“Si TrumpCare deroga la ACA, revertirá la expansión de Medi-Cal, y si el Congreso no arregla el acantilado de atención primaria para este otoño, millones de personas en California perderán acceso a la atención médica, el estado perderá 27.000 buenos empleos y la economía perderá por lo menos  $ 3,8 mil millones al año.

Aunque no hemos calculado el costo real de las Clínicas de Salud del Pueblo (CDSDP), debemos asumir que estaremos afectados por cualquier reducción de la financiación. Creemos que una simple revocación [de la ACA] sería devastador para tanta gente no sólo en el Valle de Coachella, sino en todo el país. Tenemos que creer que nuestros miembros del Congreso no quieren privar a nadie de su cobertura de salud. Trabajando con la comunidad, haremos todo lo posible para asegurar que nuestra fuerza de trabajo permanezca en el lugar y que podamos cumplir nuestra misión de servir a cualquiera en la comunidad “.

– Claudia F. Gálvez, Directora de Asuntos Gubernamentales y Comunitarios de CDSDP

“La derogación de la Ley del Cuidado de Salud a Bajo Precio y la incorporación de la Ley Americana de Cuidado de la Salud realmente harán un cambio en donde la inversión va a ser hecha a largo plazo para Medi-Cal y también para mantener la expansión de Medi-Cal que un muchos de los bajos ingresos,  personas de color en el Este del Valle de Coachella califican. Además, va a haber menos financiación en el largo plazo, debido a la forma de Medi-Cal va a ser reembolsado. Va a ser más de una subvención en bloque, que tiene un límite de cuánto está viniendo, en comparación con los fondos de contrapartida, que sería una cantidad mayor si el estado invierte más que el gobierno federal.

En el largo plazo, California se verá afectada si no recibimos los dólares federales de Medi-Cal. El estado va a tener que tomar algunas decisiones sobre si vamos a ser más estrictos sobre la elegibilidad para Medi-Cal y que podría disminuir la cantidad de personas que se puedan inscribir al programa. Y luego también tenemos que averiguar cuánto dinero vamos a tener que dejar para Health4All Kids y otros programas estatales que abren acceso a la atención de la salud para nuestra gente indocumentada.

Al final, pase lo que pase a nivel federal, vamos a seguir presionando a nuestros funcionarios electos y estamos planeando una serie de ayuntamientos aquí en el Valle de Coachella. Vamos a tener un ayuntamiento con el congresista Ruiz sobre este tema. Algunos de nosotros también estamos trabajando a nivel estatal para ver qué puede hacer el estado para invertir más de nuestro dinero para incluir la atención médica para todos “.

– Maribel Núñez, Directora de la Asociación de California (CAP por sus siglas en inglés)

Pictured above: Joyce Noche, directing attorney at the Public Law Center, said immigrants should seek out trusted service providers to see if they are eligible for the current DACA program or other forms of administrative relief. Photo: Michael Lozano / VoiceWaves

ANAHEIM, Calif. – Immigrant rights advocates are encouraging families to get ready for the possible implementation of two programs that could go into effect later this year. Both programs provide beneficiaries with temporary relief from deportation.

Even with the death of Supreme Court Justice Antonin Scalia in February, advocates say a ruling on one of the big questions before the Supreme Court – whether Obama’s executive actions on immigration will finally go into effect – remains up in the air.

Obama’s expansion of Deferred Action for Childhood Arrivals (DACA) and launch of a new program for undocumented parents of U.S. citizens or legal permanent residents, called Deferred Action for Parents of Americans (DAPA), could provide millions of undocumented immigrants temporary relief from deportation and access to work permits.

Both programs have been on hold ever since they were announced in November 2014. Their fate now rests with the U.S. Supreme Court.

With eight justices on the court, five votes are needed to overturn an injunction put in place by a lower court, thereby allowing DACA and DAPA to move forward. In the case of a 4-4 tie, the lower court’s ruling would stand but the Supreme Court’s ruling would not be precedent.

The Supreme Court is expected to hear Texas v. United States in April and announce its decision in June. If it decides in Obama’s favor, the two programs could go into effect, possibly by late summer or early fall.

In the meantime, legal experts, advocates and DACA recipients say there are steps that families can take now to get ready for their possible implementation – and take advantage of programs that are currently available.

The litigation does not affect Obama’s original DACA program announced in 2012, which remains in effect.

Joyce Noche, directing attorney at the Public Law Center, encouraged immigrants in Orange County to seek out trustworthy service providers to see if they might be eligible for the current DACA program or other forms of administrative relief. Noche spoke at a media roundtable in Anaheim organized by New America Media and Ready California, a statewide coalition working to ensure that the maximum number of eligible Californians take advantage of DACA and DAPA.

