(NewsNation) — California is the first state in the U.S. to offer state health insurance for all undocumented immigrants meeting eligibility requirements. Beginning Jan. 1, undocumented immigrants, regardless of age, may qualify for Medi-Cal, the state’s health insurance program for low-income residents.
What’s happening?
In 2022, Democratic Gov. Gavin Newsom and lawmakers agreed to provide health care access to all low-income adults regardless of their immigration status through Medi-Cal.
At the time, Newsom called the health care expansion “a transformative step towards strengthening the health care system for all Californians.”
California first extended health care benefits in 2015 to low-income children without legal status. The state later added benefits for young adults 26 years old or younger in 2019. In 2022, a California law allowed undocumented adults ages 50 or older to receive health care. Now, the remaining group, adults ages 26-49, are eligible for California’s Medicaid program, as of Jan. 1.
The update marks California’s largest health care expansion since the 2014 implementation of the Affordable Care Act.
Who is eligible for Medi-Cal?
Medi-Cal income eligibility is based on household size. To qualify, residents must earn less than 138% of the poverty level based on the amount of people living in a home.
The income restrictions based on household size are:
- One person: 20,121 annual earning
- Two people: 27,214 annual earning
- Three people: 34,307 annual earning
- Four people: 41,400 annual earning
- Five people: 48,494 annual earning
According to the state’s Department of Health, people may also receive Medi-Cal if they are: 65 or older, blind, disabled, under 21, pregnant, living in a skilled nursing or intermediate care home, on refugee status for a limited time, or are a parent or caretaker relative of an age-eligible child.
How many immigrants will be impacted?
It’s unknown exactly how many people will enroll through the most recent expansion. But state officials estimate more than 700,000 people between the ages of 26 and 49 will gain full health coverage.
Even with the expansion, University of California Berkeley’s Labor Center reports there will still be 520,000 uninsured undocumented residents who make too much money to get Medi-Cal and who also do not have health insurance coverage through their employers.
How much will it cost?
The effort will eventually cost the state of California about $3.1 billion per year. It will reportedly cost $1.2 billion in its first six months.
Newsom committed to the health care expansion when California had the largest budget surplus in its history. But the state now faces a record $68 billion budget deficit. Spending for Medi-Cal is the state’s second-largest expense in its budget.
Critics say:
Those against the move have raised concerns about the possible economic ramifications of the expansion.
“Regardless of what your position is on this, it doesn’t make sense for us to be adding to our deficit,” Republican state Sen. Roger Niello, the vice-chair of the Senate Budget and Fiscal Review Committee, told The Associated Press.
Opponents also worry the expansion will place a strain on Medi-Cal and health care providers.
“Medi-Cal is already strained by serving 14.6 million Californians—more than a third of the state’s population. Adding 764,000 more individuals to the system will certainly exacerbate current provider access problems,” the California Senate Republicans wrote in response to Newsom’s budget proposal.
Supporters say:
Immigration advocates think giving people access to health care will keep them healthier and save California’s money long-term.
“It’s a win-win, because it allows us to provide comprehensive care and we believe this will help keep our communities healthier,” Dr. Efrain Talamantes, chief operating officer at AltaMed in Los Angeles, the largest federally qualified health center in California, told The Associated Press.
While research shows that immigrants use fewer healthcare resources than non-immigrants, supporters hope the expansion will encourage undocumented immigrants to get help.
“This is a really major step in California,” Nedy Velazquez, border policy coordinator at Alliance San Diego, told KFMB-TV. “A lot of undocumented people and a lot of low-income people, because they don’t have access to these resources, they wait until the very end to hopefully receive some care and by then it’s too late.”
Are other states providing coverage for migrants?
State data compiled by KFF Health News shows around a dozen states and the District of Columbia provide full health insurance coverage to more than 1 million low-income immigrants, regardless of legal status. The organization predicts that by 2025, enrollment in these programs could nearly double.
NewsNation’s Cassie Buchman and The Associated Press contributed to this report.
