LAO Estimates Costs of Expanding Medi-Cal to Undocumented Residents

The California Legislative Analyst’s Office (LAO) this week issued an analysis of the estimated costs of expanding full-scope Medi-Cal coverage to all otherwise-eligible residents regardless of immigration status. The LAO notes their analysis is not of a specific legislative measure – such as AB 4 (Arambula) – but instead a cost estimate of a coverage expansion.

According to the LAO, with a January 1, 2022, implementation date, the additional cost of expanding full-scope coverage to all otherwise-eligible individuals but for their immigration status would total $790 million General Fund ($870 million total funds) in 2021-22. On an ongoing basis, the LAO estimates the additional cost of expansion would be $2.1 billion General Fund (nearly $2.4 billion total funds). The LAO anticipates ongoing costs likely would grow over time in line with inflation and would be adjusted to reflect changes in caseload and utilization.

The additional costs of coverage expansion reflect the difference between: 1) Medi-Cal costs of providing full-scope coverage to the newly eligible population; and 2) Medi-Cal costs that otherwise would be incurred if only restricted-scope coverage were maintained for this population. The LAO identifies a number of considerations and outstanding questions for the Legislature, primarily relative to caseload and per-enrollee costs.

The full LAO report is available here.