Access to the Health Care Safety Net in California for Unauthorized Immigrants

Helen J. Lee, MDRC
Laura Hill, Public Policy Institute of California (PPIC)
Shannon McConville, Public Policy Institute of California (PPIC)

The Affordable Care Act (ACA) promises to greatly reduce the number of uninsured residents, yet several million in Californians will still lack health insurance. The largest group of California’s uninsured will be unauthorized immigrants (Long and Gruber 2011), and they will continue to rely on safety net providers for their health care needs. Our paper addresses two issues: (1) how unauthorized immigrants are distributed in relation to health care safety net providers in the state, and (2) what safety net providers in impacted communities are doing to prepare for changes post-ACA. Using a spatial analysis of unauthorized immigrants, community clinics, and hospital emergency departments at the zip code level, we identify areas of alignment and mismatch of unauthorized immigrants with current safety net resources. We then interviewed safety net providers and immigrant advocates in impacted areas to learn how they are preparing to serve this communities in the post-ACA environment.