California Expands Medi-Cal Coverage Yet Again

Leading the Nation in Serving the Health Care Needs of Low-Income Families and Undocumented Residents

Starting on January 1 this year, California became the first state in the nation to ensure that all low-income residents qualify for Medi-Cal, the state’s version of Medicaid. The expansion includes undocumented immigrants who are otherwise eligible for Medi-Cal based on income or other qualifying conditions, such as disability, pregnancy, or foster care status. This move is great news not only for the people who will now get healthcare they couldn’t receive before, but also for all Californians who will benefit from improved public health overall.

Along with the expansion, however, it will be crucial for the Department of Health Care Services as well as policyholders and their families to be on alert for bad faith insurance practices by Anthem, Health Net, Blue Shield Promise Health, and other insurance companies servicing Medi-Cal recipients. Bad faith claim denials in Medi-Cal are not only wrongful but also especially damaging for people on the fringe of society like undocumented immigrants who already face language barriers and other hurdles when it comes to accessing preventive care and other forms of healthcare. Learn more below about California’s new first-in-nation law, and contact Gianelli & Morris for help with unreasonable claim denials from a team of skilled and experienced California insurance bad faith lawyers.

California’s Long March Toward Universal Healthcare

This latest move is the first significant expansion of Medicaid in California since 2014 when the state expanded Medi-Cal eligibility to most low-income adults under the Affordable Care Act (aka ACA or Obamacare). When first enacted in 2010, the ACA only covered low-income individuals belonging to specific categories of eligibility, such as seniors, persons with disabilities, and parents of minor children. The long march toward universal coverage envisaged in the ACA is nearly complete in California now, thanks to this recent change. Before the new policy for 2024, undocumented immigrants could only get a stripped-down version of Medi-Cal that covered medical emergencies or certain specified conditions. Prior to this year, lawful immigration status was a precondition to qualifying for comprehensive Medi-Cal services. Undocumented immigrants were the largest (and hopefully last remaining) group of uninsured persons in California.

California first expanded Medi-Cal to low-income children without regard to immigration status in 2016. This move applied mainly to children who entered the US without proper documentation since children of undocumented immigrants born in the United States automatically receive “birthright” citizenship. Medi-Cal was next expanded in 2020 to young adults between the ages of 19 and 26. Eligibility was broadened once more in 2022, this time to include adults aged 50 and over. This expansion was especially significant, not just for its large increase in numbers, but also because it would include a less healthy and more expensive population to serve compared to children and young adults.

The expansion of Medi-Cal to undocumented immigrants in California is now complete with the decision this year to cover individuals between the ages of 26 and 49. This move will likely see the largest increase yet in Medi-Cal enrollees. While this expansion will be the largest by far in terms of numbers of new enrollees, it will likely be a more diverse mix of people with different health status and needs as a group, compared to children or older adults, say. The cost of this latest expansion is therefore not yet known, but it is expected to approach $3 billion.

Over three-quarters of a million immigrants are expected to enroll under the expanded eligibility rule, although it might take some convincing, as many undocumented immigrants are wary of applying for government services out of fear their immigrant status will be reported to Immigration and Customs Enforcement or that they will be deported under the “public charge rule” regarding admission to the United States. Neither worry should be of concern to apply for Medi-Cal under the new rule.

Contact Gianelli & Morris for Help With Bad Faith Medi-Cal Insurance Denials

Medi-Cal is crucial for undocumented immigrants who often don’t get health insurance from their employers and are not eligible to apply for coverage from the healthcare marketplace, aka Covered California. As attorneys who regularly take on insurance companies when they mistreat Medi-Cal recipients, we encourage all California residents to secure adequate healthcare coverage and to be vigilant in asserting their rights to be treated fairly and receive the services they need, whether through private insurance, employer-sponsored plans, Covered California or Medi-Cal.

Thanks to the Public Policy Institute of California for its excellent reporting on this significant Medi-Cal expansion. If your request or claim for coverage or healthcare services has been unreasonably denied by Anthem, Health Net, Blue Shield Promise Health Plan, or other Medi-Cal insurance companies in California, call Gianelli & Morris at 213-489-1600 for a free case evaluation to find out how we can help.