California becomes first state to provide health insurance to all eligible undocumented adults


Undocumented Californians are leaving health care clinics with smiles when they learn they are newly eligible for Medi-Cal insurance. Immigrant advocates for health insurance expansion have been in the works for decades.

This is an Espaol article.

Perla Lopez handed Baudeleo a stack of papers, a 44-year-old undocumented immigrant and day laborer. He has helped them apply for Medi-Cal at St. John’s Community Health’s benefits center in South Los Angeles.

If you see anything in the county you don’t understand, come back here, Lopez says to Baudillio in Spanish.

Application takes less than 20 minutes. The paperwork, though brief, marks a major milestone in the decades-long expansion of health care for undocumented immigrants in California.

Starting Jan. 1, for the first time, undocumented immigrants of all ages will qualify for Medi-Cal, the state health insurance program for extremely low-income people. This makes California the only state to provide funding for comprehensive health care for undocumented immigrants.

Baudillio, who was previously denied coverage and asked that his last name not be published to protect him from immigration officials, will join more than 700,000 undocumented immigrants between the ages of 26 and 49 who are eligible for Medicare. -Will become eligible as part of Cal. The final expansion of the program has been described as the realization of a long-awaited dream for Californians without legal status.

“This is literally the culmination of decades of work, and it’s huge,” said Sarah Darr, policy director of the California Immigrant Policy Center. It’s huge because of all the work, effort, and advocacy that went into making it possible, and it’s even bigger because of the impact it has had.

Governor Gavin Newsom and the state’s Democratic-led legislature have committed more than $4 billion annually to Medi-Cal expansion. Newsom’s 2022 budget made the latest expansion possible, and although the state is now headed for a $68 billion deficit, advocates say the positive impact Medi-Cal will have on individual health is invaluable.

This change is deeply connected to Lopez, who himself is undecided.

Last year, when the state expanded Medi-Cal to immigrants over 50, Lopez’s mother was finally able to get medication and blood testing equipment for her diabetes. This year, surrounded by tinsel and other Christmas decorations in a brightly lit office, Lopez is glad she gets the chance to deliver good news to undocumented patients.

“It really touches me,” said Lopez, who is eligible to work through the Deferred Action for Childhood Arrivals program. This is a stress that we take away from them. For people with health problems, Medi-Cal really makes a difference.

Medi-Cal document at St. John’s Community Health in Los Angeles on December 19, 2023. Undocumented adults will become eligible for Medi-Cal health care coverage in the new year. Photo by Lauren Justice for CalMatters

The clinic where Lopez works estimates that about 13,000 of its patients will become eligible for Medi-Cal in the new year. They’re part of the largest group in California’s ambitious plan to close the insurance gap. Nearly half of the enrollees expected to qualify for Medi-Cal are in Los Angeles County alone.

This is an exciting moment for us as well as our patients,” said Anne Urga, benefits consultant coordinator at St. John’s Community Health. they are ready. Many of them require or are waiting for visits from specialists.

California’s health insurance expansion

The last expansion took place nine years after the then government. Jerry Brown signed legislation making undocumented children eligible for state insurance in 2015, and it’s thanks to the efforts of advocates trekking to the Capitol to plead their case.

When we talk to people who are affected by this, the difference it makes in their lives really can’t even be described in numbers and words, said Darr of the California Immigrant Policy Center. In many cases people have been living without any type of health care for decades.

Full-scope Medi-Cal, which provides access to primary and preventive care, specialists, pharmaceuticals and other wraparound services, will change lives, Dar said. California does not share immigration information with federal authorities, and enrolling in Medi-Cal will not jeopardize your chances of pursuing legal residency, known as the public charge rule.

The California Immigrant Policy Center, along with the consumer advocacy group Health Access California, has been a leading force in the campaign to eliminate citizenship requirements for Medi-Cal. The task was not easy even in left-leaning California. Many moderate Democrats voted against the legislation or avoided paying attention to the debate in the early days, but gradually, public opinion and political will changed, Darr said.

According to a survey by the Public Policy Institute of California, about 66% of California adults supported health coverage for undocumented immigrants in March 2021, up from 54% in 2015.

Former Republican President Donald Trump criticized California’s expansion to young adults in 2020, claiming that California and other states would bankrupt our country by providing free taxpayer-funded healthcare to millions of illegal aliens. Elected California Republicans, though less harsh in their condemnation of the state’s immigration policies in recent years, have accused Newsom of overburdening the state budget and the Medi-Cal system.

