The California Department of Health Care Services (DHCS), which is under the California Health and Human Services Agency, announced that the expansion took effect on Jan. 1. Under the health coverage expansion, individuals aged 26 to 49 will be eligible for health insurance in the Golden State.
California has been progressively broadening access to Medi-Cal, having previously extended coverage to illegal immigrant children in 2016, individuals under 26 in 2020 and those over 50 in 2022. With the latest move, the state is set to become the only one nationwide offering free health care for individuals with low incomes irrespective of their citizenship status.
This expansion, which would cost the state around $1.2 billion, is part of the $310.8 billion 2023-2024 budget approved by Gov. Gavin Newsom. This would bring the number of uninsured individuals under 65 in California to a record-low 2.57 million.
But according to the California Simulation of Insurance Markets (CalSIM), around 520,000 illegals remain uninsured. This group earns too much for Medi-Cal insurance and lacks employer coverage, putting them at risk for exclusion from Covered California enrollment and federal subsidies.
Based on CalSIM's projections, approximately 110,000 illegals in California will pay the full cost of individual market coverage. Cost remains a prevalent barrier for those eligible for Covered California or employer coverage and a lack of awareness and administrative hurdles further impede access to health insurance.
However, the Golden State's decision to cover illegals did not sit well with many. Critics expressed concerns that the expansion may act as a motivator for many more illegals to enter the U.S. unlawfully. Jon Coupal, president of the Howard Jarvis Taxpayers Association, was among those critics.
"I think many of us are very sympathetic to the immigrant community, but we really wish we had better control of who enters this nation and this state," said Coupal, the association's third president. As per the Pew Research Center, illegals make up about nine percent of California's workforce. Illegals have a significant presence in the state's agriculture, construction and manufacturing sectors.
But as hundreds of thousands anticipate accessing Medi-Cal coverage in the coming year, millions of Californians face potential removal from the rolls due to resumed eligibility verifications. The state resumed the verification process after the expiration of federal healthcare policies enacted during the Wuhan coronavirus (COVID-19) pandemic earlier last year.
State records show that over 930,000 people had their Medi-Cal terminated as of October, with nearly 90 percent of cases attributed to procedural issues such as missing paperwork. The California Health Care Foundation estimates that two to three million Californians could lose their coverage during the ongoing verification process.
Currently, over 15 million Californians, representing 40 percent of the state's population, are enrolled in the Medi-Cal program. As the state navigates the complex landscape of healthcare access, the expansion sparks debates about immigration policy, fiscal responsibility and the balance between providing services and ensuring control over illegal immigration.
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