Primary-care providers say an expansion of Medi-Cal coverage to undocumented children in California will help them serve a population that is flooding the system. But low Medi-Cal payment rates could limit the value of expansion.
Gov. Jerry Brown and legislative leaders announced the proposal last week to cover children under age 19 as part of a budget deal.
About 170,000 kids could qualify for the expansion. Coverage to qualifying children would begin in May 2016, costing $40 million under the new budget and an estimated $132 million in annual funding after that. Currently, the state offers undocumented immigrants only emergency and pregnancy-related services.
“Some parents may delay seeking care for their child, hoping they'll get better because they are nervous they'll get a big bill at the hospital” or that they may be reported to immigration officials, said Janet Coffman, associate professor of health policy at the University of California at San Francisco.
For children illegally in the country to be eligible for Medi-Cal, the state's healthcare program for the poor, a family of four would have to make less than $59,625 a year.
The policy change means children will be able to access preventive services and not have to wait for an emergency to seek care.
However, Medi-Cal rates paid to providers are so low that there's a shortage of physicians who accept Medi-Cal, said Jan Emerson-Shea, vice president of external affairs at the California Hospital Association. The state ranks 48th in the nation in how much it pays hospitals, doctors and other providers for treating Medi-Cal patients, according to the Kaiser Family Foundation.