Will Harris offer health insurance to immigrants? Look no further than California

Actions speak louder than words. That adage is worth remembering as Vice President Kamala Harris and her running mate, Minnesota Gov. Tim Waltz, try to minimize their record of providing health care to those in the country illegally.

Walz signed into law in Minnesota which allowed such immigrants to access the state’s free health care program for low-income residents, among other public benefits. When asked about it, the governor could only say, “Well, it’s not the position of vice president.”

Harris, meanwhile, shied away from any clear explanation of her position. During the presidential elections in 2019, she was an active supporter of “Medicine for All”, including those who are in the country illegally.

Now campaign leaders insist that is no longer her position. But Harris herself did not directly reject Medicare for All.

“60 minutes” host Bill Whitaker asked her about it this month. “You were for Medicare for all, now you’re not. People don’t really know what you believe or what you stand for. And I know you heard that,” Whitaker said.

Harris responded that she believed in “consensus building.”

So what might a Harris presidency do for health care? Perhaps her home state of California offers some clues.

The Golden State has done more than any other state to expand Medicaid eligibility for unauthorized immigrants. The effort, launched during Harris’ tenure as California attorney general, allowed 1.8 million non-citizens to qualify for Medi-Cal, the government’s version of the program, at enormous cost.

In January, the last stage of this expansion took effect, obliging state taxpayers to cover the medical care of 700,000 people. unauthorized immigrants of working age. California’s nonpartisan Office of Legislative Analysts projected that the new benefit would cost more than $1.2 billion in the first six months and $3.1 billion a year after that.

Medi-Cal covers more than 14 million Californians — about a third of the state’s population. In June, Gov. Gavin Newsom and the Legislature had to try to close a budget deficit of nearly $47 billion for this fiscal year.

Enrolling more unauthorized immigrants will further strain the program.

Medi-Cal is almost a tipping point. To control rising costs, it pays providers some of the lowest reimbursement rates in the country. Hospitals receive only 74% of what it costs them to serve Medi-Cal beneficiaries. This is evidenced by the report for 2023 more than half of California’s hospitals were losing moneyand one in five faced the threat of closure.

The country cannot afford to let the politics of Harris’ home state become national. All the problems currently plaguing California’s health care system — overcrowding, underfunding and rising costs — will spread across the country.

With 11 million unauthorized immigrants currently in the United States, the strain on already overburdened Medicaid programs will be unsustainable.

Even without a California-style expansion, state and federal taxpayers have spent $16.2 billion on emergency health care for undocumented immigrants through Medicaid since the Biden-Harris administration took office.

Medicaid spending is already out of control. According to the latest federal data, it will grow 10% to more than $800 billion nationwide in 2022. The Centers for Medicare and Medicaid Services predict that spending on the program will top $870 billion next year.

Harris and Waltz are trying to campaign as centrists. But their results are significantly to the left of the average voter, especially on health care. Taxpayers cannot afford the involuntary Medicaid expansion that Harris plans for the rest of the country.

Sally K. Pipes is president, CEO, and Thomas W. Smith Fellow in Health Policy at the Pacific Research Institute. Her latest book is False Premise, False Promise: The Disastrous Reality of Health Care for All (Encounter 2020). Follow her on X: @sallypipes .