A bill to provide state subsidized health care to some low-income immigrants in the U.S. illegally and allow those who can afford it to buy their own insurance cleared the State Senate Tuesday and will now go to the Assembly.

Sen. Ricardo Lara (D-Bell Gardens) authored the bill, SB 4, known as the Health for All Act, to extend health coverage because unauthorized immigrants are not eligible to buy insurance under the Affordable Care Act. If it is approved, California would become the first state to offer health insurance to those in the country without permission.

Initially the bill was more expansive, offering state subsidized insurance to all immigrants here illegally, but it was scaled back to address concerns about cost. According to the Public Policy Institute of California there are about 2.6 million unauthorized immigrants in the state - more than half live in Southern California. Experts estimate more than 1 million unauthorized immigrants are uninsured.

The bill the Senate approved was amended last week and has three main provisions:

Allows those in the U.S. illegally to purchase unsubsidized health insurance through Covered California if the federal government grants permission;

Provides access to Medi-Cal for those 19 and under regardless of immigration status;

Extends Medi-Cal access to adults over 19 regardless of immigration, if funding is available.

Lara called the vote a "decisive step forward"

"Providing quality health care to hundreds of thousands of kids in California will be transformational to thousands of families," Lara said about the bill. "Ensuring every kid in California grows up healthy with an opportunity to thrive and succeed is the right thing to do."

The estimated annual cost of the bill ranges from $280 million to as high as $740 million. The range is so wide because of the federal programs that may allow some unauthorized immigrants to get temporary legal status, which would make them eligible for Medi-Cal.

Community activists are optimistic about the future of the bill.

“The future of California depends on all children and their families having access to the quality health coverage and care they need to survive and thrive," said Alex Johnson, executive director of the Children's Defense Fund.

Opponents of the bill argue it will overburden the state financially at a time when the budget is already stretched and they worry access to health insurance would serve as a beacon for future waves of unauthorized immigration to the state.

