California approves $315 million Medicaid expansion for some undocumented immigrants
Following the Democratic state legislature’s approval of a budget plan, California is set to become the first state to offer Medicaid benefits to undocumented immigrants between the ages of 19 and 25. The expansion is projected to cost $315 million by 2021, with California taxpayers footing approximately 80 percent of the bill. The remainder will be paid for with federal dollars under a provision of federal law that allows funds to be used for emergency, labor and delivery care. A spokesperson for CMS confirmed that the state’s approach is legal. The recently passed state budget also enacts other health reforms, including a state-level individual mandate.
Half of undocumented Californians have incomes below Medicaid limit
To qualify for Medicaid expansion, applicants must earn less than 138 percent of the federal poverty level — $17,236 for a single adult, or $35,535 for a family of four in 2019. According to a report by the Public Policy Institute of California, just over half of undocumented immigrants in the state have incomes below this limit. Undocumented Californians with higher incomes would not be able to enroll and are also ineligible for subsidized insurance on the state Obamacare exchange. But it may be possible for undocumented individuals above the Medicaid limit to buy unsubsidized coverage outside of the state exchange.
Income distribution of undocumented immigrants in California, as a percentage of the federal poverty level
Nationwide, nearly half of undocumented immigrants are uninsured
Because most safety net health programs — including state Medicaid programs and Obamacare — exclude undocumented immigrants, they constitute a large portion of the remaining population of uninsured adults and children nationwide. In California, undocumented children under age 19 already qualify for Medicaid coverage.
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