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Sacramento's Idea of Health: Undocumented Welcome

The opinions expressed by columnists are their own and do not necessarily represent the views of

"There are also those who claim that our reform effort will insure illegal immigrants. This, too, is false. The reforms I'm proposing would not apply to those who are here illegally," President Barack Obama proclaimed in a 2009 speech to Congress. It was a memorable event, in part because Rep. Joe Wilson, R-S.C., shouted, "You lie." Editorial page umbrage followed.


This month, the California Senate proved that, though Wilson was wrong to heckle the president, he had reason to challenge the sincerity of Obama's pledge. By a 28-11 vote, the Democratic-controlled state Senate became the first U.S. legislative body to vote to expand health care to immigrants who are here illegally. Senate Bill 4, by state Sen. Ricardo Lara, would allow Californians without documentation to buy Affordable Care Act policies (assuming the feds grant a waiver), authorize residents up to age 19 to enroll in Medi-Cal regardless of immigration status and allow some people 19 or older to enroll in Medi-Cal regardless of immigration status.

This is how change happens. Last year, Lara's first "Health for All" bill promised health care to all California residents regardless of immigration status. The tab was $1.3 billion. It was too pricey, so he peeled it back, and back some more -- to a projected $135 million. How? The bill that passed the state Senate would provide Medi-Cal to minors regardless of immigration status but no subsidy for undocumented residents who want to purchase private plans through Covered California, absent a federal subsidy. Also, SB 4 would put a cap on unauthorized adults applying for Medi-Cal. When it looks as if the funding will run out, the state probably will not accept new enrollees.


What is the cap on undocumented enrollees? Don't know. "The cap would depend on budget allocations to be decided next year," answered Lara spokesman Jesse Melgar.

In a way, it doesn't matter. If SB 4 becomes law, the camel's nose will have penetrated the tent. Within six years of the president's promising that immigrants in the country would not be eligible for Obamacare -- presumably because that would be wrong -- the first state will have bypassed that promise. You just know that Sacramento will continue to push to expand the number of immigrants eligible for benefits. No one ever told the Democratic Legislature that you cannot say "yes" to everyone.

Sure, Sacto solons look generous waving Medi-Cal before some 1 million immigrants who came here illegally. But with Medi-Cal paying doctors as little as $16 for a patient visit, many physicians are refusing to take more Medi-Cal patients. Pols don't care if already there are not enough doctors to pay for the program's existing 12 million recipients. They look good; the docs look greedy.

As it is, Medi-Cal provided "limited scope" benefits -- pregnancy care, emergency care and long-term care -- to 786,600 unauthorized immigrants last year. If you want more of something, reward it. If California offers "full scope" coverage to people if they come here illegally, opined Jon Fleischman, publisher of the conservative FlashReport, "there is no amount of border security that you can erect that will come between smart people and (this) free stuff."


Though their GOP caucus opposed the bill, two Republican state senators voted for it. "There is a cycle that occurs when one party becomes so dominant that the other party finally stops fighting," Fleischman observed. And really, why speak against the bill? To point out any negative consequences is to invite the left to brand you as heartless and racist. A California Senate analysis lists more than 70 groups that support SB 4 but not one opponent.

One of the GOP yes votes, state Sen. Anthony Cannella, told me he sees the measure as a "moral issue." Undocumented immigrants work hard, he said, but have "no rights," even though they have been "contributing to our way of life." When immigrants try to cross the border, they see two signs, he added. "One says, 'Do not enter.' The other says, 'Help wanted.'"

Cannella said the answer is better enforcement of the border.

Though 11 Republican state senators voted against SB 4, they were low-key in their opposition. When a bill is going to pass anyway, why throw out red-meat quotes that would be used against you in the next election? State Senate Minority Leader Bob Huff called the bill's intent "admirable. But without money from Congress and President Obama, it will be very difficult and costly for California taxpayers to fund all of these bill proposals." Smart, earnest, boring tone. This is one Republican who knows better than to point out that Democrats lied when they promised Obamacare would not apply to immigrants who came here illegally.


Asked whether he'll sign or veto SB 4, Gov. Jerry Brown told a reporter that "there's not a lot more money to be spent" on top of what he allocated in his revised May budget. In this one-party state, only Democratic Gov. Brown can save Californians from a Legislature that can't say "no" to a chance to spend other people's money.

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