California Could Become The First State To Extend Health Coverage To Undocumented Young Adults

California could soon become the first state in the nation to extend health coverage to undocumented young adults ages 19 to 26.

The Health4All Young Adults budget proposal has already been allocated in the state Senate and Assembly budget committees, and is now headed to the governor's desk. It would build on California's already-instated Health4All Kids policy, which extends Medi-Cal coverage to all low-income children in California, regardless of immigration status. (Quick refresher: Medi-Cal is California's Medicaid program. It's equally financed by the state and federal government, and provides health coverage for low-income individuals living in the state). The Health4All Kids program, which was approved in 2015 and went into effect in 2016, has extended coverage to undocumented kids for the past year. However, once undocumented young adults turn 19, they age out of the program and are no longer eligible for Medi-Cal coverage.

"A lot of [kids who were formerly enrolled in Health4All] are going to be left without coverage when they turn 19," according to Betzabel Estudillo, the California Immigrant Policy Center's Health Policy Manager. Under the proposed budget investment, Medi-Cal coverage would be expanded to cover undocumented young adults ages 19 to 26 whose incomes are at or below 138% of the federal poverty level (the existing cut-off for Medi-Cal). Estudillo told LAist that there are approximately 100,000 Californians who fall into that demographic and who would be eligible for coverage. About half of all low-income undocumented young adults are currently uninsured, according to the UC Berkeley Labor Center's estimates.

Estudillo, who has been working alongside other immigrant rights advocates to help pass the budget proposal, told LAist that the budget proposal's 19-to-26 age range was chosen to align with Affordable Care Act standards. "The age aligns with ACA provisions of young adults staying on their parents' health plan until the age of 26, as well as foster youths continuing to receive Medi-Cal until the age of 26," she explained.

The proposal put forth by the California Immigrant Policy Center and Health Access California would require between $80 and $90 million be allocated from Proposition 56 (the state tobacco tax that passed last November) funds. Undocumented young adults in California currently have extremely limited access to publicly-funded health programs. Low-income undocumented young adults are solely eligible for emergency-only Medi-Cal, not for primary or preventive care available through full-scope Medi-Cal. "As a result, undocumented and uninsured Californians live sicker, die younger, and are one emergency away from financial ruin," according to the California Immigrant Policy Center's brief.

"We want to ensure that this budget investment is included in our state budget for 2017-2018," Estudillo told LAist. "The governor ultimately has the decision to approve what's in the budget," she explained. Lawmakers have until June 15 to finalize the budget before it heads to Governor Brown's desk. The governor will then be responsible for signing the budget and making any changes. Rachel Linn-Gish, director of communications for Health Access, told the California Health Report that members of the legislature hope to convince the governor over the coming days to approve the proposal, or at least come up with a compromise.

"While the federal administration is moving forward on immigration enforcement policy and trying to take away healthcare from people, California has a unique opportunity to lead, and to make an important investment in providing healthcare coverage to all young people in our state," Estudillo said.