California is preparing for the final expansion to Medi-Cal in January 2024, which will include all low-income Californians regardless of immigration status. In a recent presentation, PPIC researcher Shalini Mustara outlined findings from a new PPIC report on services that undocumented patients tend to utilize in community clinics, helping states prepare for an influx of new patients. This was useful information. PPIC Researcher Paulette Cha moderated a panel discussion on lessons learned from her recent series of Medi-Cal expansions.
While undocumented patients of all ages are less likely than current Medi-Cal patients to visit a doctor’s office, especially for preventive health services, Mustara reported that they are receiving age-specific tests at similar rates. In addition, undocumented patients in Los Angeles County, which has a large immigrant population, were more likely to have had a fecal colonoscopy and a shingles vaccination on record. These tests do not require a referral.
“Common chronic conditions start to emerge in patients’ 30s and 40s,” said John Heinzman, associate professor of family medicine at Oregon Health & Science University School of Medicine. If a patient has her Medi-Cal, health care providers can diagnose, start treatment, educate, and intervene before complications occur. “Medi-Cal coverage expands everyday treatment options. [A health concern then becomes] Will it be a matter of a few months, or will it develop into a long-term and difficult problem? ”
Mustara found that being in the country illegally makes visits more likely to be for behavioral health purposes, and this trend is especially strong among young people (ages 19 to 25) in Los Angeles County. Demand for mental health services, such as counseling, is high despite long wait times to see a provider and a shortage of mental health providers.
Richard Pan, a former state senator and current director of the Affordable Care Commission, said, “If someone in a household has a behavioral health problem, other people in the household will “It affects their health and mental health.” Previously, one member of the household was covered by insurance, and the other was not, making treatment difficult. This gap will narrow as the economy expands in January.
Cha questioned how the state could address patients’ language needs. Although California is linguistically diverse, recruiting health care providers who are fully fluent in Spanish can be difficult. It can be even more difficult to find a provider that offers services in less commonly spoken languages, such as Asian and Pacific Islander languages.
“Lack of language can have an impact on mental health, especially when it comes to care, especially communication,” Pan said. “[Patients] Unable to communicate symptoms, [and providers] Unable to communicate treatment plan. The lack of communication means more testing, which ultimately costs more. ” Language access remains a policy area that needs to be addressed.
However, to benefit from Medi-Cal coverage, your community must be aware of its eligibility. Roshena Dury, deputy director of self-sufficiency for the California Association of County Welfare Directors, said relying on trusted messengers from community-based organizations to provide accurate information was important to counties during previous Medi-Cal expansions. He emphasized that it was helpful in the transition.
Durie also highlighted news that the county is working to automate registration. Certain people don’t have to come into the office or make phone calls. Once the January expansion occurs, the county will automatically transition to Medi-Cal. This is a step toward streamlining access for all eligible Californians.