Lara, the head of the Legislature's Latino caucus, plans to introduce legislation that would allow people who are not legal residents to get coverage, the Los Angeles Times reported Friday.
"Immigration status shouldn't bar individuals from health coverage, especially since their taxes contribute to the growth of our economy," he said.
There's a big roadblock, however. Federal law bars those in the country illegally from obtaining coverage through Covered California, the state health insurance exchange.
Lara said he's looking for other options, including expanding Medi-Cal, the state's health program for the poor, or creating a separate program within or outside of Covered California that might provide subsidies from the state but not the federal government.
The senator is also considering modeling his plan on local programs like Healthy Way LA Unmatched, which pays for care for Los Angeles residents who aren't covered by Medi-Cal, including those who don't qualify because of immigration status.
The Times said California has for decades covered legal immigrants not eligible for the federal Medicaid program, such as those who have been in the country less than five years. The state pays all of their Medi-Cal costs instead of splitting the cost with the federal government as it does for most Medi-Cal patients.
"The same logic could apply to other populations" such as noncitizens, said Anthony Wright, executive director of Health Access, an advocacy group working with Lara to fashion a bill. "There is precedent for California to be a leader. There is precedent for California to piggyback on federal programs but take an extra step to expand to additional folks."
Lara's plan was criticized by some Republican lawmakers, including Assemblyman Tim Donnelly of Twin Peaks, who's running for governor.
"California cannot afford to create another incentive to attract people to come to our state illegally in pursuit of taxpayer-subsidized benefits," Donnelly told the Times.