California becomes first state to offer health insurance to all eligible undocumented adults
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Perla Lopez hands a stack of papers to Baudeilio, a 44-year-old undocumented immigrant and day laborer. She has just helped him apply for Medi-Cal at the benefits center at St. John’s Community Health’s in South Los Angeles.
“If you see anything you don’t understand from the county, come back here,” Lopez tells Baudeilio in Spanish.
The application takes less than 20 minutes. The paperwork, though brief, marks a major milestone in California’s decades-long expansion of health care for undocumented immigrants.
Beginning Jan. 1, for the first time, undocumented immigrants of all ages will qualify for Medi-Cal, the state’s health insurance program for extremely low-income people. It makes California the only state to fund comprehensive health care for undocumented immigrants.
Baudeilio, who has been denied coverage before and asked that his last name not be published to protect him from immigration authorities, will join more than 700,000 undocumented immigrants between the ages of 26 and 49 who will become eligible for Medi-Cal as part of the state’s final expansion of the program — the realization of a long-awaited dream for Californians without legal status.
“This is the culmination of literally decades of work, and it’s huge,” said Sarah Darr, policy director for the California Immigrant Policy Center. “It’s huge because of all the work and effort and advocacy that went into making this possible, and it’s also huge because of the impact that it’s going to have.”
Gov. Gavin Newsom and the state’s Democratic-led Legislature have committed more than $4 billion to the Medi-Cal expansion annually. Newsom’s 2022 budget made the latest expansion possible, and though the state is now headed into a $68 billion deficit, advocates say the positive impact Medi-Cal will have on individual health is priceless.
The change resonates deeply with Lopez, who is herself undocumented.
Last year, when the state expanded Medi-Cal to older 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 the brightly lit office, Lopez is happy she gets 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. “It’s a stressor we take away from them…For people with health issues, Medi-Cal really makes a difference.”
The clinic where Lopez works estimates 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. Los Angeles County alone accounts for roughly half of the enrollees who are expected to qualify for Medi-Cal.
“It’s an exciting moment for our patients as well as for us,” said Annie Uraga, benefits counselor coordinator at St. John’s Community Health. “They’re ready. Many of them are in need or waiting for specialist visits.”
California’s health insurance expansion
The final expansion comes nine years after then-Gov. Jerry Brown signed the law making undocumented children eligible for state insurance in 2015, and is due to the efforts of advocates trekking to the Capitol to plead their case.
“When we talk to people who are impacted by this, the difference it makes in their lives is something that truly numbers and words cannot even describe,” Darr with the California Immigrant Policy Center said. “In many cases people have lived for decades without any kind of health care whatsoever.”
Full-scope Medi-Cal, which offers access to primary and preventive care, specialists, pharmaceuticals, and other wraparound services, will change lives, Darr said. California does not share immigration information with federal authorities, and enrolling in Medi-Cal will not threaten chances to pursue legal residency, something known as the public charge rule.
The California Immigrant Policy Center along with consumer advocacy group Health Access California have been the leading force in the campaign to eliminate citizenship requirements for Medi-Cal. The work was not easy even in left-leaning California. Many moderate Democrats voted against the legislation or refrained from weighing in on the debate in the early days, Darr said, but slowly, public opinion and political will shifted.
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