With 48 of California’s 59 counties now providing medical coverage under the Affordable Care Act to the thousands of undocumented immigrants living in the state, the question now seems to be: Is the Golden State the forerunner in a greater movement to provide health care to those in the country illegally or is this just an anomaly in the system?
The controversial push began in early 2014, when state Sen. Ricardo Lara introduced legislation that would allow all immigrants to have access to government health insurance plans. It reached its zenith in June, when Gov. Jerry Brown signed a state budget that for the first time funded health care for children of undocumented immigrants.
"It's logical that California would be out front about this," Randy Capps, director of research for U.S. programs at the Migration Policy Institute, a nonpartisan think tank, told the Los Angeles Times.
Despite the large scale support at the county level for the issue, Californians are overall split down the middle and many observers say that this is because the debate over health care for undocumented immigrants has shifted from an ideological one to one about cost. The move by many California legislators to get all of the state’s 2.6 million undocumented immigrants covered cost Sacramento $1 billion annually.
This hefty price tag would be even more of an issue in other states across the country.
"I wouldn't mistake momentum inside California for momentum outside of California," Capps said.
The ruling by the U.S. Supreme Court this summer to uphold the Affordable Care Act, however, has given lawmakers and activists throughout the country hope that they can push new initiatives through — and some say California’s more progressive policies on the issue could help spur change quicker.
"I'm sure we'll inspire other states," said UCLA health policy professor Steven Wallace. "I think it's inevitable."
Wallace added that more states may follow California’s lead by extending coverage to children in the U.S. illegally because it's considered a small, healthy population, and is seen as a good investment because many eventually become citizens.
"Kids are kind of the low-hanging fruit of the undocumented," he said. "It's politically attractive, and not terribly expensive."