This month we celebrate the start of a new era for health coverage in our state. California has removed immigration status as a barrier to enrollment in Medi-Cal, California’s Medicaid program. It’s not only a policy change with profound implications for families across California. It’s also an inspiration to keep working and fighting for health equity across the health care system.

The last remaining age group of income-eligible undocumented Californians — adults between 26 and 49 years old — became eligible on January 1. An estimated 700,000 people will gain access to the program.

These are Californians from around the world who now reside across our state, from urban centers to rural regions. They have often lived in California for years, raising families and paying taxes. During the pandemic, many worked in essential jobs and put their lives on the line for the rest of us. Despite their significant social and economic contributions, federal and state policies historically have shut them out of Medi-Cal. These barriers hurt many immigrants and were disproportionately experienced by Latino/x Californians due to the sheer size of their population.

Now, many more immigrant families, the vast majority of them Latino/x, will have the security of health coverage and protection from catastrophic medical bills. They will have access to Medi-Cal preventive services, assistance in managing chronic conditions, and mental health care. By strengthening our immigrant communities, we strengthen California.

This historic milestone is the result of tireless advocacy and unwavering dedication on the part of so many people. CHCF thanks the advocates, immigrant families, and policy leaders who championed this cause over the past decade, even when many said it was impossible. The California Department of Health Care Services (DHCS) has been a committed and collaborative partner in the rollout even as it juggles several other major initiatives.

Because eligibility without enrollment would be a hollow victory, it is critically important to support outreach that ensures that the new policies reach the people they are designed to help. There are many helpful resources to spread the word, including these tools from DHCS. Furthermore, we must continue to strengthen Medi-Cal to enable everyone who is enrolled in the program to access high-quality, people-centered care.

The hard work of creating a more inclusive health care system in California is far from over. Still, this is a moment to savor. Collectively, we should take pride and inspiration from the tangible gains we have made and the many inspired efforts that got us here. It shows that progress is possible in our health care system. If we stay the course, there is more to come.

Sandra R. Hernández

Sandra R. Hernández, MD, is president and CEO of the California Health Care Foundation. Prior to joining CHCF, Sandra was CEO of The San Francisco Foundation. She previously served as director of public health for the City and County of San Francisco. Read More

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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. Read More