New York Mayor Bill de Blasio said Tuesday that the city will provide illegal immigrants with a way to obtain affordable health care as part of a broader program to cover city residents traditionally shut out of insurance options.

The liberal mayor said it is unacceptable that 600,000 city residents still lack options. They include immigrants who cannot access federal benefits but rack up costs anyway when they show up at emergency rooms.

Across the country, meanwhile, California Gov. Gavin Newsom announced a more targeted push this week to extend health care benefits to young adult illegal immigrants, placing them on par with U.S. citizens who can stay on their parents’ plans under Obamacare.

Taken together, the proposals reopen the thorny debate over providing taxpayer-funded benefits to people living in the U.S. illegally, an idea that flies in the face of Mr. Trump’s fight against illegal immigration and places that offer them sanctuary.

Mr. de Blasio said distinguishing between illegal immigrants and citizens doesn’t make sense for health care.

“We’re going to have a lot of people going to work sick and making everyone else sick,” the mayor said on MSNBC’s “Morning Joe” program. “We want a healthy society in every sense, and here is a way to invest upfront to get it right.”

Costs to taxpayers

Democrats broached the debate over government-sponsored care for illegal immigrants during the fight over Obamacare. Wary of losing critical support among moderate Democrats, the party decided to leave illegal immigrants ineligible for benefits.

Steven A. Camarota, director of research at the Center for Immigration Studies, said extending benefits could entice more people to stay in the U.S. illegally.

“The thing about it is it does point to kind of a fundamental problem where people say things like, ‘These folks can stay here but can’t end up on the public dole,’ ” he said. “You can’t have a situation where you have these folks [who] are allowed to stay year after year and not have politicians — maybe cravenly or maybe out of principle — begin to offer them more and more benefits.”

Others worry that an expansion would erode the quality of care for citizens.

Mr. de Blasio said it will cost the city about $100 million per year to fund health care services for illegal immigrants and legal residents.

The plan, dubbed NYC Care, would allow anyone to go to city health clinics, hospitals and 70 other locations and receive primary care, specialty care, prescription drugs and other services priced on sliding scale so patients can afford them.

The program will start this summer in the Bronx and is scheduled to reach all five boroughs by 2021.

Mr. Newsom’s plan is more modest in scope.

He wants to raise the age limit for illegal immigrants covered by Medi-Cal from 19 to 26, which would make California “the first state in the nation to cover young undocumented adults through a state Medicaid program,” the governor’s office said Monday, just hours after Mr. Newsom took office.

The state legislative analyst’s office calculated that it would cost about $140 million to extend full Medi-Cal services to illegal immigrants ages 19 to 26.

That is still not as sweeping as California Democrats’ previous attempts to extend state-funded health care to all illegal immigrant residents older than 19, which would cost an estimated $3 billion.

Campaign promises

“This is where the rhetoric of campaigning and making promises to many different base groups meets the reality of governing and trying to do so much or too quickly,” said David McCuan, a politics professor at Sonoma State University.

He called the Newsom plan “a building block” and said the new governor would likely be happy with that description.

Yet Mr. Newsom’s campaign promises were more expansive. He ran on a universal health care platform and will be working with a newly elected Democratic supermajority in the state Legislature.

Analysts say Mr. Newsom’s early push to cover young illegal immigrants would tap into a multibillion-dollar surplus left by Gov. Jerry Brown.

Skeptics said the cost of providing benefits for young illegal immigrants will soar over time. State estimates suggest it could reach more than $400 million by the 2020-2021 fiscal year.

“It’s going to be a pretty big number,” said Jon Coupal, president of the Howard Jarvis Taxpayers Association in Sacramento.

He noted that California already has the nation’s highest income tax — 13.3 percent — and the highest state sales tax at 7.25 percent, not including local add-ons.

“The question is, should California’s taxpayers bear the financial burden of bad immigration policies by progressives in the state of California and now at the national level?” Mr. Coupal said.

“In the same inaugural address, [Mr. Newsom] talked about being fiscally conservative, so you’re getting mixed messages from the governor,” he said. “There’s simply no way he can expand all these programs and pay for it without significantly raising taxes.”

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