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Coverage for Immigrant Children and Families in California

Coverage for Immigrant Children and Families in California

This post originally appeared on the Center for Children and Families' Children's Health Policy Blog.

This week, Georgetown University’s Center for Children and Families and The Children’s Partnership released a new paper outlining how to get ready for big coverage opportunities in California. It highlights opportunities that will provide coverage to more than a million people in California’s immigrant families when immigration relief takes effect.

But as spelled out in the paper, Immigration Relief for Parents and Youth = Whole Family Health Coverage in California, while we wait for some of the immigration relief-related coverage options in California to become available, there is a lot that advocates and community organizations can do right now to cover eligible children and youth in immigrant families. Here is the rundown of coverage opportunities “now playing” in California and also “coming soon” that could get many more children, youth, and parents in immigrant families covered.

Now Playing: More than 400,000 children in immigrant families are already eligible for full scope or state-funded Medi-Cal but are not yet enrolled. It is not too soon to roll up our sleeves and get to work on covering them. Here’s the breakdown:

  • More than 200,000 youth who qualify for the 2012 Deferred Action for Childhood Arrivals (DACA) program are estimated eligible for Medi-Cal but not yet enrolled. The initial DACA program announced in 2012 is for youth who came to the US before their 16th birthday; have continuously lived in the US since January 15, 2008; are at least 15 years old; are currently enrolled in school or qualifying adult education; or have graduated or obtained a certificate of completion of high school. Our estimates show that of the 343,000 youth qualified for the 2012 DACA program in California, 60%, or 206,000, are uninsured and eligible for state-funded Medi-Cal. Not all of these 343,000 youth have applied for or been granted DACA status, but if they do receive DACA status and meet the income requirements, they are eligible for a state-funded version of Medi-Cal.
  • More than 200,000 citizen or lawfully residing children in immigrant families are eligible for Medi-Cal but not yet enrolled. Our estimates show that 1.6 million children are living with immigrant parents who will be eligible for the new Deferred Action for Parents of Americans (DAPA) program in California. DAPA was announced on November 20, 2014, and, when implemented, will allow undocumented immigrant parents who have U.S. citizen or lawful permanent resident children to apply for work authorization and protection from deportation if the parent has been in the U.S. since January 1, 2010. Of those 1.6 million California children in DAPA families, 14%, or 223,000 children, are currently eligible for full scope Medi-Cal but remain uninsured. Reaching and enrolling these 223,000 children living in DAPA families would make a huge dent in the number of California’s uninsured children. This map shows that most of these DAPA families live in Southern California, with the greatest concentration in Los Angeles County, followed by Orange County, San Diego County, Riverside County, and San Bernardino County.

Coming Soon: There are also opportunities to provide health coverage to more than 800,000 additional immigrant children, youth, and parents and the time to prepare is now. California's most recent budget included funds for providing coverage to all children regardless of immigration status. And, when DAPA and the 2014 expanded DACA program take effect, hundreds of thousands of children, youth, and parents will be eligible for state-funded Medi-Cal. People granted DAPA or DACA statuses are not eligible for federal matching funds for Medicaid or CHIP or for federal premium tax credits in the health insurance marketplace. However, California provides state-funded Medi-Cal coverage for persons residing under color of law (or PRUCOLs), and DACA grantees.

  • 170,000 children in California will be eligible for state-funded Medi-Cal regardless of immigration status. California recently passed a budget bill (SB 75) that includes health coverage for all children up to 266 percent of the federal poverty level, regardless of immigration status. (Editor's Note: While the budget does included funding for expanding Medi-Cal to all children regardless of immigration status, the legislation that will enact that expansion, SB 4, authored by Senator Ricardo Lara, is currently making its way through the legislature.) Children will enroll in a state-funded version of Medi-Cal and coverage will begin no sooner than May 2016. The expansion is estimated to cover 170,000 children.
  • More than 600,000 parents in California will qualify for DAPA and likely to be eligible for state-funded Medi-Cal if granted DAPA status. More than 1 million parents in California are estimated to qualify for DAPA and 56 percent are low income by Medi-Cal standards and lack health insurance.
  • More than 50,000 youth in California will qualify for the 2014 expanded DACA program and are likely to be eligible for state-funded Medi-Cal if granted DACA status. The expanded DACA program, announced on November 20, 2014, but on hold because of litigation, is also for youth who came to the US before their 16th birthday but who have continuously lived in the US since January 1, 2010 and meet other requirements. Estimates show that of 92,000 youth qualified for expanded DACA, 60 percent or 55,200 are uninsured and likely eligible for state-funded Medi-Cal.

If you are a children’s or immigration advocate or social service provider in California, our paper also provides specific suggestions about what you or your organization can do to help get children, youth, and parents in immigrant families covered. If advocates, service providers, and others working on health care, immigration, and child and family wellbeing work together to educate and enroll children and families in health insurance, it could lead to a significant reduction in California’s uninsured rate.

State-funded Medicaid coverage for DAPA and DACA grantees and the new coverage opportunity for children regardless of immigration status is unique to California and a few other states. But, all states cover citizen children in immigrant families. And, the majority of other states (28) provide coverage to lawfully residing children in immigrant families. Although, there is always more work to be done get these eligible children enrolled in health coverage.

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