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As a practicing physician for more than 20 years and the son of two immigrant parents, patients often ask me whether applying for Medi-Cal health care coverage will affect their ability to stay in this country.
In the immigrant community, many people believe they have one of two choices: sign up for Medi-Cal and expose your status to the government, risking deportation or adversely impacting your path to becoming a US citizen; or go without health coverage and pay out of pocket or avoid seeking medical care at all. As the chief health equity officer at L.A. Care Health Plan serving vulnerable low-income residents in Los Angeles County I hear questions like:
- “If I sign up for Medi-Cal or receive public benefits, will I get deported or lose my ability to get a green card?”
- “OK, I signed up, but what does this mean? Will someone from Homeland Security or ICE (Immigration and Customs Enforcement) arrest and deport me?”
- “What if signing up for services makes me or my family a target?”
In reality, these fears are unfounded. Signing up for Medi-Cal does not impact a person’s ability to obtain naturalization, and the information is not shared with ICE. Also, until now, most undocumented adults in California were ineligible for Medi-Cal.
The Hard Work Begins
That’s why I am so glad that starting January 1, 2024, California expanded Medi-Cal to include all California residents with low incomes, including undocumented residents. After expanding Medi-Cal to eligible children and seniors, regardless of their citizenship and immigration status, this expansion for 26- to 49-year-olds gets us closer than ever to universal health coverage.
While some may argue that the hard part was getting the expansion approved, I would say that now the real work begins: encouraging undocumented Californians to sign up for Medi-Cal. We need to sign people up and address their immigration concerns at the same time.
To do this, we must begin by acknowledging skepticism and addressing it head on. For the communities we serve — particularly the vulnerable populations included in this expansion — skepticism is at an all-time high.
I want to make it very clear: Medi-Cal has expanded to include every low-income California resident regardless of immigration status. This means that no matter what your immigration status, medical history, or age, everyone is eligible to apply for Medi-Cal, without fear of being deported or having Medi-Cal coverage impact their path to citizenship.
When my patients ask me if they should apply for Medi-Cal, I can now assure them it is safe. If you’re an adult with no current coverage, you can apply for Medi-Cal now.
In addition, if you were under fee-for-service restricted scope Medi-Cal, you automatically transitioned to full-scope Medi-Cal on January 1.
Signing Up for Medi-Cal Won’t Block People from a Green Card
As for concerns about future green card status, the fact is federal immigration officials cannot use Medi-Cal enrollment as a factor when granting green cards to residents. Qualified immigrants can access public benefits like Medi-Cal, food and housing support, and other public services without fear of immigration consequences. This includes asylees, refugees and their families.
Fear of signing up for public benefits was exacerbated under the Trump administration’s short-lived public-charge rule, which was revoked in 2021. It’s going to take all of us to make the message clear: Do not be afraid of signing up for health benefits through Medi-Cal. It will not affect your future ability to get a green card.
I see the transformative power of accessible health care every day. This month, an estimated 270,000 new Los Angeles County residents will be able to take advantage of this incredible, life-saving resource. Medi-Cal expansion is going to require all of us — health plans, community-based organizations, physicians, elected officials and everyday Angelenos — to get the word out. As for L.A. Care, we’re expanding our onboarding operations, and our L.A. Care/Blue Shield Promise Community Resource Centers will be helping with in-person enrollment — but we need everyone’s help.
To my fellow Californians, I urge you to tell your friends and neighbors who may be eligible for Medi-Cal as part of this expansion to visit benefitscal.com or coveredca.com.
We have come so far — and now it’s time to act. Let’s work collectively to make California a beacon of hope and health for all.
This article first appeared on California Health Report and is republished here under a Creative Commons license.
Authors & Contributors
Alexander Li
Alexander (Alex) Li, MD is the chief health equity officer of L.A. Care Health Plan, the nation’s largest public health plan.
Jessica Brandi Lifland
Jessica Brandi Lifland is a freelance photographer, instructor of journalism at City College of San Francisco, and mother. Her work with publications and nonprofits such as Operation Smile, Tostan, and the California Health Care Foundation has taken her all over the world, including West Africa, the Middle East, Kosovo, Burma, Haiti, and South America.
For two decades she has been photographing the National Cowboy Poetry Gathering and has been working on a long-term project documenting the lives of the cowboy poets of the American West in affiliation with the Western Folklife Center. She plans to make her project into a book.
