California: Holy Crap, how did I forget about this?? Up to 700,000 more undocumented immigrants to become eligible for Medicaid starting January 1st!

Good grief. I have no idea how I missed this legislation. I had read about and even written about it several times over the past several years, but I sort of lost track of it since the COVID pandemic hit.

Back in 2016, California passed a bill which extened eligibility for Medi-Cal (California's brand name for Medicaid) to around 170,000 undocumented children statewide...although this ultimately ended up resulting in around 250,000 children being added to the roles.

Then, in 2019, California's expansion of Medicaid to undocumented residents moved to the next phase: Around 100,000 more young undocumented adults aged 19 - 25 years old.

In May 2022, Medi-Cal was further expanded to cover perhaps 25,000 undocumented immigrants aged 50+.

Well, it turns out that there's one more phase to expansion of Medicaid benefits to undocumented Californians of any age...and it's the big one. Via Bernard Wolfson of KFF Health News:


On Jan. 1, immigrants may qualify for Medi-Cal regardless of legal status

The change is expected to add over 700,000 first-time enrollees.

...Milagro and her husband are among the more than 700,000 immigrants ages 26-49 expected to newly qualify for full health insurance come Jan. 1. That’s when California takes the final step in opening up Medi-Cal, the state’s health care program for low-income residents, to everyone who meets eligibility requirements, regardless of their immigration status.

Getting quality care through Medi-Cal can be a challenge, but this population — often household breadwinners who can’t afford to get sick — stand to gain far better access to services such as primary and specialty care, routine dental checkups, prescription medications, inpatient hospital care, lab tests, scans, and mental health services.

New enrollees will join more than 655,000 children, young adults through age 25, and adults 50 or over who have already signed up for Medi-Cal through previous expansions to residents lacking legal authorization, according to the most recent data from the state Department of Health Care Services.

(Yes, I'm aware that the numbers in the prior phases only add up to around 375,000. Some of the difference is due to population growth or simply underestimating either the popularity of the program or just how many undocumented residents of those age groups there actually are).

...Extending full Medi-Cal coverage to eligible individuals in the 26-49 age range regardless of immigration status is projected to cost the state $1.4 billion in the first six months and $3.4 billion a year upon full implementation.

The state’s estimate of just over 700,000 new enrollees is based on the number of people in the age group who are already signed up for a narrower set of benefits, known as “restricted scope” Medi-Cal, including Milagro. They will be automatically switched over to full Medi-Cal on Jan. 1. The state has begun mailing notices informing them of expanded benefits and directing them to choose a Medi-Cal health plan unless they live in a county with only one plan.

The remaining residents in the 26-49 age range covered by this expansion will be harder to reach because the state does not know who, where, or how numerous they are. Patient advocates, community groups, and county welfare offices face a number of obstacles: language barriers, wariness of governmental agencies, and fear that signing up for public benefits could jeopardize the chances for legal residency.