Background: The low-income undocumented in California are primarily Latino and have limited opportunities for health insurance coverage. They are prohibited from purchasing policies in insurance marketplaces and are only eligible for restricted scope Medicaid, which is primarily emergency and pregnancy-related care. Lack of coverage is likely to have negative consequences for their access to care.

Objectives: To analyze health status and utilization of undocumented compared with other California residents.

Methods: We used data from the 2016 and 2017 California Health Interview Survey and used descriptive and multivariate logistic regression analyses. We included individuals ages 19-64 with incomes up to 138% of federal poverty guidelines (n=6,715).

Results: Compared to documented residents, the undocumented were less likely to report having chronic conditions (e.g., asthma, high blood pressure, heart disease), high psychological distress, or smoker. But they were as likely to be overweight or obese, have diabetes, or report being in fair or poor health. The undocumented were significantly more likely to lack a usual source of care, but less likely to have visited a doctor or the emergency department last year compared to the documented. Among those who had visited the doctor last year, the undocumented were significantly less likely to have had 5 or more visits. In adjusted multivariate analyses, the descriptive results were generally sustained.

Conclusions: These data contradict perceptions that undocumented California residents are sicker and use more health services. Extending Medicaid eligibility to low-income undocumented can reduce access disparities and excluding them may adversely impact overall population health.