By Enrico A. Marcelli, Manuel Pastor, and Steven P. Wallace
Please note: reports dated earlier than June 2020 were published under our previous names: the USC Program for Environmental and Regional Equity (PERE) or the USC Center for the Study of Immigrant Integration (CSII).
The Affordable Care Act has had dramatic impacts on reducing the numbers of uninsured Americans. However, it explicitly left out one important segment of the population with a noticeable lack of access to health insurance and medical care: unauthorized immigrants.
While the politics of that decision were understandable, the consequences are problematic in states like California where an important share of the population (roughly seven percent) is undocumented and where an even larger share of children (nearly a fifth) have at least one undocumented parent.
Insurance matters, although the connection to health is sometimes tenuous and unclear. Still, most Americans would rather be with than without—and one clear connection that does promote individual well-being is the way in which medical insurance helps to reduce financial risk and stress.
The benefits also seem to accrue beyond the individual: there are broad public health benefits to having more people covered and the current undocumented population, which is often younger and healthier, could actually help improve risk in insurance pools.
While this makes access to health insurance an important issue for everyone in California, it is particularly important to a series of fourteen communities being supported by The California Endowment (TCE) under its “Building Healthy Communities” (BHC) program. These areas have significant undocumented populations that report very low rates of insurance coverage. When insurance is spotty, communities are forced to rely on a patchwork of county-level services aimed at providing indigent care as well as various philanthropic efforts seeking to expand the safety net.
Fortunately, the state seems to be recognizing that it needs to do better: recently passed legislation provides access to Medi-Cal for undocumented children in the state. This is creating a template for expansion to adults as well for potentially creating opportunities to buy health insurance in a market akin to that created by the state’s insurance exchange, Covered California.
Research suggests that expanding access to medical insurance could be a gain for the future of the state. But getting there requires not just facts but vision, values, and strategies. The fourteen BHC communities are working with others in a campaign called “Health4All” to try to build public will and remedy the gaps.
We suggest that the Golden State’s decision makers would do well to listen to their arguments: since mass deportation is unlikely and comprehensive immigration reform seems inevitable (even if distant), the real choice facing the state is whether or not we provide the right policies and programs for a healthy California.
Read our other publications by research area
Immigrant Integration & Racial Justice
Our work on immigrant integration and racial justice brings together three emphases: scholarship that draws on academic theory and rigorous research, data that provides information structured to highlight the process of immigrant integration over time, and engagement that seeks to create new dialogues with government, community organizers, business and civic leaders, immigrants and the voting public to advance immigrant integration and racial equity.
Economic Inclusion & Climate Equity
In the area of economic inclusion, we at ERI advance academic theory and practical applications linking economic growth, environmental quality, and civic health with bridging of racial and other gaps; produce accessible and actionable data and analysis through the data tools; and establish research partnerships to deepen and advance the dialogue, planning, and actions around racial equity, environmental justice, and the built environment.
Social Movements & Governing Power
ERI’s work in the area of governing power includes: conducting cross-disciplinary studies of today’s social movements, supporting learning and strategizing efforts to advance dialogues among organizers, funders, intermediaries, evaluators, and academics, and developing research-based social change frameworks and tools to inform—and be informed by—real-world, real-time efforts towards a vision of deep change.
In 2020, the USC Program for Environmental and Regional Equity (PERE) and the USC Center for the Study of Immigrant Integration (CSII) merged to form the USC Equity Research Institute (ERI).
The full list of publications published under our previous and current names can be found in our publications directory.