During his campaign for the passage of the Affordable Care Act in 2010, President Obama furiously beat back allegations from Republicans that the landmark health law would be used to extend coverage to undocumented immigrants.

Six years later in California, however, the political calculus is very different. Democrats in the Golden State legislature are pushing to expand the state’s ACA system to cover all residents, regardless of immigration status.

To do that, however, they need some help from the feds. Luckily for California Democrats, however, their wish to expand care to the undocumented does not need approval from the GOP-controlled Congress. It only requires the consent of the Obama administration.

The state will soon submit a Section 1332 waiver request to the administration asking for permission to allow undocumented immigrants to purchase plans on the state exchange. According to the ACA, the administration may grant the waiver if the state can show that the policy will not harm law’s existing finances.

The state’s Democrats appear united behind the goal. Every member of its Democratic Congressional delegation signed a letter to the administration asking for the waiver to be approved.

California Gov. Jerry Brown and others have argued that extending coverage to undocumented immigrants will be good for the state’s fiscal situation and the state economy. Those who lack insurance drive up costs for everybody else by racking up uncompensated ER bills, they point out.

But even if California’s request is granted, the effect will be limited by the fact that undocumented immigrants will remain ineligible for the tax credits and subsidies that most exchange customers use to buy ACA plans.

One of the major challenges in getting and keeping people enrolled in health plans has been the difficulty of verifying immigration status. Many have been improperly kicked off of plans because they have failed to submit the documentation necessary to prove that they’re legal residents or citizens.

“California has decided to make the marketplace — the health exchange — offered in California available the undocumented families, without charging federal taxpayers a single penny,” Rep. Xavier Becerra, D-Calif., said in a statement. “Now they will have an opportunity to get affordable health care insurance and not get ripped off by those who try to get advantage of them.”

Instant Insights /

California Dems push to expand ACA to undocumented immigrants

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