This assemblymember continues effort to expand health care access to undocumented | Opinion

While President Donald Trump tries to carry out an anti-immigrant campaign that targets undocumented residents, strips temporary protective status from immigrants who fled their home country for their own safety and denies birthright citizenship to individuals whose parents were undocumented, Assemblymember Joaquín Arámbula continues to look for ways to support that population at the state level.

“It’s not my first change in federal administration,” the Fresno Democrat told The Fresno Bee Editorial Board. “I was sworn in under the 44th president; have seen the 45th and 46th president sworn in; and now we’re in the 47th administration.”

Arámbula has managed to convince fellow lawmakers and Gov. Gavin Newsom to extend MediCal to the undocumented.

“We’ve been able to enroll a million Californians into Medi-Cal and believe that the next logical step for us to take is to focus on the income thresholds and those who are exceeding them and who still can’t afford health care today,” Arámbula said.

That optimism could run into harsh reality from Washington, D.C. where House Republicans are planning to strip $880 million in Medicaid, whose funds help California maintain the array of benefits and beneficiaries of the state’s Medi-Cal program.

Instead of circling the wagons or waving the white flag on health care for undocumented residents, Arámbula has another pro-immigrant health bill, Assembly Bill 4. The legislation would create “a mirrored” exchange between MediCal and Covered California that allows undocumented individuals to qualify if their monthly income exceeds 138% of the federal poverty level because harvest work spikes their pay.

“We don’t get to choose when we get sick,” the assemblyman said, noting that many farmworker families meet income thresholds during non-harvest months.

His legislation acknowledges that immigrants, both documented and undocumented, have “historically and systematically faced barriers” in accessing healthcare. Providing that access, he notes, has a positive impact on people’s health and well-being.

California has an estimated 1.8 million undocumented residents. The California Budget & Policy Center said undocumented workers contributed $8.5 billion in state and local taxes in 2022. Arámbula said that, despite their contributions, they are not allowed to access the same subsidized health care as other taxpayers.

That’s why he championed legislation to expand MediCal to undocumented children under 19 in 2021, to residents 50 years and older in 2022 and to all income-eligible undocumented immigrants in 2024. California is among seven states that have expanded fully state-funded health coverage to income-eligible adults regardless of immigration status.

Advocates say the $4 billion annual cost for California is a worthy investment: Providing access to preventive care makes individuals healthier and cuts down on costly trips to the emergency room. A 2022 study showed that immigrants contributed $58.3 billion more in premiums and taxes nationally in 2017 than insurers and government paid for their health care. U.S.-born citizens, on the other hand, took out $67.2 billion more than they contributed.

Arámbula doesn’t worry about Trump

“We’ve continued to make progress towards a more equitable and inclusive health care delivery system,” Arámbula told The Bee. “We’ll continue that effort and believe that this movement can gain momentum so that we can ultimately address the affordability crisis that too many families are struggling with right now.”

Californians who have historically and systematically faced barriers to accessing health care include people of color and immigrants, both documented and undocumented.

A doctor by training, Arámbula saw the need to provide health care access to undocumented residents growing up in Delano.

“I saw what happens for so many of our community members whose lives are affected because of their inability to access care,” he said. “I saw that injustice first-hand as their lives were shortened and their families affected.”

Arámbula said the undocumented community “works hard, early in the morning til late at night, to put food on the table, to keep our elderly and our disabled when they’re sick, to build our skyscrapers. Rarely do they receive the resources they need to stay healthy and to thrive.”

Without undocumented contributions, California would not be the world’s fifth-largest economy. Arámbula believes those contributors need to have access to healthcare. We agree.