Noche told reporters that while no one knows how the court will rule, a majority of law professors believe the president was within his power to announce his 2014 executive actions on immigration.

“We believe these programs are perfectly legal and will also be upheld,” said Hairo Cortes, program coordinator of Orange County Immigrant Youth United, who said that families should start preparing now for their implementation.

Residents can start gathering documents that prove they have been living continuously in the United States, he said. Those who have had contact with law enforcement can visit a trusted legal service provider to inquire about what is on their record.

Undocumented immigrants who came to the country as children should continue to apply for and renew DACA, said Cortes. DACA recipients who meet income requirements are eligible for full-scope Medi-Cal, California’s health care program for low-income residents.

For Avila Medrano, 23, DACA allowed her to get treatment for several health problems though Medi-Cal. When she was hospitalized recently, Medrano was able to get Medi-Cal to cover her hospital stay, medicines, and visits to doctors.

“When DACA came around, I saw hope,” said Medrano.

David Lee, a Korean American DACA recipient who was formerly homeless, said a man from church helped connect him to the local non-profit organization Korean Community Services.

“He told me I could work legally and there’s a program called DACA,” said Lee. “I didn’t believe it but I needed help. So I applied for DACA and it went through.”

Lee, who is now able to work legally, also said he now feels freer because of DACA. He explained that as a breakdancer, he used to be embarrassed to have to present a passport in order to enter a nightclub. Now he can use his ID to go out dancing.

“Thanks to DACA,” he said, “I can have more fun. I feel more free.”

Cortes said there are actions that families can take regardless of their status.

As of May 2016, all undocumented minors will be able to access full-scope Medi-Cal, so parents are encouraged to enroll their children in emergency Medi-Cal now.

Undocumented immigrants in California are encouraged to continue to apply for driver’s licenses, available to all qualifying residents regardless of immigration status, through the state law AB 60.

Eligible green card holders can apply for U.S. citizenship; and U.S. citizens can register to vote.

Concerned residents can also make their voices heard through organizing, Cortes said.

“We’re seeing a greater organizing effort now in New York, Chicago, people standing up against raids,” said Cortes, who noted that a recent protest in Santa Ana called for an end to deportations.

News of immigration raids on Central American refugees in other parts of the country has put immigrant communities on edge, noted Carlos Perea, project manager at Resistencia, Autonomia, Igualdad, lideraZgo (RAIZ)‬.

“There’s already enough fear and panic in the community,” said Perea, “that anytime the community hears about raids and [law enforcement’s] cooperation with ICE [Immigration and Customs Enforcement], the community will freak out.”

Perea said it’s important for undocumented families to have a plan of action if they come in contact with ICE agents, so they will be able to get the help they need should they be detained. Perea suggests that families have an emergency contact who will be able to take action if family members are detained; they should contact a trusted immigration lawyer or advocacy organization that will be able to mobilize on their behalf; and they should have an emergency plan for their children.

Meanwhile, Lee encouraged other undocumented immigrants in his community to see if they qualified for DACA so they could be free from the threat of deportation and be able to work legally.

“Don’t be skeptical [of applying for DACA] like I was,” he says. “Take action.”

For more information about Ready California, visit Ready-California.org.

Ed. Note: Beginning in May, California will become the fifth and largest state to provide healthcare to undocumented children from low-income families through the state healthcare system, Medi-Cal. Under SB4, known as #Health4All Kids, the state will set aside $40 million for the program in the first year, and an estimated $132 million annually once the program is fully implemented. An estimated 170,000 undocumented kids, many of them residing in Riverside County, will become eligible for health care coverage under Medi-Cal once Health4All Kids takes effect. Coachella Unincorporated interviewed Luz Moreno, community engagement program manager for the non-profit Clinicas de Salud del Pueblo, which is working to help families get enrolled, about what the new law means for the Eastern Coachella Valley.

Why is Health4All Kids important for families in the Eastern Coachella Valley?

Health is a human right which we all deserve to have. Health coverage provides preventive care and peace of mind. But because of financial barriers, many families choose not to seek healthcare for their children when needed. Children may be more vulnerable to disease, asthma, colds, and they need to have their yearly checkups and vaccinations. [Health 4 All Kids] will provide families in the Eastern Coachella Valley with peace of mind, and encourage preventive health care methods. It will have a positive impact for our families.

How are clinics in the Eastern Coachella Valley helping families apply for Health4All Kids?

[Our clinics] have Certified Enrollment Counselors located at each clinic daily that assist with the enrollment process. Through our outreach department we go door to door sharing information on enrollment and clinic services. We are available to do presentations and enrollment activities when requested, and we also participate in community fairs to spread the word.

