Proposed Budget Changes Could Affect Access to State-Funded Medi-Cal Coverage

By Julie Schurman, Director of Public Policy, The Arc & UCP California Collaboration

In January, Governor Gavin Newsom released a proposed state budget that includes changes to Medi-Cal eligibility rules for certain Californians. The proposal would impose work requirements and more frequent eligibility checks, every six months, on individuals enrolled in the state-only funded Medi-Cal program.

State-only funded Medi-Cal provides health coverage for Californians who are NOT eligible for federally funded Medicaid (California’s Medi-Cal). This includes immigrants with unsatisfactory immigrant status.

Under the proposal, individuals enrolled in this program would be required to demonstrate work activity and renew their eligibility every six months in order to maintain coverage.

Why Work Requirements Are Problematic for Everyone

Research consistently shows that work requirements in safety net programs do not significantly increase employment. Instead, they create administrative barriers that cause people to lose coverage even when they remain eligible.

The proposal would also require Medi-Cal enrollees to renew their eligibility every six months. Frequent renewals make it harder for people to stay enrolled and increase the workload for already stretched county eligibility offices.

For immigrants without satisfactory immigration status, these requirements create an additional and unique barrier. To verify work activity, employers must certify employment. Many employers are unlikely to provide that certification. As a result, the requirement effectively creates an impossible standard for many people to meet.

Privacy and Safety Concerns

Requiring additional documentation related to employment also raises serious concerns about privacy and safety. Recent federal guidance allows certain information collected through public programs to be shared with federal immigration authorities.

Advocates warn that collecting employment and work authorization information could expose families to additional risks and discourage people from seeking health care altogether.

These concerns extend beyond immigrants without satisfactory immigration status. Fear of enforcement actions can deter immigrants who are legally allowed to be in the U.S. and even U.S. citizens in mixed status families from accessing health services.

Impact on People with Disabilities

Immigrants with disabilities and their families could face additional challenges under this proposal.

While some individuals with medical conditions can be exempt from work requirements under certain circumstances, people must report their disability status to qualify for those exemptions. Many individuals may hesitate to share sensitive information with government agencies due to privacy concerns and fears about immigration enforcement.

This creates another barrier to care for a population that already faces significant challenges accessing services.

A Broad Coalition Is Speaking Out

More than 70 organizations have signed a letter urging the Legislature to reject this proposal. The coalition includes health providers, immigrant rights groups, disability advocates, and civil rights organizations.

The Arc of California and El Arc de California joined this effort alongside organizations such as Western Center on Law and Poverty, Disability Rights California, Health Access California, and the California Foundation for Independent Living Centers.

Together, these groups warn that the proposal would increase administrative costs, reduce access to care, and harm immigrant communities without improving employment outcomes.

Know Your Rights! Support for Immigrants

By Joe Perales, Director, El Arc de California

Immigrants, whether documented, undocumented, United States (U.S.) citizens or non-citizens, play a vital role in shaping communities across the country. Yet, many experience significant challenges, including harassment, discrimination, and uncertainty about their rights. It is crucial to understand that everyone in the U.S.—regardless of immigration status—is entitled to basic protections under the law.

The Arc of California and El Arc de California have put together some general guidelines to help immigrants know their rights, where to report harassment or discrimination, and how to seek assistance if experiencing barriers. This information was gathered from various credible sources listed at the end of this document.

CLICK HERE TO DOWNLOAD GUIDE IN ENGLISH

CLICK HERE TO DOWNLOAD GUIDE IN SPANISH

RIGHTS OF IMMIGRANTS WITH DISABILITIES UPHELD: Public Charge Rule Blocked During COVID-19

Last week, federal courts issued multiple important decisions in the litigation challenging the Trump Administration’s public charge immigration rule and related policies. We break down these decisions below. The key takeaway is that the public charge rule is currently blocked nationwide for the duration of the COVID-19 public health emergency.

This rule has been the focus of many lawsuits around the United States and has been in effect since January. It is a test used on people trying to immigrate or get a green card. Immigration officials are required to look at all of the relevant details about a person (the “totality of circumstances”) to decide if they are likely to need to use benefit programs. This only applies to the person trying to change their immigration status. Services other family members use don’t count against them. Yes, that includes regional center services, IHSS, and other public services!

Legal challenges to both the Department of Homeland Security (DHS) and State Department regulations are ongoing and could result in the regulations being implemented once again. Individuals who expect to apply for a visa or lawful permanent resident status should consult an immigration lawyer. To find help in your area, visit immigrationadvocates.org/nonprofit/legaldirectory.

For more information on these injunctions, see the Protecting Immigrant Families Campaign website.

With this new change, the public charge rule is temporarily on hold across the country. It could be re-activated if this current lawsuit is appealed. Until there is a final outcome, the old rules, dating back to 1999, will be in effect.

