Fearing Deportation, Parents Worry About Enrolling Undocumented Kids In Medi-Cal

May 18, 2017 by · Leave a Comment 

Luz felt relieved and grateful when she learned that her 16-year-old son qualified for full coverage under Medi-Cal. Now, she worries that the information she provided to the government health program could put her family at risk of deportation.

Luz’s son is one of nearly 190,000 children who have enrolled in Medi-Cal since California opened it to undocumented children last year. Luz, her husband and her son came to Merced, Calif., from Mexico without papers about 10 years ago. Luz asked that the family’s last name not be used, for fear of being identified by federal immigration authorities.

In the current political climate, immigration and health advocates worry that children, like Luz’s son, will drop out of Medi-Cal and that new kids won’t enroll out of concern that personal information may be used to deport families.

Luz would need to renew her son’s coverage in October, but she remains undecided even though the program paid for his hospital visit when he injured a foot. “I’m still thinking about it,” she said.

Last May, the state Department of Health Care Services (DHCS) implemented the new “Health For All Kids” law allowing California children under 19 to receive full Medi-Cal benefits, including dental care and mental health, regardless of their immigration status. Previously, undocumented children could receive only emergency care through Medi-Cal.

California followed Illinois, Massachusetts, New York, Washington and the District of Columbia in offering state-supported health coverage to children in the country illegally.

Medi-Cal is California’s version of the federal Medicaid program for people with low incomes. The federal government pays for a significant portion of the California program, as it does for all states. But coverage for undocumented kids is entirely funded by the state.

From last May to through April 6, 189,434 undocumented children signed up for the program, according to the most recent state data. The health care services department estimates that another 61,000 children are eligible but not enrolled. Advocates say now is the time for a push to sign up these “harder-to-reach” children and to encourage those already in the program to stay.

Immigrant families have become more reluctant to share personal information with government programs because of the Trump administration’s planned changes in health care and immigration policies, according to a recent survey of 62 individuals working for pediatric practices, community clinics, local public health departments and hospitals serving immigrant communities throughout the state.

Immigrants are also increasingly skipping doctor appointments because of similar concerns, according to the survey, conducted in March by the advocacy group Children Now.

Kelly Hardy, Children Now’s managing director of health policy, said some families even have sought to withdraw their children from the Medi-Cal program because they fear that their immigration status might be shared with immigration officials.

“Holding on to the kids who have recently enrolled is going to become critically important,” Hardy said. She said she hopes families will see that the coverage is a boon to their health and will not be scared away.

In an email last week, the DHCS reiterated to California Healthline that an applicant’s immigration status is “only used for the purposes of determining Medi-Cal eligibility.”

But that doesn’t eliminate the worry for some parents.

“This fear is horrible. We don’t know who to trust,” Luz said.

Before the coverage-for-all law took effect last year, undocumented children could get coverage through the Healthy Kids insurance program in some California counties. However, many of those children have been transferred to Medi-Cal, and the Healthy Kids programs are closing down.

Carlos Jimenez, a health policy advocate at the Mixteco Community Organizing Project in Oxnard, Calif., said the nonprofit doubled its enrollment assistance efforts after the law was implemented.

Community health educators known as promotoras, spread word about the new law in farm fields, in front of supermarkets and outside churches. Last year, enrollment counselors saw up to 400 people a month who had questions about Medi-Cal, the majority looking to enroll their children, Jimenez said.

But after the November presidential election, enrollment counselors at Mixteco saw the number of people seeking help drop by nearly half, Jimenez said. Staffers had expected more inquiries about renewals by now, he said.

Most people ask whether enrolling an undocumented child would bring any problems with the U.S. Immigration and Customs Enforcement agency, Jimenez said. “We tell them their information is safe. But even then, they’re afraid.”

The Children Now survey showed that participants had questions about the future of Medi-Cal for undocumented children — in particular, whether it would continue if the Affordable Care Act were replaced.

In an interview with California Healthline in February, Sen. Ricardo Lara (D-Bell Gardens), who authored the Health for All Kids law, said there was no reason for people to be concerned about the program’s durability.

Democratic Gov. Jerry Brown continues to make this program a priority, Lara said, noting that California is spending $279.5 million to continue benefits for undocumented kids this year. That’s up from the $188 million it provided for the program last year

Health advocates in California are hoping to extend the program to young adults. Earlier this month, the California Immigrant Policy Center and Health Access California, launched an online petition requesting that full Medi-Cal benefits be made available to people ages 19 to 26.

 

This story was produced by Kaiser Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.

California Set to Be First State to Allow Undocumented Residents to Buy Health Coverage on Online Marketplace

June 9, 2016 by · Leave a Comment 

New America Media – As early as next year, undocumented immigrants will be able to buy health insurance on Covered California, the state’s online marketplace. That is, if Uncle Sam gives the state a federal waiver to do so.

In a bipartisan vote of 27 to 8, the California state senate on June 2 approved SB 10, the Health For All Waiver authored by Sen. Ricardo Lara, D-Bell Gardens. Under the proposal, the state will ask for a waiver so that undocumented adults can buy coverage on Covered California.

However, undocumented immigrants would not be able to get any subsidies when making their purchase. An estimated 390,000 immigrants who earn an income too high to qualify for Medi-Cal could purchase health care coverage through this program – if they can afford it.

