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The proportion of undocumented immigrants in the United States who lack health insurance continues to be high — around 40%1 — even as the country’s overall uninsured rate has dropped to historic lows under the Affordable Care Act (ACA). Insuring undocumented immigrants would be an important step toward achieving universal coverage, but in an increasingly hostile national political climate, the likelihood of addressing this challenge at the federal level is low. Because the ACA continues a long-standing restriction on using federal funds to insure undocumented immigrants, covering this population will probably remain largely a state prerogative in terms of both policy and funding.

State innovation can help to build an evidence base for creative policy solutions for curbing the uninsured rate among undocumented immigrants. California, home to about 2.5 million undocumented residents, introduced three relevant measures in the 2015–2016 legislative session. The first policy, passed in 2015, offers insurance coverage to undocumented-immigrant children; the second, passed in June 2016, allows undocumented-immigrant adults to participate in the state exchange; and the third, which did not make it out of committee, would have created a program similar to Medicaid for undocumented-immigrant adults. All three provide insight into the current opportunities and challenges for state-level innovation to expand health coverage.

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Also, Listen Now:  Interview with Rachel Fabi on recent legislative measures to extend insurance coverage for undocumented immigrants in California. (6:08)

 

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