Health Care Access among California’s Farmworkers

Apr 25, 2022 | by
  • Description

Recent federal and state policies may have improved access to health insurance for farmworkers, who are important contributors to California's economy and an essential link in the food supply chain. The Affordable Care Act (ACA) included an expansion of Medi-Cal to most low-income adults, and a mandate requiring companies with at least 50 workers to offer employer health insurance. California also expanded Medi-Cal to young undocumented immigrants, and will soon extend it to older individuals. This report investigates whether these policies coincided with better insurance coverage or reduced barriers to health care for immigrant farmworkers.

  • Farmworkers are aging and more likely to settle in the US with family; thus, their health care needs—and those of their families and children—will likely grow. 
  • Cost or lack of insurance are the most salient barriers to health care for farmworkers; few farmworkers note barriers related to immigration status, although being undocumented is a strong predictor of lacking health insurance. 
  • Many documented farmworkers have enrolled in Medi-Cal following the ACA expansion, which has increased coverage rates and lowered cost and insurance barriers to health care. Undocumented farmworkers have not fared as well in these areas. 
  • Employer health insurance coverage for farmworkers did not change detectably with the rollout of the ACA employer mandate, regardless of a farmworker's documentation status or whether the worker was a direct hire versus a contractor. 

These findings take on special importance during the coronavirus pandemic. Farmworkers have continued to work during the public health emergency. Yet with California's high cost of housing, many farmworkers live in crowded conditions, making it difficult to remain socially distant from other household members. Although emergency Medi-Cal covers COVID-19 treatment regardless of immigration status, long COVID and resulting disability may threaten farmworkers' health and livelihoods.