California has set another milestone this year by becoming the first state to offer taxpayer-funded health insurance for all undocumented immigrants.
Now, regardless of age, all undocumented immigrants in the Golden State qualify for Medi-Cal, the state’s version of the federal Medicaid program for American citizens with low incomes. As a result, an additional 700,000 non-citizens, ages 26 to 49, are now eligible for full coverage in the state.
Until now, Medi-Cal only covered illegal aliens over age 50.
‘This Is Fiscally Irresponsible’
Medi-Cal is creating a disastrous situation for the state, says Sally C. Pipes, president and chief executive officer of the Pacific Research Institute. “California is spending more taxpayer dollars on non-citizens—this is fiscally irresponsible,” Pipes said.
Already, one in three Californians is enrolled in Medi-Cal, at a cost of $152 billion, of which state taxpayers covered $37 billion, according to Pipes. The state is facing a budget deficit of $60 billion or more, based on projections by the State Legislative Analyst’s Office. Expanding Medi-Cal to cover 700,000 non-citizens will cost California $400 billion a year.
“There will be an added incentive now for illegals in other states to come to California to take advantage of the new state-funded benefit,” said Pipes. “And those who legitimately qualify for Medi-Cal will find it harder to find doctors to treat them. That is because doctor reimbursement rates are so much lower than what they receive for treating patients with private insurance.”
‘Vicious Circle’ of Tax Hikes
California taxpayers will have to face further increases in their very high tax burdens for the tremendous cost of covering all illegal immigrants, says Pipes.
“This decision is a major problem which will put additional pressure on the state and its budget deficit,” said Pipes. “It will result in even more people and companies leaving for states with either lower taxes or no state income tax. Then, taxes will have to increase yet again. It is a vicious circle. Californians already face the highest state tax rates in the country. The federal government cannot fund illegal immigrants, nor can it subsidize coverage for the undocumented through the Obamacare exchanges.”
Coverage, Not Care, for All
As things stand, the Affordable Care Act is becoming a replica of the British health care system, with California ahead of the curve, says Linda Gorman, director of the Independence Institute’s Health Care Policy Center.
“States have been building to this for decades,” Gorman explains. “The ACA moved the process along a lot faster. To see what is coming, look at the KFF State-Funded Health Coverage for Immigrants policy brief. Note that the section this is filed under is racial equity and health.”
“Covering all residents is the only logical endpoint when policy evaluation is primarily focused on whether or not everyone has coverage, and blames poor outcomes on ‘barriers to access,’ which include any payment at the point of service, and only pays lip service to the quality of the medical care people get,” said Gorman.
‘Quality of Care Will Fall’
A single-payer system has been a goal of the political left since 1912, but Medicaid payments do not cover providers’ total costs, says Gorman.
“Policymakers act as if expensive, sophisticated, medical staff and equipment will show up no matter what,” said Gorman. “They legislate coverage wish lists and assume that brutalized suppliers will continue to supply top-notch medical care. They are wrong and we will all suffer.”
California already depends on commercial insurers to subsidize free health care, says Gorman.
“A fair amount of (Medi-Cal’s) deficit is shifted to private payers,” said Gorman. “With fewer private payers, the private sector’s ability to make up for payment shortfalls will be limited. Capital in the private health care system that wears out will not be replaced, innovation will halt, and providers will not be as well-trained. The quality of care will fall.”
‘Tooth Fairy Model of Medicine’
Hospitals will become dependent on supplemental payments from the government and health care decisions will be made by bureaucrats, not patients, says Gorman.
“This is the tooth fairy model of medicine,” said Gorman. “As the number of people with government coverage grows, the main client of any health care provider will be the government. The ‘system’ will be unresponsive to patient needs, will be poorly equipped, and will not innovate. The wealthy and well-connected will get their care from the private sector.”
Medicaid already covers emergency services for non-citizens, says Gorman.
“They are a relatively small fraction of its total spending,” said Gorman. “Making illegal aliens eligible for standard Medicaid coverage does not increase the supply of doctors, hospitals, or medical equipment. Provider shortages already make it hard for California Medicaid patients to get the care they need. Expanding all Medi-Cal coverage to illegals will heighten the provider shortage while exacerbating California’s already severe budget problems.”
The Big Picture
What we’re witnessing in California is what two sociologists described in 1966, called the Cloward-Piven strategy, says John Dale Dunn, M.D., J.D., a physician and policy advisor to The Heartland Institute, which co-publishes Health Care News.
“If the Left pushes the welfare state and overwhelms the economy and society with unlimited migration from Third World hellholes, the Cloward-Piven strategy predicts the resulting failures of state institutions like Medi-Cal will usher in a revolution, and also, commies hope, their rise to power,” said Dunn. “California has gone commie.”
Kenneth Artz (KIApublishing@gmx.com) writes from Tyler, Texas.