Video: Health Conditions and Health Care Among California’s Undocumented Immigrants

California is preparing for its final expansion to Medi-Cal in January 2024, which will include all low-income Californians regardless of immigration status. In a recent presentation, PPIC research associate Shalini Mustala presented findings from a new PPIC report on the services that undocumented patients tend to use in community clinics, information that can help the state prepare for a new influx of patients. PPIC researcher Paulette Cha moderated a panel discussion on lessons learned from the recent round of Medi-Cal expansions.

While undocumented patients in all age groups are less likely than current Medi-Cal patients to visit clinics specifically for preventive health services, Mustala reported that undocumented patients benefit from some screenings age-appropriate services, such as mammograms and colonoscopies, at similar rates. Additionally, undocumented patients in Los Angeles County, studied among its large immigrant population, were more likely to receive a stool colon test or shingles vaccination in screening tests that do not require reference.

Common chronic illnesses begin to appear in patients in their 30s and 40s, noted John Heintzman, associate professor of family medicine at the Oregon Health and Science University School of Medicine. When patients have Medi-Cal coverage, providers can diagnose, begin treatment, educate and intervene before conditions develop complications. Medical coverage opens up routine treatment options. [A health concern then becomes] a problem lasting a few months rather than turning into a longer, debilitating problem.

Mustala found that being undocumented increases the likelihood that a visit will be related to behavioral health, a connection that is particularly strong among young adults (1925) in Los Angeles County. Demand for mental health services like counseling is high, despite long wait times to see a provider and facing a shortage of mental health providers.

When one member of a household has a behavioral health issue, it impacts the health and mental health of other members of the household, said Richard Pan, a former state senator and current board member. administration of the Health Care Affordability Board. Previous gaps in care, where one household member was covered and another was not, made treatment difficult; the January expansion closes this gap.

Cha questioned how the state could accommodate patients’ language needs. While California is linguistically diverse, it can be difficult to recruit providers who are fluent in Spanish; finding providers who work in less widely spoken languages, such as Asian or Pacific Island languages, can be more difficult.

Not speaking can affect care, especially mental health, which is about communication, Pan said. [Patients] I can’t communicate the symptoms, [and providers] I cannot communicate the treatment plan. It ends up costing more because we’re doing more testing because we can’t communicate. Access to languages ​​remains a policy area that needs to be addressed.

However, to receive Medi-Cal coverage, communities must be aware of their eligibility. Roshena Duree, deputy director of self-sufficiency at the California Association of County Welfare Directors, noted that relying on trusted messengers from community organizations to provide accurate information has helped counties in their transitions during previous Medi-Cal expansions.

Duree also highlighted news that counties are working to automate registrations. Some people will not need to visit an office or call; counties will automatically transition them to Medi-Cal when the January expansion occurs, a step toward streamlining access for all eligible Californians.