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Executive Action: Protected immigrants could access Medi-Cal, but state budget language is unclear

The proposed Calif. budget says immigrants who qualify for deportation protection under executive action
The proposed Calif. budget says immigrants who qualify for deportation protection under executive action "potentially" qualify for Medi-Cal.
Henry A. Barrios/The Californian (Bakersfield)

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It has been a little less than two months since President Obama announced his executive actions on immigration. According to the Pew Research Center, more than five million immigrants without legal status will be eligible for deportation relief once the application process begins. Roughly one million could qualify in California. But will they be able to obtain healthcare under Medi-Cal? The proposed state budget only goes so far as to say they could potentially qualify – and that has rankled immigrant advocates.

Gov. Jerry Brown’s proposed budget summary reads:

These individuals may be recognized as having Permanent Residence Under Color of Law status due to their deferred action status, and/or because the federal government does not intend to deport them. This status potentially qualifies individuals for state‑funded full‑scope Medi‑Cal, In‑Home Supportive Services, and Cash Assistance Program for Immigrants.

At this time, there is a great deal of uncertainty about the scope, timing and effect of these actions. Consequently, the Budget does not assume any higher costs from these individuals, but covering eligible immigrants under these programs could cost hundreds of millions of dollars annually. 

The description of Medi-Cal eligibility as "potential" is one sticking point - another is the lack of a specific budget commitment.

"We are very disappointed that the government said that those who receive deferred action may potentially qualify for Medi- Cal," said Reshma Shamasunder, executive director of the California Immigrant Policy Center. "We know for certain, based on California law, that they will qualify for it, if otherwise eligible. So it's time for the governor to stop using... this squishy language."

But California Department of Finance spokesman H.D. Palmer says there’s a reason why there aren't more specifics - there haven't been many specifics released by the federal government. He said it's still unclear how many could be eligible for Medi-Cal.
“The bottom line is that we don't know yet," Palmer said. "We’re still waiting for more specific guidance from the federal government regarding the status of these individuals. Once we get that guidance, we’ll have a better understanding of the number of individuals who qualify for a number of state-only programs.”
There is a precedent for coverage, though: State officials say that roughly 30,000 individuals who qualified for Deferred Action for Childhood Arrivals, which grants a two-year deportation reprieve to young immigrants who arrived as minors, have qualified for Medi-Cal.

Immigrant advocates say there's no reason those who qualify for temporary relief under executive action should be treated any differently.
"They are going to fall into the same kind of lawful status," Shamasunder said.

Palmer said that so far, it’s impossible to budget for an influx of  new Medi-Cal recipients, without knowing how many may qualify for executive action.

"Until we get that guidance from the federal government, we can't hang a specific dollar amount on what the cost to the state will be, or what types of services will be provided," Palmer said.

Either way, he said, the cost could run into the hundreds of millions of dollars. He added that more details could be added to the revised budget in May.