Historic Senate Bipartisan Vote Advances Nation’s First Bill to Expand Health Care Coverage for Undocumented Californians

June 02, 2015

SACRAMENTO, CA – The California State Senate made history today by approving Senate Bill 4 authored by Senator Ricardo Lara (D-Bell Gardens) to expand coverage to California’s undocumented population. Known as the Health for All Act, the measure provides a realistic and cost-sensitive approach to covering one of the state’s most vulnerable populations. By a vote of 28 - 11, the advancement of this bill marks the first time any legislative body in the United States approves a measure to expand access to health care for their respective undocumented population. Two Republican Senators voted in support. 

“Today’s vote is a transformational and decisive step forward on the path to achieving health for all,” said Senator Lara. “Over the past year I’ve worked to draft a bill that is realistic, balanced and fiscally prudent, while arriving at our goal of expanding access to health care for some of our most vulnerable communities. That’s what we’ve achieved with SB4 – allow undocumented Californians to purchase health insurance through a waiver, cover all children and establish a capped enrollment program for adults.”

The bill was amended in the Senate Appropriations Committee on Thursday, May 28, to address cost concerns, but preserve the intent to provide access to healthcare for every person in California, regardless of immigration status. 

The amended version of SB 4 achieves three important goals:

  • Allows undocumented Californians to buy health insurance with their own money through covered California by seeking a waiver
  • Allows all kids 19 and under to enroll in Medi-Cal, regardless of immigration status.
  • Expands access to adults 19 and over, regardless of immigration status, by establishing a capped enrollment program through Medi-Cal that will provide services as funding is made available. 

The Affordable Care Act (ACA) specifically excluded undocumented immigrants from insurance coverage provided through the health care exchange known as Covered California.  Because of that, over a million undocumented residents lack access to affordable coverage in California.  Access to preventive care keeps people healthier by providing regular check-ups and screenings, and early diagnosis of health problems ensures those problems can be treated before they become overly expensive.  By ensuring everyone has access to health care, we can improve the health of our entire community, limit the overcrowding of emergency rooms, and reduce the costs of healthcare in California.

President Obama’s Executive Action to expand the deferred action program is anticipated to have a significant impact on the costs of SB 4, potentially reducing the undocumented, uninsured population in California by almost half.  An estimated 1.25 million undocumented immigrants in California may be eligible for work authorization and relief from deportation under the Deferred Action for Childhood Arrivals (DACA) program and the new Deferred Action for Parents of U.S. Citizens and Lawful Permanent Residents (DAPA) program. The Executive Actions are currently being challenged in court. 

The community reacts:

Reshma Shamasunder, Executive Director, California Immigrant Policy Center 
"Today's vote marks a major turning point in the long quest to heal the unjust exclusion of undocumented Californians from health care. The Senate has taken a key step toward upholding a basic human right and has set a solid foundation which we are well-positioned to build upon in the future. Now, all eyes are on the Assembly. We urge the The Speaker to embrace and champion the Senate's $40 million investment in expanding access to life-saving care.  Californians from communities across the state are counting on their leadership. With this proposal, California would provide basic health coverage to more undocumented people than any other state in the nation."

"Additionally, we call upon Governor Brown to fortify the pro-immigrant legacy he has been building in recent years. Now is the time for the Governor to invest real dollars in measures like SB 4. For just two cents to every general fund dollar the state already spends on Medi-Cal, we could cover every low-income undocumented Californian in the state, and ensure that Californians do not suffer a discriminatory exclusion from a basic human right."

Pete Woiwode, Interim Executive Director, California Partnership
“Everyone benefits when all Californians, regardless of immigration status, age, income or ability, have access to health coverage- achieving a state free from poverty is not possible without it. Today,  the action to pass Senate Bill 4 is a giant step forward to achieving the state that we all deserve, a state where everyone can thrive.”

Amparo Cid, Attorney and Project Director, California Rural Legal Assistance Foundation (CRLAF)
"The community firmly stands alongside Senator Lara in the fight to ensure that all Californians have access to healthcare.  We stand alongside him because the lives of immigrants matter, doctors should be allowed to heal without making a distinction between those who have legal status and those who don’t, and because it costs more to treat a chronic condition.   It doesn't make financial or humanitarian sense to wait for a condition to elevate to the point of fulfilling the legal requirement for emergency room care.  Today, in California, we are leading and showing that there is a better and more cost-effective way.  Thank you, Senator Lara, for being brave and for exemplifying what true leadership on behalf of those who are often left out of the decision-making process looks like.  #Health4All" 

Alex Johnson, Executive Director of Children’s Defense Fund – California (CDF-CA)
“The future of California depends on all children and their families having access to the quality health coverage and care they need to survive and thrive.  Extending health coverage to undocumented children in California is a historic step, one that will save money while improving outcomes – but it cannot be not the last. We strongly support health coverage for all Californians and we will continue to fight until that has been achieved.”

Anthony Wright, Executive Director, Health Access California
“This bill would be transformational in both helping individual families and improving the health system we all rely on. Our health system is stronger if all Californians are included in coverage, and have access to cost-effective primary and preventive care,” Said Anthony Wright, executive director, Health Access California, the statewide health care consumer advocacy coalition. “This historic vote, perhaps the first of its kind by a state legislative chamber, shows the next step for both health reform and immigrant inclusion movements. Immigrants are a critical part of California’s economy and society, and it’s more efficient and equitable for them to be fully included in our health system as well.”

Marielena Hincapié, Executive Director, National Immigration Law Center
"Senator Lara's bill is urgently needed, not just for immigrant communities, but for all Californians. Our communities and economy are stronger if everyone has access to quality, affordable health care."

Wendy Lazarus, Founder and Co-President of The Children’s Partnership
“The Children’s Partnership stands with Senator Ricardo Lara and our partners to extend access to health coverage to all Californians, regardless of immigration status. One in six kids in California has an undocumented parent locked out of health coverage, and when parents get health coverage, their children are much more likely to be enrolled. If every single parent and child has preventive and ongoing care, we can reduce overall health care costs in the state, avoid expensive emergency room visits, and foster more productive communities. SB 4 is the remaining piece to ensure all of our kids are healthy and ready to learn. By enacting it into law, California will continue to lead the nation in improving access to health care and coverage in all communities, including families who are undocumented.”

Peter Manzo, President & CEO, United Ways of California (state association for the 34 local United Ways)
“SB 4 would make more efficient use of taxpayers’ dollars by encouraging preventive care and treatment of conditions before they become severe.  SB 4 would ensure that the public health and welfare of all Californians is more secure. We thank the Senate for moving this bill forward and ask the assembly to do the same.”

Riana King, a California spokeswoman for Young Invincibles 
"Young undocumented Californians are critical to our state's workforce and economy, and will be indispensable to its future. Yet hundreds of thousands of young undocumented individuals lack access to the most basic health coverage necessary to live productive lives. Senator Lara’s Health for All Act is a crucial step towards ensuring that all Californians have access to coverage, regardless of their immigration status. Young Invincibles urges the Governor and Legislature to make Health for All a reality, and ensure that our state continues to lead the way on health care reform."