Administration Appears to Reverse Decision to Deport Critically Ill Children After Pressure from Oversight Committee

Following compelling testimony given September 11th at an emergency hearing of the House Committee on Oversight & Reform, including testimony from Isabel Bueso of Concord, CA, the Department of Homeland Security (DHS) has appeared to reverse their prior decision to eliminate deferred action for children with critical medical needs and their families. The Committee issued a press release after receiving a letter from DHS stating: “If today’s statement is accurate, it appears that the Trump Administration is reversing its inhumane and disastrous decision to deport critically ill children and their families who are receiving life-saving medical treatment in the United States…we will be taking additional steps to verify that these children and their families do not need to live in fear and uncertainty.”

Isabel Bueso and her family moved to California from Guatemala 16 years ago at the invitation of UC San Francisco; however, this August, they received a letter from U.S. Citizenship and Immigration Services (USCIS) stating that they must leave the country within 33 days or face deportation. If Isabel is forced to leave the country she would be separated from life-saving treatments received weekly as part of an ongoing clinical trial. This reversal will provide temporary relief to the nightmare for the Bueso family; however, Isabel plans to lobby Congress to find a long-term solution, stating in an interview with the New York Times that “We have to find a permanent solution so that families like mine don’t have to go through this again.”

Watch Isabel Bueso’s Testimony About Medically Deferred Action for Critically Ill Children

Isabel’s testimony begins at 53:00 in the video – and she is consistently asked questions throughout the hearing.

Isabel Bueso from Concord, CA, gives testimony to the U.S. House Oversight & Reform Committee about the importance of maintaining medical deferred action for medically fragile children and adults.

Isabel and her family moved to California from Guatemala 16 years ago at the invitation of UC San Francisco; however, this August, they received a letter from U.S. Citizenship and Immigration Services (USCIS) stating that they must leave the country within 33 days or face deportation. If Isabel is forced to leave the country she would be separated from life-saving treatments received weekly as part of an ongoing clinical trial.

Isabel’s mother, Karla Bueso, is a 2007 graduate of Partners In Policymaking, an advocacy training program for people with disabilities and parents of children with disabilities that was coordinated by The Arc of California.

The Arc of California Stands with Isabel Bueso and Denounces Deportation of Medically Fragile Residents

Isabel Bueso lives in Concord, CA, is 24 years old, a recent graduate with honors of Cal State East Bay, and has an extremely rare and potentially fatal genetic disease called MPS-6. Isabel and her family came to California when she was seven years old at the invitation of UC San Francisco to test a new drug, and continues to receive weekly infusions of the life-saving drug at the hospital. The Bueso family has lived in California for 17 years under visas and Deferred Action based on humanitarian purposes and medical exemptions; however, two weeks ago they received a letter from U.S. Citizenship and Immigration Services (USCIS) stating “Your period of authorized stay has expired. You are not authorized to remain in the United States.”, and allowing 33 days for the family to leave the country voluntarily or forced removal proceedings would begin. The drug Isabel’s life depends on is not available in Guatemala and her doctors have stated that without the drug Isabel’s health would rapidly deteriorate and she would die, likely within months.

I first met Karla Bueso, Isabel’s mother, in 2007 when she participated in Partners In Policymaking, an advocacy training program for individuals with developmental disabilities and parents of children with disabilities. The Arc of California, in coordination with other family-based advocacy organizations, was running the program and I was hired as the director. Karla participated intently in the six month long training and would often share the challenges and successes she experienced. She passed that training on to her daughter Isabel, who has become an inspiring advocate at the state and national level for the rare disease community. In an interview this week Isabel said, “Before you advocate for others. Now I find I have to advocate for my own life. It’s scary.”

The Bueso family has received support from Congressman Mark DeSaulnier and Senator Kamala Harris’ office, who are seeking ways to assist. Unfortunately, the Bueso’s attorney, Martin Lawler, has stated that the federal administration has offered no appeals process. With a lack of options, the Bueso family reached out to media and is also reaching out to you and me. This week their story was shared on the Rachel Maddow show, in the New York Times, and their local news KTVU. They have also created a Change.org petition, and the family is asking that everyone sign it to create noise that can’t be ignored by the federal administration.

People with disabilities and parents of children with disabilities often face hurdle after hurdle with no other option but to overcome. For Isabel, Karla, and the Bueso family, this is a matter of life or death, one that I hope and pray is overcome.

SIGN THE PETITION NOW

UPDATE Monday, September 2: According to the New York Times the Trump administration is now reconsidering “its decision to force immigrants facing life-threatening health crises to return to their home countries.” To read the full article click here. https://www.nytimes.com/2019/09/02/us/trump-immigration-deferred-action.html

Tag: Immigrants Rights