What are some of the challenges families in the ECV face in getting enrolled?

Family members tell us there is a lack of information about where and how they can enroll for coverage. This may be because they don’t have access to computers … or simply lack transportation. Many think they do not qualify for any insurance coverage because their wages are too low, so they don’t apply. Many times they choose to pay the fine and pay cash for services or go to [Mexicali for treatment]. There are also many fears around applying for Medi-Cal. People still worry their property will be taken from them, so they don’t apply. (California law stipulates the state can take ownership of assets, including the family home, of recently deceased Medi-Cal beneficiaries.)

Families who enroll by February will ensure their kids transition to Medi-Cal without a gap in coverage once Health4All Kids takes effect. How can we encourage more families to act?

We need strategic outreach efforts, radio spots, T.V. commercials and posters. We also need to educate the community on the new Medi-Cal laws and programs. The community also needs to get informed and seek help in applying. Community members shouldn’t listen to “chismes” or gossip. Get the facts and don’t be afraid. Medi-Cal does not affect your immigration status.

Where can families enroll in in order to be ready for Health4All Kids?

Clinicas de Salud will be happy to assist with the enrollment process. Our home office is located in the Desert Alliance for Community Empowerment building in Coachella. We also have clinics in Mecca, Coachella, Indio, Westshore and Blythe. Families will need to bring proof of income, IDs, children’s birth certificates, and proof of residency [such as] a water bill.

To find out if your family qualifies for Health4All Kids, contact Clinicas de Salud del Pueblo at 760-398-5229. Additional reporting contributed by Christian Mendez.

About the author:

Amanda Flores, 15, is a lifelong Coachella resident. She joined Coachella Unincorporated earlier this year and has already written several articles on community health and farmworker services. After high school, Amanda said she wants to study law or medicine. View Amanda‘s author page here.

New America Media, News Report, Viji Sundaram, Posted: Jul 22, 2015
SAN FRANCISCO — Even as health care advocates are celebrating California’s recent “landmark victory” in getting its undocumented children health care, Latino and Asian and Pacific Islander (API) communities should show a united front and make sure that all of the state’s undocumented residents get the same benefit, urged Sen. Ricardo Lara, D-Bell Gardens.

“The API and Latino communities have similar backgrounds and we both believe in giving back to community,” said Lara at an ethnic media briefing hosted by New America Media on July 21, 2015, with his “partner in crime” as he referred to Assemblymember Rob Bonta, D-Oakland, at his side. “We’re fighters. There’s something in our DNA that wants us to go forward.”

Lara’s Health for All bill (SB 4), was originally intended to provide health care to the state’s nearly 2.6 million uninsured residents, regardless of their immigration status. That would have been done either by enrolling them in Medi-Cal, (California’s name for Medicaid, the insurance program for its low-income residents) or by allowing them, after getting a federal waiver, to buy health insurance on Covered California, the state’s health insurance marketplace, with their own money.

But last month, Governor Jerry Brown approved a $40 million budgetary allocation for providing Medi-Cal for the state’s 170,000 undocumented children, a significant victory for SB 4 supporters.

Brown’s move would reduce the cost of SB 4 significantly, but would still leave nearly 1.5 million undocumented adults uninsured.

Lara’s is optimistic that his other health care coverage bill, SB 10, will close the gap by providing those left uninsured full-scope Medi-Cal benefits if they meet eligibility requirements and if funding is available. If it’s not, they will get limited scope benefits. SB 10, like SB 4, has passed the Senate and is now before an Assembly committee.

Both bills, Lara said, will stand a good chance of passage if the AAPI and Latino communities campaign together.

The health care bills are “about inclusion, collaboration and partnership,” Bonta agreed, as he addressed the packed room of reporters and some health care advocates. For his part, he will inspire all Asian Americans to campaign for the bills, he said.

Lara once again slammed President Obama for excluding undocumented immigrants from benefiting from the 2010 Affordable Care Act (ACA). ACA was designed to provide affordable health care for all legally residing U.S. residents.

SB 4 will seek a federal waiver to allow California’s undocumented immigrants to purchase insurance on Covered California, but without providing them subsidies. An estimated 390,000 people will benefit from the waiver, Lara said.

He pointed out that it’s in the state’s financial interest to pass his bill. Without it, undocumented immigrants will continue using hospital emergency rooms even for their basic care, currently costing the state $1.7 billion annually.

Lara said he can understand the plight of undocumented and uninsured immigrants because his Mexico-born parents were at one time in that situation themselves.

