Federal law prohibits charging the poorest Medicaid enrollees a premium, and Newsom’s $100 monthly payment would be considered unaffordable for current beneficiaries, said Laurel Lucia, director of the health care program at the University of California-Berkeley Labor Center.

California this year took the final step in opening Medi-Cal, its Medicaid program, to every eligible resident regardless of immigration status. It’s a significant expansion for an already massive safety net program.

An estimated 520,000 people in California would qualify for a Covered California plan if not for their lack of legal status, according to the labor research center at the University of California-Berkeley.

AB 4 would require Covered California, the state’s health insurance exchange, to offer health insurance policies to people who are otherwise not able to obtain coverage because of their immigration status, to the extent it can under federal law.

“It seems like a contradiction to say this law’s going to cost billions of dollars while at the same time saying it’s going to reduce workers’ total compensation,” said Lucia, who projects a far lower price tag.

The University of California-Berkeley Labor Center projected that the increase would boost wages for more than 469,000 health workers. The center estimates it would most benefit workers of color, who make up 70% of those workers, and women, who represent about three-quarters.

Medi-Cal, the state’s Medicaid program, has expanded coverage in recent years, notably to residents living in the county without legal permission. By 2024, approximately 92% of Californians under age 65 will be insured, the University of California-Berkeley Labor Center projected.

“The individual mandate was not intended to create funds for other government programs outside of health care,” said Democratic Assembly member Jim Wood, of Santa Rosa, chair of the Assembly Health Committee, at a heated budget hearing this spring. “The clear intent of the legislature was that this money was meant to go to affordability.”

Californians without legal status make up the largest portion of the state’s uninsured residents, estimated at 3 million by the UC Berkeley Labor Center.

While many Californians who earn too much to be eligible for Medi-Cal can get subsidized coverage through Covered California, an estimated 460,000 residents aren’t allowed to buy insurance through state-run insurance plans under the Affordable Care Act because they lack legal status.

Estimates from the UCLA Center for Health Policy Research and the UC Berkeley Labor Center show that 391,000 Californians previously excluded from subsidies in Covered California would be eligible for them under the new rule. Of those, an estimated 149,000 would likely enroll in a Covered California plan. Those switching from an employer-sponsored plan would save an average of $1,478 per person in 2023, according to the two centers.

If Gov. Gavin Newsom gets his way, California could allow all remaining low-income unauthorized immigrants — an estimated 700,000 people — to join Medi-Cal by 2024, or sooner.

California has a strong Medi-Cal takeup rate, with 95% of eligible people enrolled, said Laurel Lucia, director of the health care program at the Center for Labor Research and Education at the University of California-Berkeley. But of the remaining uninsured people, about 610,000 qualify for Medi-Cal, she said.

Los Angeles County officials attribute a dramatic decline in COVID-19 death and case rates among Blacks and Latinos over the past two months to aggressive workplace health enforcement and the opening of tip lines to report violations. Now, officials intend to cement those gains by creating workplace councils among employees trained to look for COVID-19 prevention violations and correct or report them — without fear of being fired or punished.