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California is ahead of the nation in its plans to insure undocumented immigrants.

Starting May 1, low-income Californians 50 and older will be eligible for healthcare coverage regardless of immigration status. Around 235,000 Californians aged 50 years and older are newly eligible for Medi-Cal, including preventive services, long-term care and In-Home Supportive Services.

California has led the way in insuring undocumented children first offering Medi-Cal coverage to children without legal status through the age of 18 in 2016. The state also expanded insurance to the undocumented up to age 26 mirroring the Affordable Care Act. In 2019, California became the first state to extend Medi-Cal coverage to all eligible undocumented young adults up to the age of 26.

But there are still many undocumented immigrants in California who are not covered. That may soon change.

In his proposed state budget released on January 2022, California Gov. Gavin Newsom included Medi-Cal coverage for an estimated 700,000 undocumented, uninsured adults with low incomes age 26–49. This would be the last remaining group excluded from enrolling in the program.

If approved by the state legislature, the additional eligibility would take effect on or after  Jan. 1, 2024.

However, undocumented immigrants who make above the income requirements for Medi-Cal could be left out. Undocumented immigrants are not eligible to purchase health insurance under the federal Affordable Care Act.

Around 90 percent of low-income undocumented adults lack health insurance, according to the UC Berkley Labor Center. Noncitizen adults are uninsured at more than three times the rate of their citizen counterparts 18.4% compared to 5.6%, according to the California Health Care Foundation. 

There is popular support among California voters to ensure all undocumented immigrants, according to the Public Policy Institute of California,

66% of Californians approve of insuring the undocumented. Support is greater among Democrats (82%) and independents (57%) than among Republicans (20%). Most Latinos (83%), African Americans (77%), and Asian Americans (70%) support insurance for the undocumented but only a slim majority of whites (51%).

In addition, an overwhelming majority of Californians, 85%, say there should be a path to citizenship for undocumented immigrants, according to the policy institute.

Medi-Cal eligibility to all immigrants without legal status is estimated to cost $2 billion, according to the California Immigrant Policy Center.

Some may argue that California can’t afford the price tag to insure undocumented immigrants.

The state has a projected surplus of $45.7 billion, which includes $20.6 billion in the General Fund for discretionary purposes, according to the governor’s budget summary.

Over one million California workers, or six percent of the workforce, are undocumented, according to the Community and Labor Center at the University of California, Merced. They deserve health insurance.

They more than pay for their insurance based on their contributions to the economy. Undocumented workers generate $3.7 billion in state and local tax revenues in California’s economy.

Many of these workers also work in essential services, such as food, farm and factory labor, and risked their lives during the pandemic to support the California economy.

The mortality rate for Latinos in Los Angeles County rose by 48 percent during the Covid-19 pandemic, more than any other ethnic group, according to Los Angeles County data. The increase in the mortality rate for other groups in Los Angeles were 23 percent for Black people, 22 percent for Asians and 7 percent for whites from 2019 to 2021.

Former U.S. Surgeon General Antonia Novello, the first woman and first Latina to hold that office, once said, “Viruses and bacteria don’t ask for a green card.”

If a person is sick, whether from COVID-19, the next variant, or some other disease we haven’t yet faced, we all are vulnerable. Let’s protect our state’s health by covering everyone regardless of immigration status.