Bonta, the co-author of the bill in the Assembly and chair of its health subcommittee, observed that when Lara first introduced his bill last year, the odds were stacked against its passage, especially given that a similar bill the senator introduced the previous year did not get out of committee because of its $1.3 billion annual price tag. This year’s bill would cost a lot less because no state subsidies will be given to those who purchase insurance on Covered California.

Three California undocumented immigrants – two from the API and one from the Hispanic community — shared their own personal stories that brought home the importance of having access to health care.

Amy Lin testified about being undocumented and uninsured. 

Amy Lin, who came with her mother to the United States from Taiwan as a 12-year-old, said it was hard for her to watch her 50-something-year-old mother slog as a domestic worker and not have health care.

“She suffered lower back pain and joint pain that became chronic,” Lin, now 23, and a Deferred Action for Childhood Arrivals (DACA) beneficiary said. “She relied on over-the-counter pain relievers. We bonded over the massages I gave her.”

Lara’s bill, she asserted, means a lot to the hundreds of thousands of undocumented immigrants who face a similar situation.

Jesus Castro, 20, who immigrated to the United States with his parents from his native Mexico in 2001, recalled how as a young boy he once dislocated his elbow playing baseball. The curandero his father took him to told Castro a story to distract him as he popped the elbow back in place.

His 44-year-old mother, Christine Marquez, told how she too had to rely on such remedies to treat her frequent nosebleeds and other health issues. She recently quit her job because of a slipped disc.

Twenty-seven-year-old Samoan native Tali Seumanutafa recalled how she went through some 25 surgeries to treat a crippling bone disease. The Shriner’s Hospital paid for her surgeries and hospitalization until she turned 18 and aged out of its charitable care program. When the disease recurred in 2011, she checked in at San Francisco General. She was left with a half a million dollar bill that she has not paid.

“I’m unsure of where me and the bill stand,” Seumanutafa said, noting that she now feels more secure because she has Medi-Cal, thanks to her DACA status.

One of the issues many of the state’s lawmakers are concerned about is whether providing Medi-Cal to the state’s undocumented will give them access to health care given the shortage of doctors in the Medi-Cal network. Asked about this, Lara said that both he and Bonta are working on addressing this issue.

Last month, Bonta was appointed chair of the Public Health and Developmental Services Committee that was set up to convene extraordinary sessions to discuss, among other things, how the state can allocate more money for its Medi-Cal program.

“It’s always good to have the chair of the health committee support your bills,” Lara said, turning toward Bonta with a smile.

Both lawmakers agreed that if California, which Bonta called “the most progressive state in the nation,” succeeded in getting health care for all its residents, the rest of the country would likely follow suit.

“California is coming to a neighborhood near you, whether you like it or not,” Lara said.

New America Media, News Report, Viji Sundaram, Posted: Jun 16, 2015

Sen. Ricardo Lara and Senate President pro Tempore Kevin de León discuss the state budget that passed this week. (Photo courtesy of Sen. Lara’s office.)

Calling it one of the “best” budgets the state has ever had, California Gov. Jerry Brown said the $167.6 billion dollar budget the legislature passed Tuesday would pump more money into child care and education, pay down the state’s debt by $1.9 billion and provide health care for its undocumented children.

“This is just one step and we need to do more,” Brown said during a press conference, referring to the $40 million budgetary allocation for providing health insurance to an estimated 170,000 undocumented children in the state  through Medi-Cal – California’s name for Medicaid, the health insurance program for low-income people.

A jubilant Sen. Ricardo Lara, D-Bell Gardens, called the $40 million allocation a “modest investment in health care that will be transformational in the lives of not only children,” but also their families and the community as a whole.

He noted that the budget deal “affirms our commitment to embrace and integrate our immigrant community, to lead where the federal government has failed and to acknowledge the hard work and sacrifice of a community that contributes billions of dollars” to the state’s economy.

“This expansion of coverage to all children regardless of immigration status would make California’s children healthier, our health system stronger, and our families and communities more financially secure,” asserted Anthony Wright, executive director of Health Access California, the statewide health care consumer advocacy coalition.

Lara’s own Health for All bill (SB 4) will provide health insurance for all Californians regardless of their immigration status. It is now before the Assembly, after it cleared the Senate last month. If it is signed into law, California would be the first state in the country to provide state-funded health insurance to its undocumented residents.

The original intent of SB 4 was to provide health care for the state’s nearly 1.5 million undocumented residents, both adults and children, either through Medi-Cal or by allowing them to purchase health insurance on the state’s exchange. But the state must first seek a waiver from the federal government to allow them to purchase health insurance on the state’s exchange, Covered California. The Affordable Care Act prevents undocumented U.S. residents from any federally funded health insurance program. The waiver will be sought if SB 4 passes.

