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Medi-Cal Expansion Not Enough

Summary: California’s Medi-Cal expansion for undocumented immigrants is laudatory … but is just a partial fix, leaving millions uncovered. It falls profoundly short of what is needed to cover everyone with high quality insurance, while saving money and boosting the economy: single payer.

California is expanding Medi-Cal – but hundreds of thousands of immigrants will still be left behind
CalMatters
February 28, 2022
By Ana B. Ibarra

Experts say allowing people to sign up for comprehensive Medi-Cal coverage regardless of their immigration status is the single biggest step California can take to insure as many people as possible in the current system. Newsom called his latest planned expansion “universal access to coverage.”

But the expansion would still leave several hundred thousand undocumented immigrants uninsured. They are unable to qualify because they have jobs where they earn above Medi-Cal’s annual income thresholds for most adults.

That leaves many low-income immigrants with few viable options for health coverage. While most Californians who earn over the Medi-Cal limit can get subsidized coverage through Covered California, undocumented people are not allowed to buy insurance through the marketplace under the federal Affordable Care Act.

In 2023, after Medi-Cal expands to cover undocumented immigrants 50 and older, about 3.2 million people will remain uninsured in California, according to researchers at the UC Berkeley Labor Center and the UCLA Center for Health Policy Research. Of those, 1.16 million will be unauthorized immigrants.  

Even if Newsom’s next step is approved — covering undocumented adults 26 to 49 years old as early as 2024 — that would still leave roughly 450,000 undocumented people under 65 with no health coverage.

Lack of access because of immigration status is just one piece of the remaining uninsured. Many other Californians forgo coverage despite being eligible, likely because of the cost. According to the UC Berkeley and UCLA study, 2 million uninsured people qualify for Medi-Cal, employer coverage or Covered California.

Comment by: Don McCanne

Well, so we can’t have single payer reform because it is too expensive, and we can’t afford the taxes to pay for it. But at least we can fill in much of the void in California and other states by providing Medi-Cal (Medicaid) to the undocumented… or can we? Check out the numbers.

Hundreds of thousands of the undocumented in California would still be left out and millions of other Californians would remain uncovered for other reasons, primarily for lack of affordability of insurance. And worse, our highly dysfunctional, fragmented healthcare financing system that shunts much of our healthcare dollars to entrepreneurial interests while impairing access to needed care would remain in place. Defective incremental patches can never serve as an effective substitute for a comprehensive, equitable, publicly administered, affordable, progressively funded program that is truly universal for life.

The recent Nation article by Michael Lighty shows how ridiculous our concern over single payer costs and taxes has been when we could have an ideal single payer system for less money than we are paying for our current inadequate, dysfunctional system. And the recent study from the Congressional Budget Office shows us that spending on a single payer system would not only fix our healthcare financing system and bring comprehensive health care to everyone, it would also provide improvements to the economy that would benefit all of us.

Merriam-Webster’s definition 3b for insanity: “something utterly foolish or unreasonable”

Now there is an instance we can save on healthcare that doesn’t even take a psychiatrist to manage. Let’s just get rid of our current dysfunctional financing system and substitute it with a single payer system. We’ll not only cure our insanity, we’ll be money ahead!

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