As they scrambled to finalize next year’s state budget, California lawmakers this week abruptly dropped a plan to offer full Medicaid benefits to young adults living in the country illegally.
The proposal, which would have used money from California’s recently implemented tobacco tax, passed through budget committees last month. That had led some proponents to believe it might succeed, despite the nation’s fraught political climate over immigration and plans in Washington to cut Medicaid spending.
There was a “realistic hope” that the proposal might be included in the state budget that lawmakers are expected to vote on and send to Gov. Jerry Brown on Thursday, said Daniel Zingale, a senior vice president at the California Endowment. “I wouldn’t say people are shocked, but there is definitely some disappointment. There are a lot of complicated crosscurrents, especially with what is going on in the federal government.”
There were many competing priorities for use of the tobacco tax money, said Stan Rosenstein, a health care consultant in Sacramento and former director of California’s Medicaid program. The tax is expected to raise about $1.2 billion in the first year, and how to spend it has been the subject of a months-long political tussle in the statehouse.
“It always comes down to negotiations … there is always a limited amount of money and a long list of how to spend it,” Rosenstein said, adding that boosting Medicaid payments for doctors and dentists was “the basis of the [tobacco tax] initiative.”
Under a deal announced Monday, legislators plan to send the governor a budget that includes $325 million to boost payments for doctors and $140 million for dentists in Medi-Cal, California’s Medicaid program.
The plan scrapped by legislators would have extended coverage to approximately 80,000 immigrants ages 19 to 26 living in the country without permission, at a cost of up to $86 million. It would have made California the first state to provide full Medicaid benefits to adults living here illegally. California and a handful of other states already offer full Medicaid coverage to children regardless of immigration status.
Expanding eligibility for Medi-Cal may not be the prime concern at this point, especially when “there is a big cloud over the entire Medicaid program,” Rosenstein said, referring to proposed GOP cutbacks. “We’ve got to see what the federal government does.”
We The People Rising, a Claremont, Calif.-based group that opposes unlawful immigration and had argued against the extension of Medi-Cal for undocumented immigrants, praised lawmakers’ decision to drop the plan.
“I think this was a good move, one reason being that our budget should be dedicated to helping our own citizens,” said Robin Hvidston, the group’s executive director.
Immigrant and health care advocates in the state said they will continue their push to extend benefits to young adults in the country without permission.
“We’re disappointed that we missed this opportunity, but absolutely, we’ll be back,” said Anthony Wright, executive director of Health Access, a health consumer advocacy group in Sacramento. “We’re committed to the goal.”
Kenia, 21, a college student from South Gate, had pinned her hopes on getting Medi-Cal coverage. She arrived in the country in 2008 at the age of 12 — about a year too late to qualify for the immigration relief program known as Deferred Action for Childhood Arrivals, or DACA, and the full Medi-Cal benefits that could accompany it. She asked that her last name not be used for fear of deportation.
Two years ago, Kenia had her first seizure and was taken to a local hospital. Her three-hour stay resulted in bills adding up to about $10,000, she said. She applied for emergency Medi-Cal, which ended up covering the hospital cost.
Her seizures have continued, but she does not know what causes them or how to stop them because she can’t afford follow-up doctor visits and tests, she said.
“This really hurts,” Kenia said of the decision to drop Medi-Cal for undocumented young adults from the budget. “Where do we get the money from?”