In January 2024 California became the first and only state to offer Medi-Cal to all California residents, regardless of immigration status. The new Medi-Cal Expansion between the ages of 26 to 49 can be provided full coverage of Medi-Cal if they meet the eligibility criteria. All other Medi-Cal requirements still apply, including income eligibility.

According to the California Department of Health Care Services (DHCS), applying for or having Medi-Cal will not affect an individual’s immigration status and will not make anyone a public charge. 

Eduardo Ramirez is an Associate Director of the Sustainable Rural Communities Project and a Department of Justice Accredited Representative. Ramirez’s work consists of providing immigration legal services to immigrants primarily in Northern California and San Joaquin Valley. 

Ramirez spoke with Kern Sol News to go into depth on reassuring undocumented individuals that if they apply or have Medi-Cal they will not be a public charge by the state.

What is considered as a public charge for immigrants in California today?  

Ramirez: So public charges [are] technically a grant of admissibility for individuals who are trying to get a green card through a family petition. In other words, there’s many ways that individuals can get a green card. When the individual is trying to get a green card through a family petition, [for example] I’m a U. S. citizen but my brother I petitioned for, let’s say is from Mexico. That’s considered a family petition, or if I petition for a spouse or for a child, or for my parents. All those are considered family petitions. So everybody who’s trying to get a green card through the family petition route has to prove a lot of requirements to immigration.

One of those requirements is that they have to show that they’re not going to be what’s called a public charge, meaning that they’re not going to rely primarily on government support. Either of these two kinds of benefits: cash aid benefits and/or long-term institutionalized care at a government expense. 

So when they’re applying for the green card, the officer is [asking these questions] based on the evidence, is this person likely to in the future, once they get their green card?  Is it likely that these individuals are going to be relying on cash aid once they live in the United States?  Or is it likely that they’re going to end up needing long-term institutionalized care at the government’s expense?

And if the answer to that is yes then that individual can get their green card application denied and not get a green card. It’s been a rule that has been in existence for a very long time. Because it is very case-specific analysis and the rule itself is very nuanced, there tends to be a lot of confusion in the community as to what that rule is and whether or not individuals can jeopardize their eligibility for immigration status or lose their current immigration status.

If they become a public charge but it’s a very narrow rule that only applies to a very specific amount of people and most people in my experience, haven’t been denied a green card because they would be a public charge in the future. 

Does the new Medi-Cal Expansion affect public charge?

Ramirez: So the MediCal expansion for the remaining documented uninsured is not considered cash aid, and it’s not considered long-term institutionalized care.

An individual who does participate in that kind of Medi-Cal really shouldn’t have to worry about public charge issues. I think the only red flag or the only exception to that rule is if that person is considering or is likely to receive long-term institutionalized care. Which Medi Cal could pay that person then they may have a little bit of trouble getting a green card in the future through a family petition because they used Medi-Cal to pay for long-term care. If that’s a situation that an individual finds [themself] in, then they should consult an immigration attorney to get a consultation on the case.

But in my experience, that tends to be the minority with a very [small] fraction of the population. I’ve never met somebody in my years of advocacy that [was] under that category. But yet again, it is a fear, right? A lot of people don’t understand public charge.

There’s been a lot of changes and attempts to reform public charge rules over the past [years], especially the past presidential administration. But the general message from the community, from our organization, and from partners across the state is, Medi-Cal is now safe to use and it doesn’t really affect your immigration status.

And the receipt of Medi-Cal alone is not going to make somebody a public charge.  

How can more people be reassured that they won’t be a public charge or have these fears? Are there any programs, resources?  

Ramirez: It all comes down to a case analysis. If an individual does have concerns as to whether public charge may be an issue to them then they should get an immigration consultation.

The California Department of Social Services website [has] a lot of immigration services and contractors. It’s basically funding from the state that they issue to legal service providers where they can look up organizations by region that may be offering consultations for free.

There are various websites, referrals for resources that nonprofits provide either consultations at low cost or for free. Where they can get an individualized assessment and there’s others that are not going to be applying for any immigration benefits soon or they already know that the receipt of Medi-Cal alone doesn’t affect them for immigration purposes and they feel pretty confident.

What is a question you commonly get about public charge?

Ramirez: I think the main question [is if] my U.S. citizen child or my lawful immigrant resident child is receiving Medical or any other means to test its benefit, can that affect my immigration status?

For public charge purposes, the answer is no. Because when children are receiving benefits, the person receiving the benefit is a child. It’s not the parent. That’s a very repetitive question that we get related to public charge. 

Is there anything else you would like to share that I didn’t ask?

Ramirez: One of the messages we share with the community is that the Medi-Cal expansion is something that’s historic.

It’s something that’s been worked on for many years. And the fact that we’re able to close the gap to this eligible population from 26 to 49, means that for Medi-Cal purposes, immigration status no longer matters. Medi-Cal is available to any undocumented immigrant of any age so long as they meet the requirements, such as income and others.

Immigration status is no longer a barrier. We encourage individuals who are eligible for Medi-Cal to apply, to enroll, and to use the benefits to the maximum. 

I think it’s just as important to be informed about where your immigration situation is. To be able to take full advantage of your health benefits. If anybody is already participating in Medi-Cal and have any questions or concerns of whether it impacts their immigration status don’t run and count for your benefits out of fear.

Get the consultation first and then make the best decision for you.