–The movement to improve the lives of immigrant families hit a roadblock in June when a deadlocked US Supreme Court prevented, for now, expansion of the Deferred Action for Childhood Arrivals (DACA) program and implementation of the new Deferred Action for Parents of Americans and Legal Permanent Residents (DAPA) program. These programs were designed to protect millions of undocumented children and parents across the country from deportation. This disappointing decision leaves families in fear, with uncertain futures, and further from fulfilling the American promise of life, liberty, and the pursuit of happiness.

California continues to pursue state-level efforts to create an inclusive environment for all aspiring Americans. The expansion of full-scope Medi-Cal to all undocumented children in low-income households that took effect in May is another example of California’s clear commitment to inclusivity, which is even more important in the face of this ruling and the lack of movement in Congress on immigration reform.

As we seek to ensure every California child has coverage, it is imperative that the high court’s ruling does not adversely impact enrollment made possible by the state’s historic policy. The Medi-Cal expansion has the potential to help more than 185,000 children statewide, yet there remain multiple barriers to enrollment. Now more than ever, undocumented families may fear providing information to government officials and, as a result, refrain from seeking critical health coverage for their children. More information is needed at the community level to assuage families’ fears and drive home the importance of enrolling their kids.

Advocacy organizations like The Children’s Partnership, community health centers like Clínica Monseñor Oscar A. Romero in Los Angeles, the California Department of Health Care Services (DHCS), county eligibility workers, and a variety of state and local partners are working tirelessly to ensure newly eligible children are signed up. In the coming months, it’s essential that we clearly explain to immigrant families that:

• The Supreme Court ruling has no impact on the Medi-Cal expansion. All income-eligible children, regardless of immigration status, now have access to full-scope Medi-Cal. Health application information is used only to verify eligibility for health programs and not for immigration enforcement.
• The ruling has no impact on people deemed eligible for the original DACA program (see question 2), which is still accepting applications and renewals. This has important implications for health coverage of undocumented families. All those accepted into the original DACA program are also eligible for Medi-Cal. An estimated 11,000 Californians (PDF) who qualified for the original DACA program are now covered by full-scope Medi-Cal.

The good news is that the Medi-Cal expansion is off to a strong start. DHCS reports that so far more than 125,000 kids have successfully enrolled in full-scope Medi-Cal since the expansion went into effect in May 2016. Community health centers continue to play a vital role in helping children enroll and providing them with the care they need. Clínica Romero has already seen a huge difference, with newly enrolled kids coming in for long-delayed care, including dental, vision, and mental health services.

Much work remains, as thousands of eligible kids are still not enrolled. For organizations on the front lines of outreach and enrollment, tools and resources related to the expansion of Medi-Cal are available at the ALL IN for Health website. For example, the California Welfare Directors Association recently released a list of designated county staff with whom partners can work to assist immigrants and mixed-status families (those in which some members are legally present and others are undocumented) having trouble with the Medi-Cal application.

The fight also continues to build a more just and inclusive, and therefore healthier, society. An estimated 1.1 million Californians (PDF) could have gained health coverage through Medi-Cal and Covered California with the expanded DACA and DAPA programs. Parents living under the threat of deportation are less likely to get the health services they need and frequently are too scared to enroll their children in vital public programs. Children in constant fear that a parent or loved one will be deported are more likely to suffer depression and anxiety, which can have a tangible effect on brain development, performance in school, and long-term life outcomes. As advocates and health care providers in the community, we see this reality every day.

California has led the way with policies for expanding Medi-Cal, providing in-state tuition and state educational grants to undocumented students, and allowing undocumented immigrants to apply for driver licenses. Immigrants are part of the fabric of society, and we must keep pushing the envelope. The immigrant community’s health, well-being, and ability to realize its full potential are directly linked to the future success of our state and nation.

Mayra E. Alvarez

Mayra E. Alvarez, MHA, is President of The Children’s Partnership, a statewide advocacy organization working to advance child health equity through policy, research, and community engagement. She also serves as a commissioner on the California Mental Health Services Oversight and Accountability Commission and First 5 California Commission. Previously, she served at the US Department of Health and Human Services during the Obama-Biden administration, including at the Centers for Medicare and Medicaid Services, the Office of Minority Health, and the Office of Health Reform. Alvarez is from outside San Diego and is the proud daughter of Mexican immigrants.

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Sandra Rossato

Sandra B. Rossato is executive director of Clínica Monseñor Oscar A. Romero, a Federally Qualified Health Center with two sites whose mission is to provide affordable, quality health care, health education, and advocacy to the uninsured and underserved communities of greater Los Angeles. She is part of the California immigrant policy leadership and a member of the University of Southern California Dean’s Community Leadership Council.