Medi-Cal deal benefits 5K Marin undocumented residents
January 26, 2024
By RICHARD HALSTEAD | rhalstead@marinij.com | Marin Independent Journal
Nearly 5,200 undocumented Marin County residents became eligible for full Medi-Cal coverage at the beginning of this year because of a 2022 budget deal between Gov. Gavin Newsom and the Legislature.
The arrangement covers undocumented residents from 26 to 49 years old. Announcing the deal in May 2023, Sen. Maria Elena Durazo, D-Los Angeles, said approximately 700,000 undocumented residents statewide were expected to gain full coverage. Durazo said the income cap for a family of four would be $36,156.
Kari Beuerman, director of Marin County’s social services division, said the county has “5,169 people in this age category who currently receive limited scope Medi-Cal and will be converted over to full scope.”
As it stands, the residents are eligible for only emergency and pregnancy-related services. Full-scope Medi-Cal services include doctor visits, laboratory and x-ray services, prescriptions and medications, inpatient and outpatient hospital care, emergency room visits and mental health services.
“Access to full scope MediCal gives individuals and families the full array of healthcare options, including preventative health care,” Beuerman wrote in an email. “We are thrilled that documentation status no longer presents as big a barrier to wellbeing for the immigrant population. County eligibility staff are working hard to respond to the growing demand.”
The state has expanded comprehensive Medi-Cal coverage for undocumented immigrants in a number of steps in recent years. In 2015, Gov. Jerry Brown signed a bill that enabled undocumented children to receive full coverage. In 2019, Newsom signed another law that expanded full-scope coverage to undocumented adults ages 19 through 25. In 2021, Newsom signed Assembly Bill 133, providing full coverage to undocumented immigrants 50 and older.
Beuerman wrote that during the previous expansion of Medi-Cal coverage, 1,200 people in Marin switched from limited-scope MediCal to full coverage.
“These were the people who were already known to us, and that process happened largely automatically,” she wrote.
“In addition, due to outreach and engagement, we have enrolled an additional 571 Marin County residents onto full scope MediCal as part of this initiative,” Beuerman wrote. “Our outreach continues, as we believe there are many more people who are potentially eligible but either are not aware that they qualify or are frightened to apply.”
In 2020, the Trump administration enacted a rule that denied green cards, or permanent legal status, to immigrants who were judged likely to require public benefits such as Medicaid, housing vouchers or food stamps. The Biden administration ended the practice in 2021.
State laws protect the privacy of Medi-Cal recipients. The California Department of Health Care Services is not allowed to answer questions related to immigration or public charge.
“Our certified enrollment counselors attended a training led by the state regarding potential apprehension some undocumented individuals may harbor about enrolling in Medi-Cal,” said Dr. Farhan Fadoo, chief executive of Marin Community Clinics.
Fadoo added that if patients require more assistance, they are being referred to Canal Alliance, a nonprofit that serves San Rafael’s predominantly Latino Canal neighborhood.
Fadoo said that patients of Marin Community Clinics now have to wait a couple of weeks for routine care and establishing visits, but same-day appointments can be made for people with urgent needs.
“We’re in a perennial recruitment cycle to grow primary care and to attract additional clinicians to this area,” he said, “because even as we sit here today there’s a lot of unmet need.”
Tammy Whiteduck, Canal Alliance’s director of social services, said the “Medi-Cal expansion is such a win for the Latino community here in Marin.”
“We see clients coming in every day with medical bills they are not in a position to afford,” Whiteduck said. “I’m beyond certain this increased eligibility will also allow people to seek much-needed medical attention proactively and without fear.”
The latest expansion in coverage was not welcomed by Republicans in the Legislature. In a 2022 budget analysis, the California Senate Republican Caucus wrote that “Medi-Cal is already strained by serving 14.6 million Californians — more than a third of the state’s population. Adding 764,000 more individuals to the system will certainly exacerbate current provider access problems.”
Senate Minority Leader Brian Jones was quoted by ABC News as saying, “Given the fact that over 300,000 undocumented migrants have crossed into California at the Mexico border in 2023 alone, the costs for this program are only going to increase from here.”
According to the Pew Research Center, the number of monthly migrant encounters — detentions or immediate expulsions by authorities — fell to a 20-year low of 16,182 in April 2020. The number soared to 206,239 in November 2022, according to the most recent monthly data from U.S. Customs and Border Protection.
Newsom stuck with the coverage expansion when he unveiled his 2024-25 budget proposal earlier this month, despite the fact that the state is facing an imposing budget deficit. The nonpartisan Legislative Analyst’s Office has estimated the deficit to be $68 billion, while Newsom has pegged it at $38 billion. The latest Medi-Cal expansion for the 26-to-49 age bracket will cost an estimated $2.6 billion annually.
Marin County’s number of Medi-Cal recipients grew from 26,190 in October 2013 to 57,244 in October 2022. In October 2023, the number fell to 56,506. The reduction might have been because during this period, the state reinstituted requirements that recipients reapply annually. The rules were relaxed during the height of the COVID-19 pandemic.
