key takeaway
California’s expansion of Medi-Cal to include all eligible residents, regardless of immigration status, has improved health outcomes for non-citizen children. However, gaps remain for undocumented adults who lack coverage, highlighting the need for continued efforts to promote health equity and economic stability for all Californians.
Immigrants are an integral part of California’s communities and the state’s social fabric. Over the years, California has set itself apart from other states by advancing inclusive policies that support immigrants while fostering economic growth. A key example is the state’s efforts to make coverage through Medi-Cal, California’s state Medicaid program, more accessible for immigrants. This year, California became the first state in the nation to expand comprehensive Medi-Cal coverage to all eligible Californians, regardless of immigration status. The timeline below shows the steps that state leaders have taken to end the unjust exclusions in Medi-Cal.
A look at reported health status shows promising signs that Medi-Cal expansion to undocumented Californians is positively impacting health.1Our analysis focuses on the Medi-Cal expansion to undocumented children. Data for the most recent Medi-Cal expansion are not yet available for analysis. Analysis for the 2020 expansion to young adults is excluded due to potential confounding effects stemming from the COVID-19 pandemic. Data show that the proportion of non-citizen children who reported being in excellent health after the expansion increased by 10 percentage points from 20% to 30%. In contrast, citizen children, who were not affected, did not experience any change in their reported health status. At a high level, this analysis suggests there is a link between access and improved health status.
While California has led the nation in closing health coverage gaps, access is still limited for undocumented Californians who do not qualify for Medi-Cal or lack employer-based health insurance. The percentage of uninsured Californians hit a record low in 2022 at 6.5%, but the gains are not distributed equally. Research suggests that over one in four undocumented immigrants under 64 will remain uninsured due to their exclusion from Covered California.
Ensuring that everyone has access to health care benefits all Californians, as health coverage is critical for preventing poverty and fostering economic stability. People without coverage are more likely to face high health care costs or medical debt and are less likely to receive preventive care or treatment for chronic health conditions.
Policymakers can continue to advance health equity by ending unjust exclusions in Covered California, our state’s health insurance marketplace. By building on the historic Medi-Cal expansions and investing in other equitable health policies, policymakers can ensure all Californians can be healthy and thrive.