Full-Scope Expansions: SB 75, SB 104, SB 184, and AB 133 

California has enacted multiple laws to expand full-scope Medi-cal (MC) to eligible members regardless of immigration status which include:

• State of California Senate Bill 75 (SB 75) enacted on May 1, 2016, grants full-scope MC for all children under age 19, who do not have satisfactory immigration status (SIS) or who are unable to verify satisfactory immigration status or citizenship.
• On January 1, 2020, full-scope MC eligibility was expanded to include the new young adult group aged 19-25 through SB 104 Young Adult Expansion.
• On May 1, 2022, full-scope MC eligibility was expanded to include the 50 and older population through AB 133 Older Adult Expansion.
• On January 1, 2024, full-scope MC eligibility was expanded to include adults ages 26-49 through SB 184 Age 26-49 Adult Expansion. 

Exception: Although CCHIP is listed under MAGI MC in the MC Hierarchy, CCHIP is limited to U.S. citizens and LPR children. Refer to Children's Health Care Initiative.

Individuals cannot opt out of full-scope MC benefits under SB75 & SB104, AB 133, and SB 184.

DRA and SIS verification requirements are federal regulations that still apply. If any SB 75, SB 104, AB 133, or SB 184 impacted individual is unable to provide DRA or SIS verification, he or she will remain eligible for full-scope MC under these state-funded programs. DHCS will track clients who have failed to provide DRA/SIS documents with the citizenship indicator on the Medi-Cal Eligibility Data System (MEDS).

Reminder: If a child is potentially an Unaccompanied Refugee Minor (URM) who has not yet received the certification letter from the Office of Refugee Resettlement (ORR) the child should be evaluated for regular MC. Once granted the URM status the client should be forwarded to Foster Care (FC).

SB 75, SB 104, and SB 184 Age Policy

SB 75 and SB 104 grant full-scope MC to all individuals regardless of their immigration status aged 25 and under, or over age 50. Individuals who turn 26 years old are no longer eligible for full-scope MC under SB 104. If a client continues to meet all eligibility requirements for MC, the first full month that he/she is 26 years old the client will be eligible for full-scope MC under SB 184.

Note: Undocumented clients without satisfactory immigration status are not eligible for APTC through Covered California.

ExampleExampleJessica is 13 and she is undocumented. The household income increases to 300% FPL. The EW updates CalSAWS with the increased income and the clients are placed onto Soft Pause. The EW completes an ex-parte review and/or sends the Non-MAGI MC Screening Packet to the clients; however, the parents decline a Non-MAGI MC evaluation or do not provide the information. The EW terminates the case following the 10 day NOA requirements.

Managed Care/Fee-For-Service

Individuals receiving full-scope MC under SB 75, SB 104, AB 133, and SB 184 are subject to Managed Care requirements and will receive the Health Care Options Choice Packet; new enrollees can select the Managed Care plan by calling or returning the packet. If no plan is chosen, DHCS will assign a plan.

Note: Fee-for-Service (FFS) refers to the way providers are paid by the state. Clients with FFS MC are responsible for asking the provider if they will accept payment from MC before services are received. Not all providers accept FFS MC.

Related Topics

Citizenship/Immigration Status