According to researchers at the University of California at Berkeley and University of California in Los Angeles, expanding Medi-Cal to undocumented California residents, under Lara’s bill,  would  have cost the state between $353 and $369 million annually, representing a 2 percent increase from what it currently spends. But now that the state has approved $40 million in its budget to provide insurance for its undocumented children, the Medi-Cal cost in Lara’s bill will go down.

“It would also provide the momentum for SB 4 to move forward,” Wright said.

Senate President Pro Tem Kevin de Leon, who participated alongside the governor in the press conference and had backed SB 4 since it was introduced in the Senate late last year, said Washington’s inaction has caused “financial consequences throughout the country.”

Lara’s bill, he said, will send a “very strong message” to lawmakers in Washington who have “dithered” on immigration reform.

The governor’s remark that more needs to be done, including how to address the low Medi-Cal reimbursement rates – among the lowest in the nation — will be discussed in a special session in a few weeks.

Brown said that his office would be hiring an immigration coordinator to assist youth who have been granted temporary relief from deportation under President Obama’s executive action of 2012. One million more California residents could become eligible for deportation relief if the federal courts allow Obama’s 2014 executive action to move forward.

New America Media, News Report, Viji Sundaram, Posted: May 14, 2015

One-third of undocumented Californians earn enough to buy their own health insurance on the federal exchange, but Uncle Sam won’t let them, asserted Sen. Ricardo Lara, D-Bell Gardens. That’s forcing them to make the costly decision to go to emergency rooms when their health deteriorates.

“Allowing them to pay for their insurance makes economic sense and is the right thing to do,” said Lara, as he explained why he introduced SB 4 – otherwise known as the Health for All bill – during a May 11 tele-conference call with ethnic media.

Lara said the bill, introduced earlier this year, would give undocumented immigrants the option of buying insurance through Covered California, the marketplace exchange set up under the ACA. That is something the 2010 Affordable Care Act (ACA) denied them. Good as the ACA is, the senator pointed out, by barring undocumented immigrants from benefiting from it the federal government has “completely failed.”

Around 24 ethnic media outlets were on the New America Media-sponsored hour-long call, along with 28 health care advocates and stakeholders.

Health Access California’s executive director Anthony Wright, the other panelist on the call, who has been at the forefront of efforts to get the bill before the legislature, pointed out the stark reality of being uninsured: “You live sicker, die younger and are one emergency away from financial ruin.”

Doreena Wong, project director for the Los Angeles chapter of the Asian American Center for Advancing Justice, shared her insights on how the Health for All bill will help the state’s approximately 210,000 undocumented Asian Americans.

SB 4, now “on suspense” in the Senate Appropriations Committee (a status every bill that costs $150,000 or more is put on until all the other bills are considered) will allow all California residents to get coverage, regardless of their immigration status. It will allow residents, who meet other eligibility requirements, to enroll in Medi-Cal (known as Medicaid in the rest of the nation), the health insurance program for low-income people.

The bill will also allow those who make too much money to qualify for Medi-Cal – up to about $16,240-a-year for an individual and $33,465 for a family of four – to buy insurance under Covered California.

If SB 4 passes, Lara said, the state would seek a waiver from the federal government to allow its undocumented residents to buy on the exchange.

If, however, the federal government denies the waiver, he said, the bill will allow the state to set up a “mirror” marketplace that sells insurance plans identical to those offered through Covered California.

In either case, though, unlike legal residents who do receive federal assistance through the exchange, no subsidies will be provided to undocumented immigrants who enroll. This is a departure from Lara’s 2014 Health for All bill, SB 1005.

That bill stalled in the Senate Appropriations Committee because of its estimated cost. According to researchers at the University of California at Berkeley and University of California in Los Angeles, expanding Medi-Cal to undocumented California residents would have cost the state between $353 and $369 million in 2015, representing a 2 percent increase in state spending on Medi-Cal. An analysis by the committee pegged the cost of subsidizing insurance purchased on the marketplace at between $20 million and $40 million a year.

Since no subsidies will be offered through SB 4, the cost will be significantly less. Additionally, if President Obama’s 2014 executive action giving temporary deportation relief for undocumented immigrants is upheld, the cost of SB 4 could drop by about $100 to $300 million a year, Wright pointed out. That’s because many of the 500,000 undocumented immigrants in California – the bulk of whom are under 45 – could enter the workforce and get employer-sponsored health insurance.

Wright noted that it would be a relatively “small financial investment” by the state to cover its undocumented residents. Of the 12 million California residents who are currently on the Medi-Cal rolls, “many are in the Emergency Medi-Cal program” for undocumented residents. That program allows them to seek hospital care only for pregnancy-related issues or for emergencies.

