12 Feb Medi-Cal Expanded to All Undocumented Californians, but Income Limits Leave Many Out

Ricardo Perez in 2021 was a Medi-Cal enrollment navigator with the Center for Human Development in Concord. (CC Pulse file)

By Ana Tellez-Witrago

Esther, 49, started losing her teeth in her mid-30s. The Richmond resident didn’t have insurance and couldn’t afford to go to a dentist or doctor. Last year, however, extreme pain pushed her to get an emergency procedure in which all her remaining teeth were pulled. But now, she has insurance, which will enable her to get dentures.

“I have been in the United States for over 28 years. I have paid my taxes every year I worked,” Esther said. “I had children to take care of. It was either fixing my teeth or paying bills.”

As of Jan. 1, undocumented immigrants like Esther who live in California became eligible for Medi-Cal, provided they meet other eligibility requirements, regardless of age. (Medi-Cal is California’s Medicaid program, which provides public health insurance for low-income and other qualifying people.) California is now the only state to fund comprehensive health care for undocumented immigrants. A reported 700,000 people living in California will now have access under the expansion.

>>>Read: Increasing Access to Healthcare Reduces Poverty, Policy Group Finds

Previously, the state made Medi-Cal available first to undocumented children through age 18, then young adults aged 19 to 25, and then to adults 50 and over.

The move is expected to benefit many extremely low-income undocumented people. However, it still leaves many people in need of health insurance.

Esther is one of two Richmond residents the Contra Costa Pulse spoke with about the Medi-Cal expansion, one with no legal status and the other a DACA recipient. Esther has already benefited from the change; the other is ineligible. Because of their immigration statuses, both asked only to be identified by first name.

With her new Medi-Cal coverage, Esther was able to get fitted for dentures and will soon pick them up. She also plans to see a doctor to find out what caused her tooth loss. Esther is grateful for the expansion of Medi-Cal that will help others like her. But she also worries about people who are still uninsured.

People like Jazmin, 40, who make above the income limits to qualify for Medi-Cal. As a DACA recipient, Jazmin is legally allowed to work in the United States. Although she is low-income, she makes too much money to qualify for Medi-Cal. The income limit in Contra Costa County, as in most of California, is 138% of the Federal Poverty Level, or $20,121 for one person a year.

>>>Read: The Expanded Child Tax Credit Gave Poor Families a Boost, But It Didn’t Last

Jazmin also cannot apply for insurance through Covered California because, according to its website, “Individuals under Deferred Action for Childhood Arrivals are not considered lawfully present. They are not eligible to purchase a health plan through Covered California or to receive financial assistance.”

Not having health coverage during the COVID-19 pandemic cost Jazmin $40,000. In 2021, Jazmin was admitted to the hospital when she could not breathe. She tested positive for COVID-19. She has had a series of health issues since she contracted COVID. It affected her hearing and lungs. In 2023, she was admitted to the emergency room due to extreme migraines. She now has medical debt and no option but to pay it off in monthly installments.

“I was shocked when I saw the money you need to make to qualify for Medi-Cal,” she said. “How can anyone survive in the Bay Area or California with that?”

>>>Read: ‘Am I Really That Sick?’ Healthcare Costs Weigh on Undocumented People

According to the authors of the proposed California Assembly Bill 4, collectively, millions of undocumented Californians contribute approximately $3.7 billion in state and local taxes every year. Yet, like Jazmin, they cannot access the same subsidized health care as other taxpayers in the state.

If approved by the state Legislature, AB 4 would allow DACA recipients to apply for affordable health insurance via Covered California. However, with California’s budget deficit, supporters of the bill, like senior director of Healthy Contra Costa Roxanne Carrillo Garza, expect it will need a lot of public support to help it pass.

>>>Read: Agency Encourages Undocumented Californians to Apply for Medi-Cal

Locally, Garza said Healthy Contra Costa is working with community members, the Contra Costa Health Department, and the Contra Costa Board of Supervisors to find a way to raise the income level limits to allow more people to qualify for Medi-Cal, following the lead of some other Bay Area counties, including San Francisco, which have higher income limits. Healthy Contra Costa plans to make a presentation on this topic before the Board of Supervisors in March.

To apply for Medi-Cal in Contra Costa County, call 1-800-709-8348 or visit the Employment and Human Services Department website at https://ehsd.org/apply-for-services/.