California's Universal Healthcare: Reaching Immigrants

Health Care Access

Central LA

Expand existing project, program, or initiative

California will seek to enroll more than 700,000 undocumented immigrants in health coverage, over 200,000 of whom are in Los Angeles County, in advance of the coverage start date of 1-1-24. However, many are "hard to reach" due to language and other barriers. Los Angeles County is home to one of the largest concentrations of non-English, non-Spanish speaking Central American immigrants in the country, but the US Census does not track them. MCHA has worked with immigrants since our founding in 1996. Our outreach staff speak Mayan languages, as the languages of Guatemala are called, and know their communities. Immigrants have attended our weekly classes and other events, and been assisted with housing, health and food issues since our founding. But fear, bureaucracy, illiteracy, language barriers, and confusion or lack of knowledge about the need to sign up and choose a health plan, for example, will keep many from receiving this essential support.

Through direct outreach, classes, word of mouth, videos and use of social media in several indigenous languages and Spanish, we will inform immigrants of the upcoming health coverage opportunity, and refer them to our enrollment staff. We have used radio shows and FB Live programs with success for Census work and during the pandemic. On 1-1-24, these enrollments will become "full scope" Medi-Cal providing vision, dental, in-home support and other services. It is essential to utilize immigrants to reach out to immigrants because of fear, misinformation and bureaucracy. MCHA has extensive connections already with Central American clientele, and will use direct contact - phone calls and texting, our events, door-to-door and and community opportunities, such as marketplaces and social services sites - to address three major issues: Lack of awareness. Although full health coverage expanded to young adults 18-26 in 2020, and to adults 50 and over in 2022, we still see eligible immigrants not enrolled. Fear. Under the prior administration, prohibition against immigrant use of government benefits expanded. The fear that using government benefits would impact one's immigration status was and is a barrier, although prohibitions have been lifted. Bureaucracy. Unfortunately, completing an enrollment successfully can be difficult, even more so since enrollment and maintenance of one's benefits is largely online. This is a huge hurdle for those with an often unwritten language.

If successful, a large majority of the eligible population will be enrolled in health coverage as of 1-1-24 or shortly thereafter and will have the opportunity to address longstanding chronic conditions, get glasses and dental care, and help to stay in their home if infirm, among other benefits. Being healthy affects the ability to work and support oneself and one's family, family relationships and mental health. Health care is complex and overwhelming for those born in this country with a command of the English language. It is more so for someone who has no one to assist them in their own language. Longer term, we hope to help enumerate and bring focus to the issues these groups face. If successful, interpretation in non-English, non-Spanish languages will be recognized as a right, fewer immigrants will be uninsured, and more immigrants will be healthy, with their post emergency, chronic and other care needs addressed.

Our project has measured its impact with numbers of people who were assisted with health coverage issues, enrolled in health care, and who renewed their health care. Our in-language outreach staff worked to reach neighborhoods for the census, encouraging people to be counted, when the pandemic struck, in 2020. After 2020, they worked on addressing COVID protection and then vaccination and treatment awareness and participation, reaching thousands. We are contributing to a whole that only improves over time, with multiple agency's efforts and policy work. We see this change slowly, in the willingness of people to enroll in benefits and the spread of coverage to include now, in California, everyone who lives here regardless of immigration status. This is a huge accomplishment that we have helped to bring about with both our direct services to reach, enroll, troubleshoot, and renew health coverage, and our policy work to improve the process to reach more people and to improve quality.