California Becomes First State To Offer Health Insurance To All Eligible Undocumented Adults
finally
Undocumented Californians leave health clinics "smiling" after learning they qualify for Medi-Cal. It's been decades since health insurance expansion was achieved for immigrant attorneys.
This article is in Spanish.
Perla Lopez handed a stack of papers to Baudelio, a 44-year-old undocumented migrant and day laborer. She helped apply for Medi-Cal at San John's Community Health Center in South Los Angeles.
"If you see something around you that you don't understand, come back here," Lopez Baudelio said in Spanish.
Filling out the application does not take more than 20 minutes. While the document is brief, it is an important step in a decades-long expansion of health care for undocumented immigrants in California.
Starting Jan. 1, for the first time, undocumented immigrants of all ages will be eligible for Medi-Cal, the government's health insurance program for very low-income people. This makes California the only state to offer universal health care to undocumented immigrants.
Baudelio, who was previously denied coverage and asked that his last name not be published, joins the ranks of 700,000 undocumented immigrants between the ages of 26 and 49 who are eligible for Medi-Cal. The latest expansion of the state program is a long-held desire for undocumented Californians.
"This is the culmination of decades of work, and it's huge," said Sarah Durr, policy director of the California Immigration Policy Center. "The work and effort and advocacy that goes into making this happen and the impact it creates is incredible."
Gov. Gavin Newsom and the state Legislature, led by Democrats, have allocated more than $4 billion a year to expand Medi-Cal. Newsom's 2022 budget allowed for the last possible expansion, and while the state is now headed for a $68 billion deficit, advocates say the positive impact Medi-Cal can have on a person's health is invaluable.
The change has had a profound effect on Lopez, who is undocumented herself.
Last year, when the state expanded Medi-Cal to immigrants over 50, Lopez's mother finally had access to medication and blood tests to screen for diabetes. This year, in a bright office surrounded by lights and other Christmas decorations, Lopez is excited to share the good news with undocumented patients.
"It really impressed me," said Lopez, who is eligible to work under the Deferred Action for Childhood Arrivals program. "We relieve stress...Medi-Cal helps people with health problems."
The clinic where Lopez works estimates 13,000 of its patients will be eligible for Medi-Cal in the new year. They are part of a larger group on an ambitious plan to close California's insurance gap. Los Angeles County alone accounts for about half of the enrollees who will be eligible for Medi-Cal.
"It's an exciting time for our patients and for us," said Annie Uraga, benefits consultant coordinator in St. Petersburg. John's Community Health. "They are ready, many need or are waiting for specialists to arrive.
Health insurance expansion in California.
The last expansion came nine years later: Gov. In 2015, Jerry Brun signed legislation to make undocumented children eligible for public insurance, thanks to the efforts of advocates who came to the Capitol to plead their case.
"When we talk to people who are affected by this, we see that the changes in their lives cannot be described in numbers or words," said Dar of the California Immigration Policy Center. "In many cases, people live without a health care system for decades. »
Full Scope Medi-Cal, which provides primary and preventive care, specialty care, pharmaceuticals and other comprehensive services, will change people's lives, Dare said. California doesn't share immigration information with federal authorities, and enrolling in Medi-Cal doesn't put them at risk of getting legal residency, called the public payment rule.
The California Immigration Policy Center, along with the consumer advocacy group Health Access California, is leading a campaign to eliminate Medi-Cal's citizenship requirements. Even in left-leaning California, the going was tough. Many moderate Democrats voted against the bill or abstained in early debates, but gradually public opinion and political will shifted, Dare said.
In March 2021, 66 percent of California adults supported health insurance for undocumented immigrants, up from 54 percent in 2015, according to a survey by the Public Policy Institute of California.
Former Republican President Donald Trump opposed California's youth expansion in 2020, accusing California and other states of "providing free, taxpayer-funded health care to millions of illegal aliens." Republican lawmakers in California have accused Newsom of straining the state's budget and health care system, despite becoming less critical of the state's immigration policies in recent years.
“Medi-Cal is struggling to serve 14.6 million Californians, more than one-third of the state's population. "Adding 764,000 more people to the system would exacerbate existing access challenges for providers," a group of Senate Republicans said in their January 2022 budget review.
Rachel Lynn Gish, director of communications for Health Access California, said Newsom was instrumental in moving the movement forward. This year, Newsom, who took office in 2019, campaigned on a promise to create universal health care in California, and his supporters have spent his entire state term fulfilling that promise.
"If you're not talking about coverage for everyone, regardless of immigration status, you can't talk about coverage for everyone," Lynn Gish said. "Governor Newsom has made that his main platform from day one, and I think it's hard to separate the two.
Still, Newsom is under pressure to do more and faster for undocumented immigrants. Advocates and some lawmakers have urged Newsom to speed up this latest expansion, in part because of the disproportionate impact of COVID-19 on the wages of essential workers, many of whom are undocumented.
The expansion is expected to cost more than $835 million over the next six months and $2.6 billion thereafter. Previous expansions opened the door to more than 1.1 million undocumented people, costing the state about $1.6 billion a year, according to previous reports from the Bureau of Legal Analysis. While the $4 billion total price tag is significant, it's only a small portion of Medi-Cal's massive $37 billion budget.
However, many undocumented Californians are ineligible for health insurance. About half a million immigrants earn too much to qualify for Medi-Cal but still can't afford private insurance. Advocates want to expand California's coverage to include this population, but the state's growing deficit makes that impossible in the near future.
Health disparities among undocumented immigrants
Undocumented immigrants often miss out on health care, making it difficult to compare their health to that of other Californians. Some studies show that chronic diseases such as heart disease, asthma and high blood pressure are on the rise. Undocumented immigrants in California suffer from depression and poor health.
Chief Operating Officer of AltaMed in Los Angeles, California's largest federal medical center, Dr. Efren Talmantes said he often sees undocumented youth who feel healthy but "always suffer from undiagnosed chronic illnesses." He said
This change will allow Talamantes and others serving these communities to provide accessible, quality care to patients. While California provides emergency medical care to many undocumented immigrants and some counties fund their own programs, the wait for those services can take months.
"Today, when these patients accept Medi-Cal and are part of our managed care plan, we get comprehensive coverage from primary and specialty care to hospital care," Talamantes said.
Miriam Pozulos is one of them. The Los Angeles mom said the expansion will ease the financial pressure on her family. She and her husband pay for medical care out of pocket and rarely go there. Both have already applied for full Medi-Cal for January.
"When my family and I heard about this expansion, we were really hoping that it would happen and that we could get the help we needed without worrying about, 'I'm going to have to pay this big bill,'" Pozulos said. . he said in spanish
At the San Juan Community Health Center, Lopez will help improve another undocumented immigrant emergency medical service that will be available online next month for full coverage. Wilder, 41, who asked that his last name not be used to protect him from immigration officials, said he needed two root canals totaling $8,000. Wilder said he had been looking for a cheaper alternative for months without success. He also needs blood pressure medication, but can't always afford it.
The expansion of Medi-Cal means she can finally take control of her own health.
"It's nice to see them leave happy and smiling," Lopez said. "Even if we have three hours, they will be relieved to go to the doctor."
With the support of the California Health Care Foundation (CHCF) , it ensures that people get the care they need, when they need it, at a price they can afford. For more information, visit www.chcf.org .
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