California Faces Challenges Enrolling Undocumented Children in Medi-Cal

Woman doctor talking to her little patient (iStockphoto/Getty images)

Hundreds of thousands of low-income, undocumented children in California will be eligible to enroll in full-scope health coverage through Medi-Cal starting on May 1 under legislation approved last year.

As officials try to get the word out about California's decision to open the program to children from low-income families regardless of immigration status, these kids will still face significant barriers to obtaining the coverage, says the San Bernardino County Sun.

Officials say they hope community clinics, religious groups and ethnic media outlets will help alert undocumented immigrants to enroll their children. Even so, state officials expect only about half of eligible kids to enroll in the program in its first year, the Sun writes.

Many undocumented families may be reluctant to participate out of fear that it would put at risk their chance to obtain a legal immigration status. Lack of empowerment and confusion over how and why to enroll may also make it difficult to reach the eligible families, experts say.

The expansion will extend Medi-Cal coverage to about 170,000 undocumented immigrant children under age 19. About 115,000 undocumented children are currently enrolled in restricted Medi-Cal programs and 55,000 eligible children aren’t receiving coverage, the Sun writes.


Also, the process of moving eligible children into full scope Medi-Cal from their current more limited plans creates administrative hurdles that could cause disruptions in care or even lead to families dropping out of the system, the California Health Care Foundation writes.

The Medi-Cal expansion will help these undocumented children get preventive care, such as physicals and immunizations, mental health care, and vision care, Assemblywoman Cheryl Brown, D-San Bernardino, told the Sun.

How to provide health care to undocumented immigrants has been the subject of recent political debate. Under the Affordable Care Act, undocumented immigrants were excluded from purchasing coverage through Covered California.

After rejecting the idea of covering both undocumented adults and children, California lawmakers granted full-scope coverage to the children as long as they meet the income standards. The program will cost $40 million in this year's budget and an estimated $132 million each following year.

"This is a major investment that California is doing, and it's completely the reverse of what we’re seeing at the national level," said state Sen. Ricardo Lara, D-Bell Gardens, who led the health care expansion effort, told the Los Angeles Times in October.

Offering Medi-Cal coverage to undocumented children is a good long-term investment for the state, experts say. It will bring down health care costs by reducing trips to the emergency room for routine care and help ease stress on community health centers, which often treat undocumented patients without reimbursement, experts told California Healthline in July.

Eligible children can be enrolled in-person at county social services offices, or online or by mail through Covered California, according to the California Department of Health Care Services.

"We have a big challenge ahead of us to dispel the perception that undocumented people are forever left out," Daniel Zingale, senior vice president at the California Endowment told California Healthline.