Laura Cruz, 52, pulls out the salsa from her fridge in her home in Kern County. She’s preparing lunch for her 12-year-old daughter, who will be arriving home from summer school.
Cruz is undocumented. When she first arrived in Bakersfield from Mexico in 2003, she cleaned houses and took care of the children of farmworkers in her neighborhood.
Seven years later, doctors diagnosed her with lupus, an autoimmune disease that causes the immune system to attack the body's organs. Because of her diagnosis and documentation status, Cruz says it’s been hard for her to find work, making her husband the sole provider for their family.
“It’s difficult,” she says in Spanish. “You either attend to your health; you pay for groceries or you pay your bills, but you can’t do it all.”
Her lupus treatment has been so costly that her family hasn’t been able to take a vacation in more than a decade. Still, Cruz considers herself one of the lucky ones. She gets health insurance through her husband, who works as a fumigator.
“However, we still have to pay the copayment,” she says. “It’s not health insurance that’s free.”
This week, state lawmakers approved the budget for the 2021-22 fiscal year. It includes funding for the extension of full-scope Medi-Cal to low-income undocumented residents ages 50 and older.
Access to health care is a chief concern for many undocumented Californians like Cruz, according to civil rights advocate Dolores Huerta, founder of the Dolores Huerta Foundation, which works to help organize and advocate for under-served communities in the Central Valley.
“Health care is always the first thing that they mentioned, because it can be so devastating for families when someone gets sick,” Huerta says. “And again, when people have to go to the emergency room, because they can't get health care anywhere else.”
Fresno lawmaker pushes for Medi-Cal for all
Last year, undocumented people ages 19 to 25 gained acces to Medi-Cal. Huerta says state leaders’ recent decision to offer Medi-Cal to everyone over age 50, regardless of status, is the right decision.
But Fresno-area Assemblymember Joaquin Arambula is pushing for something even bigger: Full-scope Medi-Cal for all undocumented low-income residents.
“Because they pay their fair share of taxes into a system that they are unjustly excluded from,” he says. “I believe after going through this pandemic, it's now time for us to figure out how to systemically expand access to those who are most vulnerable.”
The state Legislative Analyst’s Office estimates there are nearly 1 million Califorians who would gain access to Medi-Cal, if it were expanded to all qualified adults regardless of immigration status. Arambula believes the legislature’s deal is a good first step in shrinking that number, since it will cover about 250,000 people.
“This is more than an appropriate way for us to make a downpayment while working on a plan to get towards universal coverage within this governorship, ” he says.
Yet more than 700,000 undocumented people between ages 26 and 49 still don’t qualify.
The campaign to expand Medi-Cal is more than 7 years in the making, according to Sarah Dar, Director of Health and Public Benefits at the California Immigrant Policy Center.
“The goal has always been to cover everyone, not to do it incrementally, with different age brackets,” she says.
She says it was difficult to get then-Gov. Jerry Brown, and Gov. Gavin Newsom, to fully invest in Medi-Cal for all low-income undocumented residents because it covers a variety of medical services including doctor visits, hospital stays and prescription drugs. But the pandemic’s impact on essential workers and the undocumented community has highlighted the need for expanded access to health care, she said.
"We've sort of, over the years, been put in a position of being asked, ‘Well, if we can't do everyone, where should we start?’ and our coalition really, several years ago said, ‘you know, if we have to start somewhere, it's our elders,’” she says.
Medi-Cal expansion begins in 2022
Laura Cruz agrees that many older undocumented residents don’t get the medical attention they need.
“They don’t shy away from the doctor because they don’t want to go or for a lack of interest,” she says. “but because their economic status doesn’t allow for it.”
When Cruz learned that the state legislators and the governor had a reach a deal that included low-income undocumented people 50 years and older she said it gave her goosebumps.
They’re still struggling to recover financially from the pandemic, but she says now that she qualifies for Medical, taking a trip to the beach with her family is within reach.
Low-income undocumented residents ages 50 and older will be eligible for Medi-Cal beginning in May 2022.
