Medi-Cal: eligibility: immigration status.

Plain English Breakdown

The bill summary and digest do not provide specific details about when the changes will take effect or what the exact exceptions to the $30 monthly premium requirement might be.

Medi-Cal Eligibility: Immigration Status

This bill changes Medi-Cal eligibility rules so that individuals aged 19 or older without satisfactory immigration status can receive full health care benefits, except for certain dental services and subject to the payment of a monthly premium.

What This Bill Does

• Changes the Medi-Cal program to allow individuals aged 19 or older who do not have satisfactory immigration status to be eligible for all Medi-Cal benefits if they meet other eligibility requirements, with exceptions for specified dental benefits.
• Requires these individuals to pay a monthly premium of $30, except in certain cases where exceptions apply.
• Imposes new responsibilities on counties to determine Medi-Cal eligibility under the revised rules.

Who It Names or Affects

• Individuals aged 19 or older who do not have satisfactory immigration status and are eligible for Medi-Cal benefits.
• Counties responsible for determining Medi-Cal eligibility.

Terms To Know

Medi-Cal

A health care program in California that provides medical services to low-income individuals, funded partly by the federal government through Medicaid.

Satisfactory immigration status

Having legal documentation proving lawful presence or permanent residence in the United States.

Limits and Unknowns

• The bill does not specify when it will take effect.
• It is unclear what specific exceptions exist for individuals who do not have to pay the $30 monthly premium.
• Counties may face additional costs due to changes in Medi-Cal eligibility determinations.

Official Summary Text

SB 1422, as introduced, Durazo.
Medi-Cal: eligibility: immigration status.
Existing law establishes the Medi-Cal program, which is administered by the State Department of Health Care Services and under which qualified low-income individuals receive health care services. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. Existing law sets a schedule of benefits that are covered by the Medi-Cal program.
The federal Medicaid program prohibits payment to a state for medical assistance furnished to an alien who is not lawfully admitted for permanent residence or otherwise permanently residing in the United States under color of law. Existing state law extends Medi-Cal eligibility for the full scope of Medi-Cal benefits to individuals who do not have satisfactory immigration status if they are otherwise eligible for those benefits, with the exception of specified dental benefits for
individuals who are 19 years of age or older. Existing law makes an individual who is 19 years of age or older, who does not have satisfactory immigration status, and who applies for Medi-Cal on or after January 1, 2026, or loses eligibility for eligibility for full-scope Medi-Cal on or after January 1, 2026, eligible only for pregnancy-related services and emergency medical treatment. Existing law, beginning no sooner than July 1, 2027, as specified, requires individuals who do not have satisfactory immigration status, who are not pregnant, and who are 19 to 59 years of age, inclusive, to pay a monthly premium of $30, subject to certain exceptions.
This bill would instead make an individual who is 19 years of age or older, who does not have satisfactory immigration status, eligible for the full scope of Medi-Cal benefits subject to certain limitations, such as the payment of premiums and certain dental benefits.
Because
counties are required to make Medi-Cal eligibility determinations and this bill would alter Medi-Cal eligibility, the bill would impose a state-mandated local program.
The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
This bill would provide that, if the Commission on State Mandates determines that the bill contains costs mandated by the state, reimbursement for those costs shall be made pursuant to the statutory provisions noted above.

Current Bill Text

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