Healthcare Expansion & Political Posturing In California

By CA Republican Assemblymember Devon J. Mathis

Governor Newsom’s announcement that the state of California will expand Medi-Cal eligibility to approximately 750,000 undocumented immigrants in our state has sparked a fiery debate among my colleagues in the Legislature. On my side of the aisle, some Republicans rightly mention that our state should address the $68 Billion budget deficit that our government has irresponsibly incurred before adding new expenditures. While some claim that offering healthcare eligibility to undocumented immigrants would pose a burdensome cost to California taxpayers, the evidence does not support this narrative.

We all can agree that our current immigration policy is broken and that Congress needs to stop politicizing this issue as a means to score political points. We need a solid policy that addresses the disastrous crisis at our border while also providing a realistic solution for the millions of undocumented immigrants in this State who are forced to hide in the shadows. However, until Congress gets its act together, we have no choice but to work within the system that we have. The best we can do in the State Legislature is to make our healthcare system more efficient and fiscally responsible, which is exactly what expanding healthcare eligibility to undocumented immigrants does.

Under the Emergency Medical Treatment and Labor Act of 1986, hospital emergency rooms are already legally required to provide treatment to anyone who requires assistance, regardless of their ability to pay, insurance status, or citizenship. If the people using these hospital services do not pay for whatever reason, the cost is then billed to the taxpayer or to the hospitals, who then have to divert limited funds away from other critical medical services.

In reality, this means that undocumented immigrants get access to emergency medical services but not the healthcare coverage that would prevent them from ending up in the emergency room in the first place. It is this imbalance that helps drive up costs within our already-failing state healthcare system and for California taxpayers. This failing healthcare system disproportionately hurts communities like mine since reimbursement rates for rural hospitals tend to be lower than those of hospitals from more urban areas even though rural residents, on average, tend to be older, sicker, and more likely to be uninsured.

It’s well-documented that preventative care reduces overall healthcare costs by catching and preventing medical issues before they become more severe to where the patient has to get treated in an emergency room, where the costs are much higher for the hospitals and the taxpayers. California’s decision to allow undocumented immigrants from ages 26 to 49 to qualify for Medi-Cal benefits is estimated to cost $2.6 Billion annually but it will save billions more in healthcare costs as it allows these people to get access to the preventative care required to stay out of hospitals. These preventative care services include dental visits, vaccinations, allergy medication, insulin, mammograms, medical screenings, and many more services that ensure that Medi-Cal recipients get the assistance they need to stay out of hospitals. As a result, the new California policy saves money in the long run and ensures our communities stay healthy.

One of my colleagues in the Legislature on my side of the aisle has decided to give his campaign a bit of a boost by introducing a bill that would, in his words, “revoke all taxpayer funding for health care for illegal immigrants in the California State Budget.” While this statement-piece legislation might sound fiscally responsible, it is anything but. It would just encourage the undocumented population to avoid or delay receiving preventative care, therefore ensuring that taxpayers and hospitals will continue to foot the bill for more costly procedures later on when these people inevitably end up in the hospitals and can’t afford to pay for their services. This bill comes from a #NOOB Legislator who clearly does not understand how our healthcare system works and is just trying to create a red meat issue at the expense of our state’s already-failing healthcare system.

People aren’t taking the time to understand the mechanics or economics of how state and federal healthcare law works. This confusion is only made worse by the unnecessarily combative and harmful rhetoric of those who choose to incite rage and anger against our friends and our neighbors.

Our healthcare system needs actual solutions, not messaging bills designed to fail, and that only serve to fearmonger. Congress needs to do something about our broken immigration system but until then, we in the State Legislature must offer realistic solutions on how to improve our state healthcare system. I have called out the many problematic policies passed by this body and I will continue to call out those bad policies in my final year in Office. But making it easier for undocumented residents to get the preventative care that they need to avoid going into the emergency room is not one of those bad policies. As I’ve repeatedly shown, I am willing to work with members on both sides of the aisle to pass pragmatic policies to ensure that California’s healthcare system delivers adequate services for all of its residents.

(GOP Assemblymember Mathis represents the 33rd Assembly District, which includes the communities of Tulare, Kings, and Fresno Counties. He is backing Nikki Haley in the presidential primaries.)