PPIC Issues Report on Health Coverage for Undocumented Residents

The Public Policy Institute of California (PPIC) this week issued a report detailing health coverage and care statuses of undocumented residents in California. The latest report updates data and findings from PPIC’s previous work on the subject and examines aspects of how children in mixed-status families engage with the health care system.

Considering changes in the federal and state contexts over the past five years, including the COVID-19 pandemic, PPIC finds that:

• Uninsured rates are high for low-income undocumented immigrants; uninsured rates for those older than age 50 are especially concerning given higher levels of health care needs.
• The health care safety net serving undocumented immigrants is uneven across geography, by age group, and in some cases by health needs.
• Undocumented immigrants and their families do not use more emergency department services than other immigrants; lack of connections to the health care delivery system is a greater concern.
• Children in families with at least one undocumented member are almost 11 percent less likely to have a usual source of care compared to children in other immigrant families, although they receive health care at similar rates.

PPIC identifies a series of outstanding questions, including how to improve access to health insurance coverage and medical care for undocumented immigrants and their families. Current legislation, such as AB 4 (Arambula) and SB 56 (Durazo), proposes further expansion to cover all low-income adults regardless of immigration status. According to PPIC, expanding affordable insurance options could begin to address coverage gaps experienced by undocumented Californians.

In addition to coverage expansions, PPIC recommends incentivizing all counties to serve undocumented immigrants in their programs for the medically indigent and increasing supports for safety net providers to improve equity in accessing medical care. Outreach to immigrant communities through community-based organizations and other trusted messengers could begin to alleviate some of the fear undocumented immigrants and their family members have around government programs.

The full PPIC report on health coverage among undocumented Californians is available here.