Sen. Lara introduced the waiver as a result of President Obama’s signature health care legislation, the Affordable Care Act (ACA), which bars undocumented immigrants from purchasing health insurance on the online marketplaces set up by state or federal governments. The ACA subsidizes the costs, making the premiums affordable.

 SB 10 by Sen. Ricardo Lara (pictured) wins bipartisan support for seeking waiver to allow undocumented residents to by health insurance through Covered California. (New America Media)

SB 10 by Sen. Ricardo Lara (pictured) wins bipartisan support for seeking waiver to allow undocumented residents to by health insurance through Covered California. (New America Media)

States were, however, given a so-called 1332 waiver option so they could fashion a new coverage system customized for local preferences. Proposed state changes have varied widely, from minor fixes to substantial redirections.

In California, the state with the largest immigrant population, an estimated 3 million adults and children have been left without insurance because of the ACA barrier. Thanks to efforts spearheaded by Lara, nearly 170,000 undocumented children became eligible last month for full health coverage through Medi-Cal, the state’s name for Medicaid, the health insurance program for low-income people.

“It is immoral to discriminate against anyone based on where they were born,” Lara said in a press release after the Senate approved the SB 10 measure June 2. “This bill presents a historic opportunity for California to become the first state in the nation to request a federal waiver to allow the exchange to sell health insurance to undocumented immigrants.”

Governor Brown, the fiscally conservative leader, is expected to sign the waiver request because no state spending is involved.

“Beyond the important symbolism of inclusion, this proposal will provide a practical benefit for many California families with mixed immigration status, who will be able to buy coverage together, even if some family members are eligible for subsidies and others are not,” noted Anthony Wright, executive director of Health Access California, the statewide health care consumer advocacy coalition.

In seeking the waiver, the state must certify that the proposal will not diminish coverage or affordability on the exchange, and will not add costs for the federal government.

Then the federal Department of Health and Human Services and Department of Treasury have 225 days to make a decision. By expediting state approval of the bill, Lara hopes to have the request considered by the Obama administration before he leaves office.

Historic Vote Takes California’s Undocumented a Step Closer to Health Care

June 4, 2015 by · Leave a Comment 

New America Media – A sweeping bill that will expand health care coverage to California’s undocumented population sailed through the State Senate Wednesday on a 28 to 11 vote.

All 26 Democrats on the Senate, plus two Republicans – Assemblymembers Anthony Cannella (R-Ceres) and Andy Vidak (R-Hanford) — gave the bill their nod.

“Today’s vote is a transformational and decisive step forward on the path to achieving health for all,” said the bill’s author Sen. Ricardo Lara, (D-Bell Gardens), in a statement. “Over the past year, I’ve worked to draft a bill that is realistic, balanced and fiscally prudent, while arriving at our goal of expanding access to health care for some of our most vulnerable communities.”

The bill, if passed by the Assembly and signed by Gov. Jerry Brown, would allow undocumented Californians to buy health insurance with their own money through the online exchange, Covered California, pending permission from the federal government.

Senate Bill (SB) 4 gives all adults, regardless of their immigration status, access to health care, but it would not be an entitlement. It would only cover those enrolled up to a capped budget level each year in Medi-Cal (California’s name for Medicaid), the health insurance program for low-income people.

However, another provision of SB 4 that would allow all children, 19 and under, to enroll in Medi-Cal, would entitle all who qualify to received health benefits, no mater how limited the program’s budget is.

In May, the Senate Budget Sub-Committee set aside $40 million to begin covering children who are among the state’s nearly 2.5 million residents remaining uninsured because they don’t qualify for full-scope Medi-Cal because of their immigration status or their income level. The committee made the $40 million allocation after the Senate Appropriations Committee scaled back the cost of SB 4, pegged earlier as $740 million. A stalled version of the bill last year came with a $1.4 billion price tag.

Although legislative analysts have not yet estimated the total cost of the scaled back plan, providing Medi-Cal to the state’s 200,000 or so undocumented children could run anywhere between $7 million and $135 million. But president Obama’s executive action on immigration could greatly reduce those amounts.

“Once Obama’s executive action moves forward, the cost could drop to between $4 million and $83 million,” asserted Ronald Coleman, government policy analyst with the California Immigrant Policy Center.

The executive action, announced by the President last November, would grant a three-year renewable deportation reprieve to 5.6 million undocumented people nationwide by expanding the Deferred Action for Childhood Arrivals (DACA) program, as well as by launching the Deferred Action for Parents of Americans (DAPA) program. An estimated 1 million California residents could benefit from the programs, which are now suspended pending decisions on federal court lawsuits.

Immigrant and health care advocates in California hailed the passage of SB 4 in the Senate.

Marielena Hincapie, executive director of the National Immigration Law Center, said, “Senator Lara’s bill is urgently needed, not just for immigrant communities, but for all Californians. Our communities and economy are stronger if everyone has access to quality, affordable health care.”

Anthony Wright, executive director of Health Access California, a statewide consumer advocacy network, called the bill “transformational” and a “first of its kind by a state legislative chamber.”

Reshma Shamasunder, executive director of the California Immigrant Policy Center, urged Governor Brown to “invest real dollars in measures like SB 4.”

If the Assembly Health Committee, where the bill is now headed, approves SB 4, the Assembly Appropriations Committee has to come up with its own price tag for the bill. Both chambers would then have to reconcile the funding amount before the bill reaches the governor’s desk.

Copyright © 2017 Eastern Group Publications/EGPNews, Inc. ·