California becomes first state to offer health insurance to all undocumented immigrants

California will ring in the new year by becoming the first state to offer health insurance to all undocumented immigrants.

Starting Jan. 1, all undocumented immigrants, regardless of age, will be eligible for Medi-Cal, California’s version of the federal Medicaid program for low-income people.

Previously, undocumented immigrants were not qualified to receive comprehensive health insurance, but were allowed to receive emergency and pregnancy-related services under Medi-Cal as long as they met eligibility requirements, including income limits and California residency in 2014

In 2015, undocumented children were able to join Medi-Cal under a bill signed by then-Gov. Jerry Brown. In 2019, Governor Gavin Newsom signed into law expanding full access to Medi-Cal to young adults ages 19 to 25, regardless of citizenship or immigration status. Access was then further expanded to allow older adults age 50 and older to receive full benefits, also regardless of immigration status.

The final expansion, which takes effect Jan. 1, will make roughly 700,000 undocumented residents between the ages of 26 and 49 eligible for full coverage, according to California state Sen. Maria Elena Durazo.

“This historic investment speaks to California’s commitment to health care as a human right,” Durazo said in a statement in May.

“In California, we believe that everyone deserves access to quality, affordable health care — regardless of income or immigration status,” Governor Newsom’s office said in response to a request for comment from ABC News. “Through this expansion, we’re ensuring California families and communities are healthier, stronger and can get the care they need, when they need it.”

California’s plan to expand coverage has not been without opponents. The California Senate Republican Caucus criticized the move in an analysis of the governor’s 2022-23 budget.

“Medi-Cal is already stretched thin as it serves 14.6 million Californians — more than a third of the state’s population. Adding another 764,000 people to the system is certain to exacerbate current provider access problems,” the group wrote last year.

However, studies show that undocumented immigrants use fewer health care resources than nonimmigrants.

About 50 percent of undocumented immigrant adults in America report being uninsured, compared to just 8 percent of U.S.-born citizens, according to the nonprofit research organization KFF, because undocumented adults are more likely to work in jobs that do not provide health benefits, and face eligibility limits for federal programs.

In addition, undocumented immigrants who are eligible may face other barriers, including confusion about eligibility, language challenges and fear, KFF said.

That’s even though low-income undocumented immigrants in California are as likely as those currently enrolled in Medi-Cal to have at least one chronic disease, according to research conducted by the Public Policy Institute of California ( PPIC), a non-profit research institution.

Undocumented immigrants are just as likely to receive preventive services, such as a flu shot, and older undocumented immigrants are just as likely to receive age-appropriate health services, such as cancer screening and a shingles vaccine, at similar rates of Medi-Cal patients, PPIC found.

The California Health and Human Services Agency has allocated $835.6 million in 2023-2024 and $2.6 billion annually thereafter to expand full Medi-Cal eligibility to all income-eligible adults regardless of immigration status.

When California expanded health care coverage in 2019 to include young undocumented adults, then-President Donald Trump criticized the plan, calling it “very unfair to our citizens.”

“If you look at what they’re doing in California, how they treat people, they don’t treat their own people as well as they treat illegal immigrants,” Trump told reporters at the time. “So at what point does it stop? It’s crazy what they do. It’s crazy. And it’s mean and it’s very unfair to our citizens.”

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