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In 2024, California will be providing expanded healthcare coverage for immigrants with low incomes.
Science & Health

In 2024, California will be providing expanded healthcare coverage for immigrants with low incomes.

Starting Monday, over 700,000 undocumented immigrants in California will receive free healthcare as part of one of the state’s most ambitious efforts to expand coverage in the past ten years.

This endeavor will eventually result in the state spending approximately $3.1 billion annually and brings California closer to the Democrats’ aim of offering universal healthcare to its approximately 39 million inhabitants.

In 2022, Governor Gavin Newsom and legislators in California made a decision to offer healthcare coverage to all low-income adults, regardless of their immigration status, through the state’s Medicaid program called Medi-Cal.

California is the most populous state to guarantee such coverage, though Oregon began doing so in July.

Two years ago, when Newsom suggested the alterations, he described the expansion as a significant move towards enhancing the healthcare system for all Californians.

When Newsom initially promised this plan, California had its biggest budget surplus ever. However, with the launch of the program scheduled for next week, the state is now dealing with a $68 billion budget shortfall, leading to doubts and worries about the potential financial consequences of the program’s expansion.

Republican Senator Roger Niello, who serves as the vice-chair of the Senate Budget and Fiscal Review Committee, stated that it is illogical for us to contribute to our deficit, regardless of one’s stance on the matter.

Advocates for immigration and healthcare have been advocating for these changes for over ten years. They believe that the increased coverage will address the issue of limited access to healthcare and also save the state money in the future. Undocumented residents often postpone or avoid seeking medical care because they do not qualify for most forms of coverage. This ultimately results in higher costs when they seek emergency treatment.

Dr. Efrain Talamantes, the chief operating officer at AltaMed in Los Angeles, the largest federally qualified health center in California, stated that this is a mutually beneficial situation as it enables us to offer comprehensive care and we are confident that this will promote the overall health of our communities.

This update will mark the biggest growth in healthcare coverage in California since former President Barack Obama’s Affordable Care Act was put into effect in 2014. This act enabled states to cover adults with incomes below 138% of the federal poverty level under their Medicaid programs. As a result, California’s percentage of uninsured individuals decreased from approximately 17% to 7%.

FILE - California Gov. Gavin Newsom speaks during a Clean California event in San Francisco, Nov. 9, 2023.

FILE – California Gov. Gavin Newsom speaks during a Clean California event in San Francisco, Nov. 9, 2023.

However, a significant portion of the population was excluded: adults who reside in the United States without legal authorization. They are unable to qualify for the majority of publicly-funded assistance programs, despite being employed and contributing taxes.

Certain states have allocated government funds to assist with the costs of healthcare for certain low-income immigrants. In 2015, California was the first state to provide healthcare benefits to low-income children without legal documentation, and later expanded the coverage to include young adults and individuals over the age of 50.

The final group of individuals, aged 26-49, will now be able to qualify for the state’s Medicaid program.

The exact number of individuals who will enroll through the expansion is unknown to the state. However, state officials estimate that over 700,000 people will receive full health coverage, enabling them to receive preventative care and other necessary treatment. This number is greater than the total Medicaid population in multiple states.

Anthony Wright, executive director of Health Access California, a consumer advocacy group, stated that there has been an asterisk placed on immigration status. He also emphasized that this is a significant issue from a numerical perspective.

Conservative groups and Republicans are concerned that the recent expansion will add to the already burdened health care system and criticized the expenses associated with it.

According to the nonpartisan Legislative Analyst’s Office, state authorities evaluated that the increase will require a one-time cost of $1.2 billion in the initial six months and a yearly cost of $3.1 billion from the budget. The Medi-Cal program, which currently has an annual budget of approximately $37 billion, is the second biggest expenditure in the California budget.

In December, officials from the state Department of Finance informed The Associated Press that they had received a letter requesting state agencies to reduce expenses due to the deficit. No specific instructions were provided regarding the expansion of Medicaid.

California’s expansion of Medicaid will face other challenges. The state is chugging through a review of Medicaid enrollees’ eligibility for the first time in more than three years that was prompted by the end of some federal pandemic policies. Many immigrants who had their coverage protected during the COVID-19 pandemic now find themselves ineligible because they no longer financially qualify.

John Baackes, the Chief Executive Officer of L.A. Care Health Plan, which is the largest Medi-Cal plan in the state with almost 2.6 million members, stated that approximately 20,000 members have had their Medicaid coverage terminated during the review process in the past year. These individuals are now seeking new insurance plans. Baackes’ organization is currently working to assist these individuals in navigating through both processes.

Baackes stated that individuals are constantly bombarded with a large amount of information. It is difficult to comprehend how someone would not be completely bewildered while trying to navigate through all of it.

“The phones are constantly ringing,” he stated.

Sarah Dar, the policy director for the California Immigrant Policy Center, stated that fear and distrust are obstacles to growth.

Numerous individuals who have immigrated to the United States are hesitant to participate in public assistance programs as they fear it may hinder their ability to obtain legal status due to the “public charge” regulation. This federal law demands that those seeking permanent residency or legal status demonstrate that they will not be a financial burden to the country. While Medicaid is no longer a consideration under President Joe Biden’s administration, the concern still persists, according to the source.

Dar explained that additional resources and effort are necessary to reach this particular population, as they have a history of being completely excluded and have not had any interaction with the healthcare system or government programs for a prolonged period of time.

According to Dar, there is still progress to be made in California in achieving a “universal coverage” goal, which would result in a zero uninsured rate for the state.

Unfortunately, individuals who are residing in the United States without legal authorization are currently unable to buy insurance through Covered California, the state’s exchange program that provides significant discounts for those who meet specific income criteria. However, there is a proposed legislation in the California Legislature, backed by the California Immigrant Policy Center, that aims to modify this restriction.

Dar stated that it will be a significant task and acknowledged that there has been a decrease in revenue. However, it is our responsibility to demonstrate that during times of economic decline, these are the communities that require the most assistance.