XPost: alt.politics.immigration, alt.california.illegals, alt.politics.republicans
XPost: sac.politics, talk.politics.medicine
Local health care leaders are warning that proposed changes to
California’s Medi-Cal coverage for undocumented residents will create
more challenges to accessing health care, potentially increase the costs
for everyone and overwhelm local emergency rooms.
The changes, announced last week by Gov. Gavin Newsom as part of his
effort to address a $12 billion state deficit, would freeze enrollment
for undocumented residents over 19 and impose new monthly premiums,
reversing years of expanded health care access in Santa Cruz County.
“Is that really the way we’re going to balance the budget? On the back
of undocumented residents of California?” asked Raymon Cancino, CEO of Community Bridges. The Watsonville-based nonprofit helps residents
across Santa Cruz County access resources, such as enrolling in
Medi-Cal. The organization has nearly 8,000 undocumented clients
enrolled in the state’s health care program, Cancino said.
The impact could be particularly severe in the county’s hospital
emergency services. At Watsonville Community Hospital, where the
emergency department’s 12 beds served 35,000 patients last year, CEO
Stephen Gray predicts longer wait times and worse health outcomes.
Taking away access to health care coverage and eligibility will just
make people sicker and die earlier, said Gray. “It will put further
constraints on an already financially challenged health care system in
our community,” he said.
Medi-Cal — California’s Medicaid program — provides free or low-cost
health care to more than a third of the state’s population, and nearly
1.6 million of recipients are undocumented. Children enrolled in the
program will not be affected.
Nearly a year after expanding Medi-Cal coverage to undocumented
immigrants, Newsom is proposing to freeze enrollment for any new
undocumented recipients over the age of 19, starting next year. Newsom
also wants to implement a $100 monthly premium for all adults beginning
in 2027. If passed by the state legislature, the changes are expected to
save the state more than $5 billion.
In addition to an enrollment freeze and monthly premiums, Newsom’s
proposed budget suggests eliminating dental and long-term care coverage
under Medi-Cal for undocumented recipients.
Adults who enroll in Medi-Cal before the end of the year, and those
already enrolled, will still be eligible for coverage in 2026. There
will also be an exception for pregnant people and emergency care.
Newsom’s proposed cuts almost feel like the state is walking back on its promise to offer universal health care, said Donna Young, CEO of Salud
Para La Gente — which runs 13 health service sites across Santa Cruz
County and in northern Monterey County.
California became the second state, after Oregon, to offer full-scope
health care to all immigrants without legal status. The state began to
expand its coverage to immigrants in 2016 in phases, and opened the
eligibility for adults between 19 and 49 years old in 2024.
As a result of the expansion, the percentage of uninsured patients using Salud’s services went from 15% at the end of 2023 to 8% by the end of
last year, said Young.
Cancino said he understands that California’s budget is “extremely
tight,” but believes state officials are taking a one-sided approach to
address their budget issues by not accounting for the possibility of
families getting into significant medical debt, and discouraging people
from accessing preventative care.
Echoing Watsonville Community Hospital’s Gray, cuts to coverage, such as eliminating dental care for undocumented residents, will only end up
flooding local emergency rooms, said Laura Marcus, CEO of Dientes —
which provides dental care for free or at a reduced cost to low-income
families across the county.
Dientes is the largest dental care provider for Medi-Cal recipients in
the county, serving 15,000 patients in its four clinics — with a fifth
opening up in August, said Marcus. “This is really going to hurt about
10% of the Medi-Cal beneficiaries in our community,” Marcus said.
This year’s planned cuts remind Dr. Sepi Taghvaei, chief dental officer
for Dientes, of when the state decided to eliminate dental coverage for
adults in 2009 due to budget issues, prior to expanding its coverage for immigrants in 2016. The state reinstated dental coverage in 2018.
Taghvaei said she believes the same scenarios will happen now as
happened after 2009: people ending up in hospital emergency rooms for
problems, such as cavities or root canals, that could have been
prevented.
“People were not coming to us because nothing was covered,” Taghvaei
said. “They weren’t coming to us until it was too late. Their faces were swollen. They were in pain, they had an infection.”
Taghaevi said the recent expansion of coverage for undocumented
residents was a huge benefit to the population Dientes serves. “We’ve
always had a huge demand for our services in the county,” she said,
adding that there was an influx of patients signing up for dental
coverage through Medi-Cal thanks to the program’s expansion.
Patients who couldn’t afford to pay for the already reduced fees Dientes charges uninsured patients were able to get the treatments, said
Taghaevi. But those reduced fees will face changes in the coming months.
Starting in July, Dientes will be increasing its sliding scale fees for uninsured patients by 10% as a result of rising costs of living and
possible cuts to Medicaid at the federal level, said Marcus. The
organization is already thinking about potential budget impacts, like
having to temporarily close one of its clinics, if both the federal and
state governments cut health care funding, she said.
“The reality is we can’t afford to keep seeing uninsured patients at the
lower rates that we’ve been seeing them, so we have to pass along some
of that cost to them,” Marcus said.
Young said she’s been advocating for Medi-Cal coverage to state
legislators, visiting Sacramento to speak with legislators and also
connecting with county officials. “The plan for me is to really help
them understand the impact of Salud, community-based organizations and
health centers,” she said.
If these cuts go through at both the state and federal level, Young said
it might reverse the progress that community organizations like Salud
have made in lowering barriers to accessing health care.
“Medi-Cal is just a lifeline for so many in our community,” Young said.
“I’m concerned about the destabilization of the broader health care
system, and most importantly, I’m concerned about the impact on the
health and well being of the members of our community and those that we
serve.”
https://lookout.co/californias-planned-cuts-immigrant-health-care-could-o verwhelm-santa-cruz-county-ers-providers-warn/story
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