California Set to Offer Medicaid to Undocumented Young Adults

Ken Terry

June 10, 2019

Undocumented young adults ages 19-25 can qualify for Medi-Cal (Medicaid) coverage in California if they meet the income requirements under a budget agreement reached yesterday by the Democratic leaders of the state legislature, according to the Associated Press .

The lawmakers are expected to pass the budget measure in the Democratic-controlled legislature this week, and California Gov. Gavin Newsom is expected to sign the bill.

The legislation is the first in the nation to provide public health insurance to undocumented adults. California, five other states, and the District of Columbia already cover unauthorized immigrant children.

Proposed by Newsom as part of his budget plan, the expansion of Medi-Cal coverage will take effect Jan. 1, 2020, and will cost $98 million in the upcoming fiscal year, according to the Sacramento Bee.

Two other proposals to cover undocumented residents were rejected because of their higher costs. One of the measures would have also covered poor undocumented seniors, according to the newspaper, and the other would have given all Californians with incomes under 138% of the federal poverty level access to Medi-Cal, regardless of immigration status.

The state will pay the extra amount to insure qualifying immigrants under Medi-Cal. The federal government cannot contribute funds to cover unauthorized immigrants under current law.

Individual Mandate

The pending legislation also imposes an individual mandate to buy health insurance for California residents. A similar mandate to purchase coverage is part of the Affordable Care Act, but the tax cut legislation passed by Congress in 2017 repealed the penalty for not buying insurance.

The revenue generated by the California mandate will help fund insurance subsidies for people who earn up to six times the federal poverty level (FPL), or $150,000 per year for a family of four. A family with that much income would be eligible for a state subsidy of $100 a month to buy health coverage, USA Today reported.

Currently, under the Affordable Care Act, people between 100% and 400% of FPL receive federal government subsidies to buy insurance on a sliding scale.

Under the budget agreement, the Sacramento Bee said, $450 million will be added to the budget over 3 years to pay for middle class insurance subsidies, supplementing the funds expected to be raised by fines on people who don't buy health insurance.

The Medi-Cal coverage of some undocumented immigrants and the expanded insurance subsidies are part of Newsom's plan to achieve universal coverage for Californians. Of the 3 million state residents who are still uninsured, the majority are undocumented.

According to news reports, the budget bill targets 90,000 to 100,000 undocumented young adults. It is unclear how many more people might buy insurance with the help of the state subsidies or how many people might purchase coverage to avoid state financial penalties.

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