Medi-Cal Expansion Moves California Closer to Health Equity

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A man is seated on an exam table in a clinic being examined by a physician as California moves closer to health equity
Photo: Jessica Brandi Lifland

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.

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

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