Some lawmakers in California want to use savings from the coming Medicaid expansion to fund health insurance for those who don't already qualify, including people who migrated to the United States illegally.

Administered on a county level, the program would provide residents — with legal and illegal status alike — basic health insurance, allowing them to see a physician and receive preventive care. Such uninsured people often wait for problems to worsen and then seek treatment at a hospital emergency room, for which the U.S. guarantees universal coverage. However, the Institute of Medicine (IOM) estimates that 18,000 Americans die every year for lack of basic health coverage, with many more suffering serious health problems.

Aside from the human cost, the country loses $65 billion to $130 billion per year in wages and benefits for workers, a figure that would fall to $39 billion to $69 billion were health coverage provided to the estimated 46 million uninsured Americans.

California Senate Pro Tem Darrel Steinberg said he supported the initiative, which would be funded by an estimated $700 million in county savings from the expansion of the Medi-Cal program. "I think that people who are living in this country, working hard and pursuing [citizenship] ought to be able to care for themselves and their loved ones," he said.

Opponents of illegal immigration, however, criticized the plan. "It will hurt law-abiding citizens by taking money from them to fund the health care of criminals," Barbara Coe of the California Coalition for Immigration Reform said.

Gov. Jerry Brown, a Democrat, made no statement on the issue. However, neither the governor's budget proposal nor the federal governemt would fund the initiative, said Toby Douglas, director of the state Department of Health Care Services.

A private health care foundation, California Endowment, is now running television advertisements in support of the scheme, questioning the wisdom of denying illegal residents access to health care.

"Doesn't it make more sense to keep us all healthy, instead of treating us after we get sick?" the advertisement asks.

It is unclear how the state would compel counties to expand coverage to such residents, whether by compulsion or by passing down incentives.