California Makes History By Becoming the First State to Provide Access to Health Care for All Income-Eligible Residents, Regardless of Immigration Status

With last night’s announcement of the state budget agreement, California makes history as the first state to agree to fully remove exclusions for Medi-Cal (California’s version of Medicaid) coverage for all who are income-eligible, regardless of age or immigration status. The final 2022-23 State Budget closes the gap in coverage for approximately 700,000 undocumented Californians ages 26-49, the last remaining age group to be excluded from accessing comprehensive Medi-Cal coverage, starting no later than January 1, 2024. This is expected to lead to the largest drop in the rate of uninsured Californians in a decade.
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California – With last night’s announcement of the state budget agreement, California makes history as the first state to agree to fully remove exclusions for Medi-Cal (California’s version of Medicaid) coverage for all who are income-eligible, regardless of age or immigration status. The final 2022-23 State Budget closes the gap in coverage for approximately 700,000 undocumented Californians ages 26-49, the last remaining age group to be excluded from accessing comprehensive Medi-Cal coverage, starting no later than January 1, 2024. This is expected to lead to the largest drop in the rate of uninsured Californians in a decade.

The #Health4All coalition, consisting of over 180 state and national organizations committed to health and racial justice, has worked alongside communities for nearly a decade to lead California to achieving this victory, beginning with winning full-scope Medi-Cal for all low-income children, regardless of immigration status, in 2016. Subsequent advocacy led to removing Medi-Cal exclusions for undocumented young adults ages 19-25 in 2020. And in May of this year, California began opening Medi-Cal to all income-eligible adults ages 50 and older.

Comprehensive health coverage, like that offered through Medi-Cal, protects individuals and families from financial distress and excessive out-of-pocket spending, encourages earlier diagnosis of chronic conditions, improves use of preventive services, reduces preventable mortality, and makes communities healthier. The COVID-19 pandemic has exacerbated historical inequities within our health care system and highlighted the risk to our society when we exclude our neighbors from the programs they need to care for themselves and their communities.

As we continue to remove exclusions to critical safety net programs for all Californians, the Health4All coalition is committed to ensuring that these policy changes are implemented in a clear and equitable fashion, and that all eligible individuals are able to enroll without interruption, and as soon as possible. The coalition urges everyone who is eligible now to enroll in coverage through Medi-Cal. If you are yet to be eligible, you or your loved one can enroll now in “restricted-scope” Medi-Cal, and be moved automatically to comprehensive coverage when coverage for 26-49 year olds begins.

“California achieved this victory today thanks to the dedicated leadership of community members and advocates across the state who took bold, steady action over the course of a decade to ensure that everyone living and working in California has access to the care they need. This budget investment reflects California’s values of inclusion and fairness and should be a model for the rest of the nation,” said Sarah Dar, Director of Health & Public Benefits Policy at the California Immigrant Policy Center (CIPC). “All Californians, regardless of their age or where they were born, should have access to basic necessities like food and fair, steady wages. Yet needless barriers continue to exclude hundreds of thousands of our neighbors and families from critical, life-saving services. As we celebrate this victory alongside our neighbors and partners across the state, we remain committed to using this momentum to keep moving towards a California that works for all.”

“By removing immigration status as an eligibility barrier to Medi-Cal, California is building a more universal, efficient, and equitable health care system for all who call California home. Health care is a human right, and our health system is stronger when everyone is included,” said Jose Torres, Policy and Legislative Advocate at Health Access California, the statewide health care consumer advocacy coalition. “As the pandemic highlighted, our individual health is tied to the health of our community, and we all benefit when everyone has access to primary, preventive, and comprehensive care. With the urgency on the ongoing pandemic, we will continue to advocate to take this and other steps to universal health care as soon as possible.”

“I came to the U.S. 15 years ago as a single mom and learned to navigate the complicated health care system by myself. Having access to health care meant that I was able to take care of myself and my daughter. Even though my daughter’s immigration status was in process at that time, she was able to receive full-scope Medi-Cal because of #Health4All,” said Adrienne Bambou Diagne, a California resident. “Passing #Health4All this year in the Governor’s Budget would mean that she does not have to face the hardships when she turns 26 and ages out of the current system.”

“This is a historic moment for California, reaching a goal that was nearly impossible just 7 years ago.  Approximately 700,000 Californians, who were among our most essential workers during the pandemic, will become eligible for healthcare coverage.  Many of these Californians with no access to preventative and follow up healthcare, risked their health and safety so that other Californians could shelter in place,” said Senator María Elena Durazo (SD-24, Los Angeles). “This historic investment speaks to California’s commitment to healthcare as a human right. Thank you Governor Newsom, Legislative Leadership and colleagues, including former Senator Lara and Assemblymember Arambula, and especially the Health4All advocates for being the collective driving force to make this happen.”

“This historic investment will transform the lives of hundreds of thousands of people in California. I deeply appreciate the health and immigration advocates who for years championed this just cause, my legislative colleagues who helped fight for this crucial step, and Governor Newsom for his tenacious support of this pivotal change. California again leads by being the first state in the nation to achieve universal access to health care coverage. We know how crucial it is to bring equity to our health care system — we saw the disproportionate impact that the COVID-19 pandemic inflicted on Latinos, other ethnic minorities, and those living in our most vulnerable communities,” said Assemblymember Dr. Joaquin Arambula (D-Fresno). “Health care is key to a successful life and future, and this will benefit ALL of us in California. While this is an important moment, one more step is needed to solidify this achievement. I strongly encourage Governor Newsom to sign Assembly Bill 4 — the “Health for All” bill that I authored as the legislative guarantee of this coverage — into law.”

“We applaud the Governor for supporting another expansion of Health4All to ensure everyone can access healthcare, regardless of immigration status. However, by failing to secure an earlier implementation date of this final expansion, California risks worsening health outcomes for the most disenfranchised community members. The Latinx community experienced the most deaths throughout the pandemic and continues to experience economic losses and health hardship during the recovery phase. As we move closer to universal coverage, we know this is a matter of justice and health equity. We urge the Governor to implement this final expansion as soon as possible to ensure health equity in our state,” stated Dr. Jeffrey Reynoso, Executive Director, Latino Coalition for a Healthy California.

“The pandemic has underscored how important it is for everyone, regardless of their immigration status, to have meaningful access to health care. Local immigrant advocates have spent years advocating for this Medi-Cal expansion, which would make a difference in the lives of so many Californians who have been unfairly excluded. This historic victory is a testament to our collective power when immigrants, health advocates, labor unions, and others join forces to organize at the local level, and we hope it will inspire states across the country to follow California’s lead and ensure health care access for all,” said Marielena Hincapié, Executive Director of the National Immigration Law Center.

“Healthcare justice and immigrant justice are core values of SEIU members. Passing Health for All is the gold standard for inclusion in healthcare, an achievement that the rest of the nation can look to. I am proud of California’s progress toward inclusion of immigrant workers and our families in our healthcare system, and I’m  especially proud that SEIU members in California and our allies fought so hard and for so many years to accomplish this.” said David Huerta, President of SEIU California and SEIU-USWW (United Service Workers West).

“Thank you for including Health4All for the remaining undocumented adults. This helps all undocumented communities in California, especially in counties like San Bernardino that don’t have a county safety program for undocumented adults. We are One California!” said Maribel Nunez, Executive Director of Inland Equity Partnership Partnership.