Debra J. Saunders: Health care for California’s undocumented — pols win, doctors lose.

“There are also those who claim that our reform effort will insure illegal immigrants. This, too, is false — the reforms I’m proposing would not apply to those who are here illegally,” President Obama proclaimed in a 2009 speech to Congress. It was a memorable event in part because Rep. Joe Wilson, R-S.C., shouted, “You lie.” Editorial-page umbrage followed.

This month, the California Senate proved that, while Wilson was wrong to heckle the president, he had reason to challenge the sincerity of Obama’s pledge. By a 28-11 vote, the Democratcontrolled state Senate became the first U.S. legislative body to vote to expand health care to undocumented immigrants. Senate Bill 4 by state Sen. Ricardo Lara, D-Bell Gardens (Los Angeles County), would allow undocumented Californians to buy Affordable Care Act policies (assuming the feds grant a waiver), authorize residents up to age 19 to enroll in Medi-Cal regardless of immigration status and allow some adults to enroll in Medi-Cal regardless of immigration status.

This is how change happens. Last year, Lara’s first “Health for All” bill promised health care to all California residents regardless of immigration status. The tab was $1.3 billion. It was too pricey, so he peeled it back, and back some more — to a projected $135 million. How? The bill that passed the state Senate provides Medi-Cal to minors regardless of immigration status, but no subsidy for undocumented residents who want to purchase private plans through Covered California, absent a federal subsidy. Also, SB4 puts a cap on unauthorized adults applying for Medi-Cal. When it looks as if the funding will run out, the state probably will not accept new enrollees.

What is the cap on undocumented enrollees? Don’t know. “The cap would depend on budget allocations to be decided next year,” answered Lara spokesman Jesse Melgar.

In a way, it doesn’t matter. If SB4 becomes law, the camel’s nose will have penetrated the tent. Within six years of the president promising that immigrants in the country would not be eligible for Obamacare — presumably because that would be wrong — the first state will have bypassed that promise. You just know that Sacramento will continue to push to expand the number of undocumented immigrants eligible for benefits. No one ever told the Democratic Legislature, you cannot say “yes” to everyone.

Sure, Sacto solons look generous waving Medi-Cal before some 1 million undocumented immigrants. But with Medi-Cal paying doctors as little as $16 for a patient visit, many physicians are refusing to take more Medi-Cal patients. Pols don’t care if already there are not enough doctors to pay for the program’s existing 12 million recipients. They look good; the docs look greedy.

As it is, Medi-Cal provided “limited scope” benefits — pregnancy care, emergency care and long-term care — to 786,600 unauthorized immigrants last year. If you want more of something, reward it. If California offers “full scope” coverage to people if they come here illegally, opined Jon Fleischman, publisher of the conservative FlashReport, “There is no amount of border security that you can erect that will come between smart people and free stuff.”

While their GOP caucus opposed the bill, two Republican senators voted for it. “There is a cycle that occurs when one party becomes so dominant that the other party finally stops fighting,” Fleischman observed. And really, why speak against the bill? To point out any negative consequences is to invite the left to brand you as heartless and racist. A Senate analysis lists more than 70 groups that support SB4, but not one opponent.

One of the GOP yes votes, state Sen. Anthony Cannella of Ceres (Stanislaus County), told me he sees the measure as a “moral issue.” Undocumented immigrants work hard, he said, but have “no rights,” even though they have been “contributing to our way of life.” When immigrants try to cross the border, they see two signs, he added, “One says, ‘Do not enter.’ The other says, ‘Help wanted.’ ”

Cannella said the answer is better enforcement of the border.

While 11 Republican state senators voted against SB4, they were low-key in their opposition. When a bill is going to pass anyway, why throw out red-meat quotes that will be used against you in the next election? State Senate Minority Leader Bob Huff of Diamond Bar (Los Angeles County) called the bill’s intent “admirable. But without money from Congress and President Obama, it will be very difficult and costly for California taxpayers to fund all of these bill proposals.” Smart, earnest, boring tone. This is one Republican who knows better than to point out that Democrats lied when they promised Obamacare would not apply to undocumented immigrants.

Asked if he’ll sign or veto SB4, Gov. Jerry Brown told a reporter, “there’s not a lot more money to be spent” on top of what he allocated in his revised May budget. In this one-party state, only Democratic Gov. Brown can save Californians from a Legislature that can’t say “no” to a chance to spend other people’s money.