California is investing in its immigrant population by expanding Medi-Cal eligibility to low-income undocumented immigrants by age group. In January 2024, the program will be available to all ages, regardless of immigration status, and the state is expected to see a flood of new Medi-Cal applicants. Information about the health status of undocumented immigrants and the health services they use will help California plan for the health care needs and costs that this latest expansion may bring.
What can a visit to a community health center tell you about undocumented patients?
We are able to gain insight into health care needs by comparing the clinic visits of low-income undocumented immigrants who are eligible to enter the country but qualify for Medi-Cal with Medi-Cal patients in the same clinic. can. We surveyed 369,891 people who visited 350 community health centers (CHCs) more than 5.4 million times from January 2018 to November 2022. We use electronic health records to study several outcomes, including the types of visits patients make for medical care. Additional information can help determine whether the patient is an illegal immigrant.
CHC records list a patient’s chronic illnesses, such as heart disease, diabetes, and obesity. Chronic disease prevalence is similar for undocumented and Medi-Cal patients across the state, and an undocumented youth is healthier than his Medi-Cal patients. Chronic diseases are more common among middle-aged and older adults.
Which medical services are illegal immigrant patients likely to receive?
Although most clinic visits are coded as preventive health services (55.9% statewide, 66.8% in Los Angeles County), visits by undocumented patients are coded for preventive reasons, such as annual physicals. 20% less likely than a Medi-Cal patient visit. A variety of issues can cause this difference, from immigration-related concerns to lack of insurance.
However, undocumented patients are just as likely to receive more age-appropriate cancer screenings and vaccinations, which are important components of preventive care. Across the state, undocumented patients and her Medi-Cal patients have similar rates of being registered as having completed mammograms and colonoscopies. However, in Los Angeles County, PAP tests and laboratory tests for colon cancer are more likely to be performed among undocumented patients. Although both groups are receiving shingles, flu and COVID-19 vaccinations at similar rates in the state, the number of undocumented immigrants in L.A. exceeds their Medi-Cal peers.
Are illegal immigrants using behavioral health and telehealth?
Many undocumented immigrants are dealing with trauma, including trauma related to immigration, domestic violence, and experiencing war in their home countries, according to interviews with experts in Los Angeles. These interviewees reported that behavioral It emphasizes the strong demand for health.
or other languages.
Among undocumented patients, visits are much more likely to be for behavioral health purposes (36%) than Medi-Cal patients around California, especially those ages 26 to 49 and older. In Los Angeles County, the increase in likelihood is even larger (46%), and the difference is even larger among young people (70% more likely).
Telemedicine can alleviate logistical challenges for low-income patients, such as coordinating work schedules and arranging transportation. That’s surprising because statewide and in Los Angeles County, about a quarter of visits were telehealth visits, compared to very few before the pandemic. In Los Angeles, telemedicine visits are more likely to occur among undocumented patients than among her Medi-Cal patients, even for adults over age 50.
