Undocumented adults between the ages of 26 and 49 in California will qualify for health insurance under the state’s Medi-Cal program beginning Monday, provided they meet eligibility requirements for the program, which is designed to insure low income residents.

This move expands the state’s health insurance coverage to include all undocumented immigrants—the state previously only covered undocumented children, those between 19 and 25 and those 50 years and older.​​

This expansion—which was approved in legislation in May—will make around an additional 700,000 undocumented residents eligible for health insurance, according to California State Sen. María Elena Durazo.

The California Health and Human Services Agency will provide $835.6 million in funding between 2023 and 2024, and $2.6 billion annually to expand Medi-Cal to residents regardless of immigration status.

However, eligibility requirements still apply, including income limits based on household size, according to a release by the California Department of Health Care Services.

Participation in the program won’t hurt a person’s immigration status because the Department of Homeland Security and the U.S. Citizenship and Immigration Services doesn’t consider receipt of health, food or housing benefits a part of the public charge determination, the release says.

CHIEF CRITICS

Some experts and lawmakers have criticized the state’s decision. The California State Republican Caucus said Medi-Cal was already “strained” by the 14.6 million citizens using it, so “adding 764,000 more individuals to the system will certainly exacerbate current provider access problems.” Simon Hankinson, a senior research fellow in the Border Security and Immigration Center at the conservative Heritage Foundation said in a tweet, “No surprise [California], despite budget deficit, will give illegal immigrants subsidized health care. The question is how and when they’ll get the federal taxpayer to bail them out.” In his 2020 State of the Union Address, former President Trump said California would “bankrupt our nation by providing free taxpayer-funded healthcare to millions of illegal aliens.” “Now that California is struggling to make ends meet, using taxpayer money to cover non-citizens is simply irresponsible,” Sally Pipes, a healthcare policy expert and the president and CEO of the Pacific Research Institute, a California-based think tank promoting limited government, told the New York Post.

KEY BACKGROUND

Though California is the first state to expand health insurance to all undocumented immigrants, some states offer coverage to certain groups. New Jersey offers coverage to pregnant women and those 19 years and younger, and undocumented children are eligible for health insurance in Texas. Illinois provides coverage to kids up to 18 and passed a law to expand coverage to those 42 years and older starting on Monday, but a new 2023 law caps the amount of those between 42 and 64 who can sign up for coverage at 16,500. Undocumented immigrants use fewer health resources than non-immigrants in the U.S., according to a 2018 study published in the International Journal of Health Services. Immigrants’ health costs were between one-half and one-third of non-immigrants’ costs, the study suggested. Immigrants made up 12% of the U.S. population, but only accounted for 8.6% of the country’s healthcare spending, according to the study. Half of undocumented immigrants and about 18% of lawfully present immigrants report being uninsured, compared to less than 10% of non-immigrants, KFF, a health policy research nonprofit, reports. This is mainly due to a higher chance of immigrants working jobs where the employer doesn’t provide health insurance, though other barriers like language, fear of deportation and confusion persist.

BIG NUMBER

66%. That’s how many Californians in 2021 supported expanding health insurance access to all undocumented immigrants, according to a report by the Public Policy Institute of California. That number is up 12% from 2015.

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