurt Republican candidates’ chances in future elections, but lawmakers must defend their case to right-leaning voters.

He said many Californians have come to accept the role undocumented people play in the state’s workforce and economy.

“People who live, work and exist in that economy in the Central Valley and other predominantly agricultural areas of the state … have understood that the undocumented population is an important part of the fabric of California,” Rosales said. “People feel like they can talk more about this issue, and from a political standpoint, the reality is setting in, and that’s true for both Democrats and Republicans.”

Porterville Republican Assemblyman Devon Mathis shared his story about suicide after Assemblymember Gail Pellerin read Assembly Concurrent Resolution 106 discussing her husband's death by suicide event. Mattis served in the military, and more of his colleagues died by suicide after serving. Photography: Rahul Lal for CalMatters
Rep. Devon Mathis, a Visalia Republican, recently supported California’s expansion of Medi-Cal health insurance coverage to low-income undocumented immigrants. His stance puts him in opposition to some members of his party. Photography: Rahul Lal for CalMatters

Mathis, who will leave office at the end of this legislative year to pursue a consulting job in the southern San Joaquin Valley, said his community was the reason he wrote an op-ed in The Sacramento Bee explaining his support for California’s health care expansion. one.

“I grew up in one of the poorest areas in the state, in an area with a large Latino population; these are common things we see and know,” he said.

Mathis said: “I wrote this op-ed because I’m tired of one of the things being people on the far right trying to make everyone sound like them, and the second thing is saying Stop Speech Five minutes to see the real issues.”

Mathis’ statement echoed the votes of two former San Joaquin Valley Republicans who supported Brown’s signature law providing Medicaid to undocumented children. They are former Sen. Anthony Canela of Ceres and former Sen. Andy Vidak of Hanford.

What’s next for undocumented health care?

Earlier this month, Essaly introduced Assembly Bill 1783, which proposes taking money from expanding health insurance coverage for undocumented residents. Although that may be unlikely given the Democratic majority in the Legislature.

“As the son of immigrant parents who came to this country through legal means, I am outraged that our state government is earmarking billions of dollars for foreigners when our own citizens cannot afford health care. health care,” Essaly writes in the book. orange county register.

Medi-Cal expansion brings Newsom closer to his goal of providing universal health coverage, where everyone in the state has access to health insurance. Experts say that because California has the largest illegal immigrant population in the United States (about 2 million people), it is impossible to achieve universal coverage without reaching this population.

The Affordable Care Act provides health insurance to millions of Americans and expands public understanding of the need for insurance, but prohibits anyone without legal status from obtaining federally subsidized coverage. That means immigrants who don’t qualify for Medi-Cal have no choice but to buy coverage on the private market at full price.

Researchers at the UC Berkeley Labor Center estimate that more than 1 million undocumented people will gain coverage as a result of full Medi-Cal expansion, but another 500,000 will remain uninsured because they earn too much to qualify for Medi-Cal -Cal, but can’t get insurance. Can’t afford insurance on my own.

Democratic Assemblyman Joaquin Arambula of Fresno is introducing Assembly Bill 4, which would allow undocumented people who are not eligible for the Medi-Cal program to buy subsidized insurance. Alhambra said the goal is to create a program specifically for undocumented immigrants that mirrors the coverage options offered by Covered California, the state’s insurance marketplace. Setting up the program takes some time. He said funds would be requested from the state to provide subsidies later.

Alhambra noted that Colorado is piloting OmniSalud, a program that provides undocumented people with similar coverage options available on its marketplace at subsidized prices.

Initially, Alhambra wanted to ask the federal government to allow undocumented people into existing markets, but Alhambra said this alternative model means California’s plan would not be dependent on federal approval.

“We want to insulate ourselves from anyone who is going to be in the federal government at the end of the year,” Alhambra said.

Ana B.Ibarra. Supported by the California Healthcare Foundation (CHCF), which works to ensure People can get the care they need, when they need it, at a price they can afford.access www.chcf.org learn more.

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