Gov. Gavin Newsom is proposing to extend Medi-Cal coverage to all low-income, undocumented adults, a historic expansion that would make California the first state in the nation to provide universal health care access for all residents regardless of legal status. The plan is included in Newsom’s $286 billion state budget proposal, which is flush with a projected $45.7 billion surplus. Coverage would begin on Jan. 1, 2024 and would cost the state an ongoing $2.7 billion annually. The program’s launch in the 2023-24 fiscal year is expected to cost $819.3 million.
“Here’s the big one: California is poised to be — if this proposal is supported — the first state in the country to achieve universal access to health coverage,” he said during Monday’s announcement. “That mean means full-scope Medi-Cal, including long-term care, (In-Home Supportive Services), and behavioral health to all low-income Californians, regardless of immigration status.” The governor’s proposal would fill a gap in health care coverage for undocumented Californians.
Currently, undocumented people are eligible for Medi-Cal through age 26. Undocumented adults ages 50 and older will become eligible for Medi-Cal after May 1. Newsom in June 2021 proposed an ongoing $1.3 billion spending plan to expand Medi-Cal coverage to adults and seniors age 50 and over. Undocumented children were given extended coverage in 2016 and young adults up to the age of 26 also qualify for healthcare access under a plan passed in 2020. The state already offers some Medi-Cal coverage to undocumented individuals of all ages for emergency medical services and prenatal and maternity care. Assemblyman Joaquin Arambula, D-Fresno, who has long advocated for the proposal, said it was “exciting” and “transformative.” “Here in California, we don’t follow, we lead,” he said in a Monday interview with The Bee. “Providing healthcare access to our most vulnerable after this pandemic of the century is the absolutely appropriate response for us to take as a state.”
former physician, Arambula said he regularly served undocumented patients who delayed receiving medical attention due to their lack of healthcare coverage. “What I oftentimes would find is that our undocumented community would seek care delayed or not at all, and oftentimes forgo much of the preventative health care we know to be so beneficial,” he said. “When you don’t have health care access, you get sicker and you die sooner — that’s what I saw firsthand.” Sarah Dar, the director of health and public benefits policy at the California Immigrant Policy Center, an immigrant rights organization, said the proposed plan would allow people to get regular checkups and access to medication. She said undocumented people are “taxpayers” and “just as much a part of California as anybody else.” “We’ve really gotten to that place where everybody understands that equity matters and why it makes no sense to exclude people from our health care system,” she said. “People will have the peace of mind in knowing that they’re taken care of.” But Sen. Jim Nielsen, R-Red Bluff, opposed the proposal, arguing that it would allocate public dollars to “illegal” residents.
“He’s opening the door to a blank check providing for illegal individuals who have come to California,” Nielsen said. Still, Assemblymember Devon Mathis, R-Visalia, said the proposal could help cut costs on the healthcare system. “Healthcare access is vital, especially in underserved areas like our San Joaquin Valley,” he said in a statement. “When it comes to healthcare, we must stop dividing our people and realize we are one large community made of friends and neighbors. To my friends who may disagree, I would encourage you to look at your fiscally conservative roots to the fact that this will reduce the overall cost on our healthcare system.”
There are an estimated 2 million undocumented immigrants in California, according to the nonpartisan Public Policy Institute of California. The state contains the largest number of undocumented people in the U.S. State officials last year projected about 200,000 undocumented immigrants would be enrolled in Medi-Cal by the end of the 2026 fiscal year.
Newsom’s spending plan for the fiscal year beginning in July 2022 focuses on five pressing challenges facing California residents, including COVID-19, climate change, homelessness, inequality and public safety, according to the blueprint.
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