According to the California Immigrant Policy Center, it would cost only an additional two cents for every dollar the state currently spends on its Emergency Medi-Cal patients to provide them full-scope Medi-Cal.

Wright said the “momentum” the state has built by passing AB 60, which allows undocumented immigrants to get a driver’s license, and the Trust Act, which passed in 2013 limiting the state’s cooperation with federal immigration authorities when local law enforcement authorities apprehend an undocumented person, will more than likely carry SB 4 to the governor’s desk.

He pointed out that as undocumented immigrants are financially contributing to California’s economy – $130 billion annually to its gross domestic product and $2.2 million in state taxes, according to Lara – “they need to be included in our health care system.”

“We are better off if our health care system is stronger and everybody is included in it,” Wright said.

If SB 4 gets out of the Senate Appropriations Committee, it will come up for a vote before the full Senate some time between June 1 and 5 after which it moves to the assembly.

New America Media, News Report, Viji Sundaram, Posted: Apr 16, 2015

SACRAMENTO – After hearing heart-rending testimonials from three young undocumented immigrants who have seen first hand the havoc caused by not having access to health care, the Senate Health Committee yesterday voted 7-0 to provide health care to all Californians, regardless of their immigration status. The committee also witnessed wide-ranging support from representatives of more than 30 health care, labor, education and immigrant advocacy organizations.

The vote went along party lines, with all seven Democrats on the committee supporting SB 4, the Health for All bill sponsored by Sen. Ricardo Lara, D-Bell Gardens, with the two Republicans on the committee, Senators Janet Nguyen, R-Garden Grove, and Jim Nielsen, R-Gerber, abstaining.

Committee chair Sen. Edward Hernandez, D-West Covina, said before the vote was taken that he was convinced that every immigrant in the United States deserved access to health care. California, he agreed with Lara, should take the leadership role in making this happen.

Like Sen. Lois Wolk, D-Davis, before him, Hernandez said he too would like to be added as a co-author to SB 4.

Lara’s bill would allow low-income immigrant families in California to get regular medical care through the state’s health insurance program for low-income people called Medi-Cal (Medicaid in the rest of the nation). The bill would also allow undocumented immigrants whose incomes are above the Medi-Cal eligibility limit to purchase insurance through Covered California, the state’s online marketplace set up under the 2010 Affordable Care Act (ACA).

Undocumented immigrants are currently excluded from purchasing health care through state exchanges.

Lara said he’s been working with officials in Washington, D.C., on a federal waiver to allow undocumented immigrants to purchase insurance on the state’s exchange, Covered California. If that fails, he said, a provision in his bill would allow the state to set up a separate exchange to provide undocumented immigrants equivalent coverage.

Gabriel Aguila, a health worker with Clínica Monseñor Romero in Los Angeles, testified in Spanish that he was diagnosed with diabetes six years ago and more recently with a tumor, and accessing health care has been a challenge. “Please reform our health care system,” he pleaded.

Lara told the committee that people should not die from easily treatable illnesses and accidents simply because they cannot access health care.

It’s “one significant area where the federal government failed,” asserted Lara.

Ronald Coleman, government affairs manager with the California Immigrant Policy Center, agreed, telling the committee members, “You have to right this wrong.”

One in 10 Californians is undocumented, yet undocumented immigrants generate millions of dollars for the state economy, noted Lara.

A new 50-state study out this week by the Institute on Taxation and Economic Policy finds that the 3.1 million undocumented immigrants currently living in California collectively paid $3.2 billion in state and local taxes in 2012. This represents a $500 million increase over a similar report two years ago.

“Investing in immigrants is investing in California,” asserted Coleman.

But for the two Republicans on the committee, the question of where the bill’s funding would come from – the same question that stalled in the Senate Appropriations Committee a similar bill proposed by Lara last year – remained uncertain.

Sen. Nguyen acknowledged that “our health care system has many deficiencies,” a significant one being not having enough doctors and dentists in the Medi-Cal network because of the state’s low reimbursement rate. But if the state were to pass Lara’s bill, she wondered whether California would be able to “sustain” it financially. The bill, she said, comes with a price tag of over $1 billion, which she said would have to come out of the state’s general fund.

Lara said he agreed with Nguyen that Medi-Cal doctors needed to be reimbursed adequately. But he pointed out that SB 4, unlike SB 1005, the Health for All bill he sponsored last year, was far less costly. That’s because under SB 4, no financial support from the state would be provided for people buying insurance through the exchange. He pointed out that nearly one-third of California’s undocumented population would be able to afford to buy insurance on the marketplace without the state’s help.

