500K Undocumented Immigrants Could Be Added To Medi-Cal Rolls

As many as half a million undocumented immigrants who qualify for deferred deportation could become eligible to enroll in Medi-Cal if President Obama's executive action on immigration goes into effect, according to a policy brief released Wednesday, the Los Angeles Times reports. Medi-Cal is California's Medicaid program.

The brief was released by the UC-Berkeley Center for Labor Research and Education and the UCLA Center for Health Policy Research (Karlamangla, Los Angeles Times, 3/25).

Background

In November 2014, Obama announced a plan to allow up to five million undocumented immigrants who have lived in the U.S. for at least five years and who have no record of felony offenses or serious misdemeanors to apply for a program to avoid deportation (California Healthline, 11/21/14). In addition, Obama expanded the Deferred Action for Childhood Arrivals program (Los Angeles Times, 3/25).

The DACA program grants undocumented children legal status and authorization to work in the U.S. for two-year periods. Although Medicaid expansion under the Affordable Care Act bars coverage for undocumented immigrants, a caveat in California allows those with "deferred action status" to gain coverage.

Under federal law, undocumented immigrants still are not eligible for health benefits through the ACA's exchanges (California Healthline, 11/21/14).

Hundreds of Thousands Could Become Eligible

According to the Times, several states sued to stop Obama's plans, and a federal judge in Texas ordered a temporary injunction.

However, if the injunction is lifted, about 1.25 million undocumented immigrants in California could become eligible for some sort of relief within the state.

Of those, about 66% would be eligible for Medi-Cal coverage based on their income, according to the policy brief (Los Angeles Times, 3/25).

Specifically, the brief estimates that between 360,000 and 500,000 undocumented immigrants who qualify for DACA or Deferred Action for Parents of U.S. Citizens and Lawful Permanent Residents would become eligible for Medi-Cal. However, researchers do not expect all of those who become eligible to actually enroll (Lucia et al., UC-Berkeley/UCLA brief, 3/26).

Nadereh Poura, a UCLA professor and co-author of the brief, said, "There are several steps [to becoming eligible and enrolling], and all those hurdles have to be cleared."

Extra Beneficiaries Could Strain Medi-Cal

Some stakeholders have expressed concerns that the Medi-Cal program would not be able to keep pace with such an increase in demand, the Times reports.

The program currently covers more than 12 million residents -- nearly one-third of the state population.

Observers have said that adding hundreds of thousands of new enrollees to Medi-Cal could result in the program being unable to:

• Cover its costs, which currently total $18 billion annually; and
• Maintain enough physicians to provide care to new beneficiaries.

State Sen. Ed Hernandez (D-West Covina), who supports expanding Medi-Cal coverage, said, "There's just a lot of work that's still left" (Los Angeles Times, 3/25).