Roman Perez has worked many years in construction-related jobs, but being undocumented meant health insurance was out of reach for him and his family.
Recent changes to Medi-Cal, however, are presenting Perez and other undocumented people in the Valley with a glimmer of hope.
During a recent visit to Livingston Community Health Campus in Merced County, he came upon an event organized by Valley Onward offering assistance to sign up for Medi-Cal. Perez had been at the health campus to pick up a blood pressure monitor due to a recent diagnosis of hypertension.
“Nunca pense en aplicar por desidia – I never thought to apply out of procrastination,” Perez, a resident of Livingston for the past 18 years, said in Spanish. “I’ve never had insurance, so I hope this will help.”
With recent changes to state law, as of Jan. 1 people living in California ages 26 to 49 are eligible for Medi-Cal coverage regardless of immigration status.
That change effectively opened up Medi-Cal to all income-eligible age groups, as California in recent years included undocumented children and young adults up to age 25 and people over age 50.
According to the California Department of Healthcare services, it normally takes applicants around 45 days to hear back from local and state offices who determine eligibility.
From there, applicants choose a health plan within 30 days of approval. In the San Joaquin Valley some health plan providers are Health Plan of San Joaquin, Health Net and Kaiser Permanente.
Getting the word out
Community based organizations across the San Joaquin Valley are pushing to close the information gap and enroll as many people as possible, now that a large percentage of the population are eligible for benefits.
Without events put on by those organizations, Perez and other workers would likely not know about the available healthcare resources.
Groups like Valley Onward are often the go-between for local undocumented persons and the Medi-Cal system. El Concilio is another nonprofit working to answer Medi-Cal-related questions and offering enrollment specialists in Stockton and Modesto.
One of the biggest challenges El Concilio has with enrolling people in Medi-Cal is a lack of funding for healthcare navigators, according to Inés Ruiz-Huston, the organization’s vice president of engagement.
During a busy week, El Concilio sees roughly 50 people, but not all are able to get one-on-one attention the process requires.
El Concilio teams up with other organizations like Health Plan of San Joaquin and Health Net to make sure their clients are aware of the enrollment process.
Still, the messaging has not reached as many people as Ruiz-Huston would like.
The majority of undocumented persons seeking to take advantage of the Medi-Cal expansion through El Concilio are women, Ruiz-Huston said.
That’s likely because men in immigrant communities work multiple jobs to take care of family.
“Men don’t have time,” she said. “(Signing up for Medi-Cal) can take up to an hour. Our families want to talk, they have questions. These people are already very stressed, this stresses them more. We’re not a DMV, we want them to take their time.”
As a result, Ruiz-Huston said the organization is hoping to have more presence in the evenings and weekends, through work site recommendations and flea markets.
Addressing immigration status fears
Many undocumented people seeking help with the process need extra reassurance their immigration status will not be affected if they sign up. Some are so fearful of the process they don’t even want to provide an email address, Ruiz-Huston said.
California does not share immigration information with federal officials, and signing up will not impact whether someone is able to get a green card.
Preethi Raghu, the chief operating officer for Community Medical Centers, said it takes trusted providers like CMC to encourage people to take advantage of the expansion.
CMC is a federally-qualified health center with over two dozen branches in Stockton, Lodi, Manteca and Tracy, plus a roving health coverage counselors department.
The department creates text and mailing campaigns to patients, she said. CMC is trying to expand the outreach team further for patients who need help enrolling.
“Being able to broaden the eligibility criteria for a program such as Medi-Cal allows more people to be able to receive preventive care services, dental services, mental health services, family planning and contraception,” said Mildred Peña, senior director of strategy and execution for Health Net.
“Things that they would probably not be seeking because they (previously) didn’t have a service to cover the expense.”
Perez said he intends to fully utilize the coverage if approved. “I think this will help out a lot. You’ll pay less and can be checked out regularly. I hope it works out,” he said.
If he meets the eligibility requirements for the size of his household, Perez would be able to access benefits like vision, dental, transportation, and prescription coverage.
Elias, a Guatemalan roofer who identified himself only by his first name, also seized the opportunity at the event in Livingston.
He found out about the Medi-Cal event through a flier. He completed the application and also enjoyed chicken fajitas, Spanish rice and beans that were offered.
“I had to make sure I applied to see if my family and I could get coverage,” Elias said. “I don’t really know how it all works. I’ve never had a complete check-up. If I get sick, I usually just go to the pharmacy to get something over the counter.”
Despite expansion, challenges remain
Through the expansion, people living in the San Joaquin Valley will be able to see more doctors and specialists, but not always in a timely manner.
According to a 2021 California Health Care Foundation report on physicians, there are only 47 primary care doctors per 100,000 people across the entire San Joaquin region. There’s even fewer specialists compared to the state average.
Local health centers say they are working to address this issue. For example, Golden Valley Health Centers has prepared for the expansion for months by increasing access for patients in new and innovative ways.
Some of those methods include virtual care and telehealth appointments, increased availability of urgent care clinics and walk-in clinics that do not require an appointment, said Amy Collier Carroll, GVHC vice president and chief communications officer.
At CMC, Raghu said new adult patients may have to wait a few weeks, unlike current patients who may only need to wait about seven to 10 days to see their primary care physicians.
Exceptions may be made for patients who require transitional care from a hospital to a CMC clinic are more likely to be prioritized.
In the San Joaquin Valley “it’s always a challenge that there are more members and there are providers. That’s just the nature of the beast,” Raghu said.
“That’s why it’s particularly important for safety net organizations like ours to exist and persist and do the work we do because otherwise these members or patients will be without care.”
You can find in-person help enrolling in Medi-Cal at these local events in San Joaquin County:
El Concilio’s Multicultural Festival Weekend: At Stockton’s Weber Point Events Center, 221 N Center Street on Saturday, May 4 from 11 a.m. to 8 p.m. and Sunday, May 5 from 10 a.m. to 6 p.m.
CMC Mobile Mammogram: At 2401 West Turner Road in Lodi on Friday, April 12, 8 a.m. to 4 p.m.
Tracy Unified School District Resource Fair: At 164 West Grant Line Road in Tracy on Tuesday, May 7 from 9 a.m. to 11 a.m.
All of us Event: At the CMC Dorothy Jones Center, 2044 Fair Street in Stockton on Thursday, May 9 from 10 a.m. to 4 p.m. and Friday, May 10 from 10 a.m. to 5 p.m.
CMC Health Coverage Counselors can be reached at (209) 373-2824, through call and text.
Health Net’s helpline (800)-327-0502) is available in multiple languages.
Vivienne Aguilar is the health equity reporter for the Central Valley Journalism Collaborative, a nonprofit newsroom based in Merced, in collaboration with the California Health Care Foundation (CHCF).
Christian De Jesus Betancourt is the bilingual communities reporter at The Merced FOCUS, a nonprofit newsroom covering Merced. The Merced FOCUS is part of the Central Valley Journalism Collaborative.