In addition, he said, if the suspension placed by a Texas court on President Obama’s executive action to expand the Deferred Action for Childhood Arrivals (DACA) program and launch the Deferred Action for Parents of Americans (DAPA) program is lifted, an estimated 1.25 million undocumented immigrants in California may be eligible for work authorization and relief from deportation. That would drop by half the number of uninsured immigrants in California, thereby lowering Emergency Medi-Cal spending on them, he said.

The state is already spending about $1.7 billion on its Emergency Medi-Cal population. Under Lara’s bill, it would only be spending an additional 2 cents on every dollar it spends to provide comprehensive Medi-Cal, Coleman said.

SB4 is now headed to the Senate Appropriations Committee. If it is approved there, the full Senate will hear it.

“I’m optimistic about the bill passing, especially because both Senate President Pro Tem Kevin de Leon and Speaker of the Assembly Toni Atkins have prioritized the bill,” Lara told New America Media.

Anthony Wright, executive director of Health Access, the statewide health care consumer advocacy network, said he believed the bill would become law this year. “We have the wind on our backs,” he said.

New America Media, News Report, Viji Sundaram, Posted: Mar 12, 2015

Pictured above: DACA recipient Ana Alcantara, 22, was misinformed by her tax preparer and ended up paying an unnecessary penalty.

A new scam targeting immigrants has gotten the attention of Uncle Sam.

Health advocates are concerned that tax preparers have been misinforming, and some even outright scamming, Deferred Action for Childhood Arrivals (DACA) beneficiaries by making them pay a penalty for not having health insurance. On Wednesday, the Internal Revenue Service (IRS) released a statement clarifying that there is no such penalty for undocumented immigrants or for DACA recipients. DACA is a program announced by President Obama in 2012 that gives temporary protection against deportation to undocumented immigrants who came to this country as children.

“Advocates have been asking [the Obama administration] for a month to provide [tax preparers] some clarity,” said Angel Padilla, a health policy analyst at the Washington, D.C. office of the National Immigration Law Center. Up until now, he said, “there was not something official we [had that we] could point to from IRS that makes this clear. Now we do.”

The IRS website now reflects the clarity that advocates have been pressuring it to spell out:Individuals who are not U.S. citizens or nationals and are not lawfully present in the United States are exempt from the individual shared responsibility provision. For this purpose, an immigrant with Deferred Action for Childhood Arrivals (DACA) status is considered not lawfully present and therefore is eligible for this exemption. An individual may qualify for this exemption even if he or she has a social security number (SSN).

The confusion arises from a policy under the Affordable Care Act (ACA) that requires nearly all Americans to have some form of health insurance, or face a penalty. That coverage could come from job-based insurance; an individual health plan bought through government-run health care exchanges or elsewhere; Medicaid (known as Medi-Cal in California), a government-funded health insurance program for low-income people; or Medicare, a health insurance program for those who are over 65 or have a disability.

For 2014, the first year the policy went into effect, the penalty for failing to get such coverage was $95 per adult and $47.50 per child, or 1 percent of taxable household income, whichever was greater. The penalty will increase in subsequent years.

But the requirement to have health insurance does not extend to undocumented immigrants or DACA beneficiaries. That’s because they are not lawful residents. DACA is only a benefit eligibility category, not an immigration status.

It is a distinction that neither the Department of Health and Human Services nor the Internal Revenue Service made clear on their websites until now, Padilla said.

“That lack of clarity trickled down to tax preparers,” he said.

Brenda Ordaz, a representative of the Coalition for Humane Immigrant Rights of Los Angeles (CHIRLA) and a health navigator for the state’s health insurance marketplace, has seen the confusion first hand. A DACA recipient herself, Ordaz says other DACA recipients have been coming to her, asking why their tax preparers were making them pay penalties for not having health insurance.

She said one tax preparer asked a DACA client to pay her the penalty directly and in cash, rather than asking the IRS to deduct it from his refund.

“I’m sure some preparers are doing this to undocumented people as well,” Ordaz said.

Los Angeles resident and DACA beneficiary Ana Alcantara, 22, says her tax preparer told her she had to pay the penalty when he discovered she didn’t have health insurance. She reluctantly agreed to have the $95 deducted from her nearly $850 tax refund.

Alcantara didn’t know she was exempt from the requirement. She also didn’t know that she could have enrolled in California’s state-funded Medi-Cal program as soon as she received DACA in 2013. Even though DACA recipients are banned from accessing any federal programs, they qualify for state-funded Medi-Cal – something that many aren’t aware of.

Meanwhile, tax preparers themselves say they don’t always know if their client is a DACA recipient. One tax preparer acknowledged that she had filed tax returns for a number of clients that included the penalty because they had failed to tell her that they were DACA beneficiaries.

