Advocates: Extending Medi-Cal to Undocumented Kids a First Step

Advocates say that a provision in the fiscal year 2015-2016 state budget that extends Medi-Cal coverage to undocumented children is an important step but that several barriers to access remain, Kaiser Health News reports (Gorman, Kaiser Health News, 7/7). Medi-Cal is California's Medicaid program.

Background on Budget

Last month, Gov. Jerry Brown (D) signed a $167.6 billion state budget that includes funding to expand Medi-Cal to undocumented children.

Under the budget deal, the state in May 2016 will begin extending Medi-Cal coverage to about 170,000 undocumented immigrant children under age 19. The expansion is projected to cost $40 million in the next fiscal year and about $132 million annually following implementation (California Healthline, 6/25).

Advocates Praise Decision, but Note Barriers

Advocates have largely praised the inclusion of Medi-Cal coverage for undocumented children in the budget plan.

Aracely Patchett, an administrator at the Anaheim-based Central City Community Health Center, said the change will enable staff at the facility to refer children for specialty care.

Laurel Lucia, a health care program manager at UC-Berkeley's Center for Labor Research and Education, said offering Medi-Cal coverage to undocumented children is a good long-term investment for the state.

In addition, Carmela Castellano-Garcia, president of the California Primary Care Association, said the move will improve the bottom lines of community health centers, which have been treating such patients without reimbursement.

However, advocates noted that some undocumented immigrants might be hesitant to enroll their children in Medi-Cal.

Jacqueline Curiel, an administrator for the AltaMed Health Services Community Health Center in Santa Ana, said, "There is a lot of distrust" among undocumented immigrants. She added that many undocumented Californians are concerned that enrolling their children in Medi-Cal could jeopardize their family's chances of obtaining legal immigration status.

Daniel Zingale, senior vice president at the California Endowment, said, "We have a big challenge ahead of us to dispel the perception that undocumented people are forever left out." Zingale said community clinics, religious groups and ethnic media outlets likely will play a role in encouraging undocumented immigrants to enroll their children.

Calls for More Access, Expanded Coverage

Despite approving of the plan, some advocates say that the state still must do more to guarantee newly covered children have access to providers and to expand health coverage to undocumented adults.

According to KHN, there are about 1.16 million undocumented, low-income adults in California who do not qualify for full Medi-Cal coverage.

Claire Brindis, director of UC-San Francisco's Institute for Health Policy Studies, said that while extending Medi-Cal coverage to undocumented children "is an important investment ... it is not the full solution."

Meanwhile, opponents of further expanding Medi-Cal coverage say that California residents should not be responsible for funding health care for undocumented immigrants.

John Eastman, a professor of law at Chapman University in Orange, said, "We're talking about transferring tens of millions of dollars from taxpayers -- citizens and lawful permanent residents -- to those who have flouted our nation's immigrations laws."

Next Steps

A bill (SB 4), by state Sen. Ricardo Lara (D-Bell Gardens), would extend Medi-Cal coverage to undocumented adults in California, contingent on available funding. The measure also aims to enable such individuals to purchase unsubsidized health coverage through Covered California (Kaiser Health News, 7/7).

A similar bill stalled in a legislative committee last session after lawmakers failed to find funding to cover its estimated annual cost (California Healthline, 5/5).