When Irene Gomez meets with young undocumented families as the director of an outreach program for migrant farmworkers in Oxnard, she finds that many are struggling to get adequate medical care for their children.
Without legal residency in the United States, the families have limited access to medical services through Medi-Cal, California’s health insurance program for the poor. And affording private care is virtually impossible on a farmworkers wage. Dental and vision care is especially difficult for them to access, she said.
“We’re always talking to them about the importance of prevention and looking after oral health, but that’s hard if they don’t get consistent care,” said Gomez, a Spanish speaker, who works with the Mixteco/Indígena Community Organizing Project (MICOP) in Oxnard. “It can affect children’s education. They can develop serious problems such as cavities, and they can’t focus because of the pain.”
Now, Gomez and other outreach workers are sharing some welcome news with these families. Starting in May, the state plans to begin offering full Medi-Cal coverage to all children under 19 regardless of immigration status. That means undocumented children from low-income families will have access to medical, dental and vision benefits.
Approximately 170,000 children are expected to qualify for the program, according to California Department of Health Care Services spokesman Anthony Cava. Already, 115,000 of those children are enrolled in limited Medi-Cal benefits, known as restricted scope, which cover emergency and pregnancy-related services. These children will automatically transition to full Medi-Cal once the new law is implemented May 16.
In the meantime, community outreach organizations across the state are working hard to spread the word about the new law to their constituencies. At MICOP, information is shared via family outreach workers like Gomez, at monthly general meetings, during parenting classes and through the organization’s community radio station.
“We’re telling them: enroll in the restricted benefits and if you qualify under the guidelines you’re going to be eligible for the full scope benefits,” said Executive Director Arcenio Lopez. “We’re doing that to advance the process, to make it more effective. Don’t wait until the last minute to start with the paperwork.”
Coordinating the overall message and statewide outreach is the enrollment network California Coverage & Health Initiative, several healthcare foundations and the Department of Health Care Services, said Cava. Children Now, a California-based health advocacy organization, is among those helping to get news out to on-the-ground community groups.
Kelly Hardy, health policy director for Children Now, said spreading the message through local groups that work with specific populations such as farmworkers and indigenous immigrants is the most effective way to reach undocumented people who may be fearful and living in the shadows. They can also communicate in the language of that population.
Hardy said she expects some people will still be fearful of signing up their children for Medi-Cal. However, because many undocumented people successfully obtained California driver’s licenses last year under another change in state law, some may be less hesitant to enroll in Medi-Cal, she said.
The Department of Health Care services has said information on immigration status will only be used to determine Medi-Cal eligibility.
“Families are being assured that transitioning or enrolling children who are undocumented into full-scope Medi-Cal will not impact the children or parents in any way,” Cava wrote in an email.
But not all eligible children are expected to enroll immediately. Of the 55,000 children not yet enrolled in restricted-scope Medi-Cal ahead of the automatic transition, Cava estimated half will sign up and receive full benefits during the first year.
The state has budgeted spending $163 million on the expansion over the next two years. Although implementation is set for May 16, coverage and enrollment will be retroactive to May 1, Cava said.
Gomez, the outreach worker, said many families she speaks with are excited about the Medi-Cal expansion and eager to sign up their children. She anticipated some parents, especially those who are newer arrivals in the country, may be more fearful and hold back for a while to assess other people’s experiences under the new law before enrolling.
For Hardy, whose organization has advocated for better health coverage for undocumented children for years, the pending expansion is a turning point.
“I’m so excited because this means families will really be able to access more preventive benefits for their kids before they get to be bigger health problems,” she said. “When kids have ongoing health coverage and can access preventive services then they do better in school, they have a better chance of succeeding and really live healthier lives.”