“It’s hard to know because a lot of clients don’t open up,” explained Azucena Lopez, co-owner of Gonzales Tax Services in Madera, Calif. She said she had assumed they were lawful residents when they told her they had a work permit and social security number.

Since she became aware that her clients were DACA recipients — and were exempt from the penalty — Lopez says she has been filing amended tax returns. Alcantara’s tax preparer also has agreed to file an amendment so Alcantara can get her $95 back.

Read more about health care and DACA on the National Immigration Law Center’s website,www.nilc.org. 

VIJI SUNDARAM/New America Media

This article is also available in Spanish.

中文翻譯

OXNARD, Calif. – For years, DREAMer Rodrigo Perea, 18, lived under a threatening cloud of deportation. Now, Perea has legal permission to live and work in the U.S.– but until recently he was still in the dark about the low-income health programs he qualifies for.

He’s not alone. Thousands of immigrants, and even many health care advocates in California who work with young immigrants, are unaware that recipients of the Deferred Action for Childhood Arrivals (DACA) program may qualify for state-funded only Medi-Cal, identical in every way to the full scope federal and state funded program that shares the name.

Last August, the Obama administration initiated DACA, giving certain undocumented youth who have grown up in the United States permission to live and work in the country for two-year renewable periods.

Two months later, the administration announced that DACA recipients would not be eligible to receive federal benefits, including health insurance programs — an obvious attempt on the administration’s part to prove to its foes that DACA would not renege on the administration’s promise that undocumented individuals would not benefit from the Affordable Care Act (ACA).

The announcement enraged immigrant rights activists, who lamented the fact that DACA beneficiaries were being treated no differently than undocumented immigrants when it comes to health care, despite the Department of Homeland Security itself confirming that DACA grantees are lawfully present in the United States.

The administration’s decision effectively denies DACA recipients access to affordable health care because they will not be able to participate in the health care exchanges set up under federal health care reform, will not be covered by the federal and state funded Medicaid (known as Medi-Cal in California), and will not be covered for pre-existing health conditions.

But Perea and others like him are lucky to live in California. It’s one of only a handful of states that run a parallel Medicaid program, solely funded with state dollars. Medi-Cal was launched in 1996, soon after Washington passed the Welfare Reform Act. Under it, Congress banned some lawfully present immigrants from receiving Medicaid indefinitely and slapped a five-year waiting period on newly documented immigrants – both children and adults – before they could sign up for Medicaid.

California was among a number of states with large immigrant populations that disagreed with the ban and opted to continue financing the health insurance program for low-income immigrants regardless of how long they had resided in the United States, provided they met all the eligibility criteria for regular Medi-Cal, said Tanya Broder, a senior attorney with the National Immigration Law Center. The only difference being, the program would be supported exclusively with state dollars.

“California has long recognized the need to provide health insurance to people who are here lawfully because it believes it’s a good idea to invest in preventive care,” said Broder.

Los Angeles DREAMer Hyun Kyu (Kevin) Lee, 21, also a DACA beneficiary and a recent college graduate, unfortunately is a little too old to enroll in Medi-Cal, even though he would like the security of having health insurance. Under current Medi-Cal eligibility requirements, adults over the age of twenty must have a child to qualify.

Since its implementation, United States Citizenship and Immigration Services has received nearly 500,000 DACA applications, of which half have been approved. That number represents only about 30 percent of the estimated 1.76 million DREAMers nationwide who possibly qualify for DACA, according to the Coalition for Humane Immigration Rights of Los Angeles (CHIRLA).

In California, 73,104 youngsters have been given DACA status out of a pool of 134,167 applicants, as of the end of last March.

Perea is currently in possession of an Emergency Medi-Cal card, which has limited use. The card is given to any immigrant who is “not a lawful permanent resident or Permanently Residing in the United States Under Color of Law (PRUCOL).” Aside from emergency medical care and pre-natal care, the cardholder is eligible for organ transplant procedures and renal dialysis services. It will not cover regular outpatient care or pay for prescription drugs.

Until recently, Arcenio Lopez, associate director of the Mixteco/Indigena Community Organizing Project (MICOP) in Oxnard, said he was not aware that DREAMers like Perea, who is his client, might qualify for state-funded low-income health care. Now that he does, he said, he would put the word out through the MICOP promotoras – women from the indigenous migrant community who promote health through educational workshops.

“Many youth here never go to see a doctor or a dentist when they need to, and so many of them have dental problems,” Lopez said. “They need to have physicals and get preventative care… Having access to Medi-Cal will make a big difference to them and their families.”