By RIA ROEBUCK JOSEPH
THE CENTER SQUARE CONRIBUTOR
(The Center Square) – For the past six years, the state of California has been working to extend health coverage to more residents. Now it has taken the next step.
In 2016 full-range MediCal benefits which cover low- and no-cost health, behavioral health, substance abuse services, and dental services, were extended to children under 19 years of age in a program designed to bring quality health coverage to low income individuals and families. In 2020, this was amended to include all individuals 25 years and younger regardless of immigration status. Coverage was further extended to over 185,000 residents over 50 years regardless of immigration status in May 2022.
There is a shift happening in California’s health care coverage as the governor moves to extend MediCal to hundreds of thousands more in an important step towards universal healthcare coverage.
The latest expansion of the MediCal program seeks to provide publicly-funded health care for the incarcerated. The state has used reports on the changes made over the last six years to ask the federal government for a waiver on restrictions on publicly funded healthcare for individuals still imprisoned. Approval of the waiver is expected this month and would allow inmates to access MediCal coverage for a variety of chronic illnesses, drug addiction, mental illness and pregnancy, up to 90 days before release.
Securing health care prior to release for California’s incarcerated is just one part of a bigger picture in the California Advancing and Innovating MediCal (CalAIM) scheme which was introduced last year. That program works to address inadequate nutrition, housing instability and other social factors that can contribute to poor health.
The American Academy of Family Physicians Foundation reports that previously incarcerated individuals return to society with a number of chronic diseases including hypertension, diabetes, asthma, mental health problems, and substance use disorders as well as communicable diseases like hepatitis, HIV and tuberculosis. In fact, 1 in 12 is hospitalized within 90 days of release for an acute condition.
WIth the CalAIM program reforming MediCal, and the continuous expansion of MediCal itself, it’s not surprising that the Department of Health Care Services reports that more than half of the approximately $133 billion annual budget earmarked for MediCal is spent on populations with the highest needs: the homeless, addicted, impoverished, mentally ill and incarcerated who make up just 5% of its enrollees. Over the next five years, CalAIM, initiated by DHCS, will be redesigned to address “whole person care” in an effort to mitigate more expensive emergency visits and hospitalization.
Those formerly imprisoned face a number of challenges with reintegration. With MediCal benefits now available before their exit and an automatic enrollment requirement prior to their release in place, the road to access is made more simple, perhaps easing one aspect of transition.
With a state the size of California housing the largest population of incarcerated individuals, comprehensive programs to address their particular challenges can only help to reduce recidivism.
Governor Garvin Newsom’s 2022-23 budget proposes another MediCal expansion to include an additional 700,000 individuals irrespective of immigration status. With legislative approval,residents 26 to 49 years of age will be eligible for coverage, this will be the next step in California’s coverage expansion.
“This is an investment in our people, our economy and our future. But we’re not stopping there. California is on the path to expand Medi-Cal to all eligible Californians regardless of age or immigration status, providing the most comprehensive health coverage in the entire country,” the governor said.