Medi-Cal is already strained by serving 14.6 million Californians, more than a third of the state’s population. The Senate Republican Caucus said in a January 2022 budget analysis that adding 764,000 more individuals to the system would certainly exacerbate current provider access problems.

Benefits counselor Perla Lopez assists an undocumented adult at St. John’s Community Health on December 19, 2023 in Los Angeles. Undocumented adults will become eligible for Medi-Cal health care coverage in the new year. Photo by Lauren Justice for CalMatters

Newsom, for his part, has played a key role in leading the movement, said Rachel Lynn Gish, communications director for Health Access California. Newsom, who took office in 2019, campaigned on a promise to establish universal health care in California, and advocates have spent his governorship pushing him to follow through on that promise.

You can’t talk about coverage for everyone if you’re not talking about coverage for everyone, regardless of their immigration status, Lynn Gish said. Gov. Newsom made this a major platform of his from day one, and I think it’s hard to reconcile those two things.

Still, Newsom has faced pressure to do more for undocumented immigrants, and to do it faster. Advocates and some legislators lobbied Newsom to enact this final extension as soon as possible, in part because COVID-19 has taken a disproportionate toll on essential workers, many of whom are undocumented.

The expansion is estimated to cost more than $835 million over the next six months and more than $2.6 billion annually thereafter. Previous expansions, which opened the door to more than 1.1 million undocumented enrollees, cost the state about $1.6 billion annually, according to Office of Legislative Analysis reports. The total $4 billion price tag, although significant, represents a fraction of Medi-Cal’s massive $37 billion budget.

Still, many undocumented Californians will remain ineligible for health insurance. Nearly half a million immigrants earn too much money to qualify for Medi-Cal but still can’t afford private insurance. Advocates want to expand Covered California to include that population, but that’s unlikely in the near future as the state deficit grows.

Health disparities among undocumented immigrants

Undocumented immigrants often avoid medical care, making it difficult to compare their health with that of other Californians. Some studies indicate that they experience higher rates of chronic conditions such as heart disease, asthma, and high blood pressure. Immigrants without legal status in California are more likely to suffer from mental distress and self-report poor health.

Dr. Efrain Talamantes, chief operating officer of AltaMed in Los Angeles, California’s largest federally qualified health center, said he often sees young, undocumented individuals who feel healthy but are already suffering the ultimate damage of chronic conditions. We are struggling with problems that have not been detected.

This change will allow Talamantes and others serving those communities to deliver affordable, high-level care to patients. Although California provides emergency Medi-Cal to many undocumented immigrants and some counties fund their own programs, services can be disorganized with wait times of months.

When these patients now receive Medi-Cal and are part of a managed care health care plan with us, we are responsible for their entire care, from primary and specialty to hospital care, Talamantes said.

Benefits counselor Perla Lopez assists Wilder, 41, at St. John’s Community Health on December 19, 2023 in Los Angeles. Wilder will become eligible for Medi-Cal health care coverage in the new year. Photo by Lauren Justice for CalMatters

One such person is Miriam Pozuelos. The Los Angeles-area mother said the expansion has taken a huge financial burden off her family. She and her husband pay out of pocket for any medical services, and often go without. Both have already applied for full-scope Medi-Cal for January.

“When my family and I heard about this expansion, we were really hoping that it would actually come true and that we could start getting the care that we need and we are excited about this,” Pozuelos said in Spanish. Don’t worry that I have to pay this huge bill.

Back at the St. John’s Community Recovery Center, Lopez helps another undocumented immigrant renew her emergency Medi-Cal, which will automatically be covered at full coverage next month. Wilder, 41, who requested his last name be withheld to protect himself from immigration officials, said he needed two root canals totaling $8,000. Wilder said he searched for a cheaper alternative for months without success. He also needs medicine for high blood pressure but can’t always afford it.

The Medi-Cal expansion means he’ll finally be able to take care of his own health, he said.

It’s good to see him leave happy and smiling, Lopez said. Even if it takes us three hours, they leave with a sense of relief that they can see a doctor.

Supported by the California Health Care Foundation (CHCF), which works to ensure People need the care they need, at a price they can afford. visit to find out more.

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