June 10, 2019

California poised to expand Medicaid to 90,000 undocumented adults

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    California lawmakers on Sunday reached an agreement on a state budget deal that would make the state the first to provide full health insurance benefits to certain undocumented adults.

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    Anthony Wright, executive director of Health Access California, said the budget agreement "builds on some of [California Gov. Gavin Newsom's (D)] first-in-the-nation proposals with important next steps to a more affordable, accessible, and universal health system."

    Budget deal details

    Overall, the budget deal details how California would spend $213 billion in federal and state tax funds over the next year. State lawmakers under the budget deal are proposing to expand Medicaid coverage to nearly 90,000 undocumented adults ages 19 and 25 with incomes low enough to qualify for the program, the Associated Press reports. State officials estimate the proposal will cost California approximately $98 million annually, according to The Hill.

    California residents who are undocumented currently qualify for limited health benefits to cover emergency care and pregnancy, Politico's "Pulse" reports. Lawmakers originally had proposed to offer full health benefits to older undocumented adults, but on Sunday they revised their proposal so that it would apply only to low-income, undocumented adults ages 19 to 25, according to "Pulse."

    The budget deal also includes a proposal that would make California the first state to provide middle-income families with subsidies to cover their monthly health insurance premiums, according to The Hill.

    Under the Affordable Care Act (ACA), U.S. residents with incomes between 100% and 400% of the federal poverty level (FPL) are eligible for federal subsidies to help offset the cost of purchasing an exchange plan. However, under the proposal, California would raise the subsidy eligibility cap in the state to 600% of FPL.

    The state under the budget deal would pay for the expanded Medicaid coverage and subsidies in part by taxing uninsured state residents, which essentially represents a reinstatement of the ACA's individual mandate penalty in the state, "Pulse" reports.

    Next steps

    The state's full Legislature must approve the budget deal before it is enacted, according to The Hill.  Under state law, the California Legislature is required to enact a budget by midnight on June 15. According to "Pulse," state lawmakers are expected to approve the budget deal this week (Wise, The Hill, 6/9; AP/CBS News, 6/10; Diamond, "Pulse," Politico, 6/10; Owens, "Vitals," Axios, 6/10).

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