CA Governor & State Legislature Strike Budget Deal with Major Steps Towards a More Universal Health Care System

The state legislative leaders announced the outlines of a 2021-2022 budget agreement with Governor Newsom that includes funding for a more universal, equitable, and affordable, health care system. The final deal includes historic investments in our health system, including a first-in-the-nation end to the exclusion of income-eligible undocumented adults age 50 and over in Medi-Cal.


By opening up Medi-Cal coverage to all income-eligible Californians age 50 and over regardless of immigration status, California is not just making our health system more universal and equitable, but stronger and more resilient for all of us. Especially after a pandemic, our health care system works better when anyone who calls California home can access comprehensive and preventative health care.

So many of these immigrants have contributed over their lives to California by working, paying taxes, raising families, and being pillars to our community and economy, and they should be fully included in our health system as well. This expansion will directly benefit thousands of Californians, from vulnerable seniors to essential older workers, but also the health system we all rely on.

California becomes the first state in the country to remove these exclusions in their state Medicaid program for those 50 and above. Illinois had agreed to start covering those 65+ last year, California will now have the most expansive coverage, including children, young adults up to age 26, and now older Californians 50 and above. The expansion to older undocumented adults is estimated to provide health coverage for approximately 235,000 more Californians.

Medi-Cal Assets Test

In another major step towards universal and equitable coverage, the budget deal eliminates the Medi-Cal asset test that has for too long prevented some Californians from accessing Medi-Cal for having a small amount of savings. This will ensure access to care for seniors and people with disabilities, and allow them to have savings needed to deal with housing and other needs and emergencies.

The antiquated asset test in Medi-Cal is burdensome and inequitable for older Californians and those with disabilities. Removing this test is a necessary step to improving health care access for tens of thousands of Californians. Together, these budget actions remove unfair exclusions for older Californians to get the care and coverage they need, which was even more urgent during this pandemic.


Health care advocates praise a number of important steps to improve Medi-Cal and reduce health care disparities previously agreed upon for the 2021-22 budget:

  • Improved Medi-Cal coverage for pregnancy and post-partum to reduce inequitable maternal mortality rates for black women
  • Continuous Medi-Cal coverage for children age 0-5
  • Creating culturally appropriate Medi-Cal documents
  • Continuing Cal-AIM reforms

While this deal is a major win for expanding health care coverage, additional budget trailer bills will follow. They are expected to include key steps to improving health care affordability in Covered California and by establishing a new statewide Office of Health Care Affordability, and other improvements to bolstering benefits and coverage to reduce health disparities.