California may pull health care from eligible undocumented migrants

California Gov. Gavin Newsom (D) positions himself as a national figure for Democrats searching for party leadership following President Donald Trump's return to office. But his administration has just pulled back on the promise of health care for all in its latest budget proposal.

For years, Newsom made expanding California's public health care program toward a single-payer system one of the tentpole issues of his political career. Instead, his spending plan for the coming year would see undocumented migrants paying a hefty monthly premium to participate in the state's Medi-Cal Medicaid program. The shift would also block new enrollees starting in the coming year.

'Significant retreat' on a 'linchpin' issue

Newsom's budget proposal comes as the costs of his health care plan have "exceeded expectations" amid broader anticipation of "challenging economic times ahead," said the Los Angeles Times. Requiring Medi-Cal participants with "unsatisfactory immigration status" to pay a $100 monthly premium would "reduce the financial burden on the state" and could ultimately "lower the total number of people enrolled" in the program "if some immigrants cannot afford the new premiums."

The Week

Escape your echo chamber. Get the facts behind the news, plus analysis from multiple perspectives.

SUBSCRIBE & SAVE

Sign up for The Week's Free Newsletters

From our morning news briefing to a weekly Good News Newsletter, get the best of The Week delivered directly to your inbox.

From our morning news briefing to a weekly Good News Newsletter, get the best of The Week delivered directly to your inbox.

Sign up

The proposed changes represent a "significant retreat on an issue" that Newsom has held as a "linchpin" of his broader goal of universal health care coverage in California, Politico said. The backtracking will be a "political gift to conservatives" and is "certain to encounter resistance" from California's Democratic lawmakers and health care advocates alike.

While Newsom has blamed the state budget shortfalls "partly on a projected $16 billion drop in tax revenues resulting from Trump's turbulent trade wars," it's been "clear for months" that the state's Medi-Cal program for low-income residents of all immigration statuses has cost "billions more than expected," said The New York Times. The "conundrum" facing Newsom is whether to cut Medi-Cal benefits for all participants, including citizens, focus solely on immigrant participants or "pursue some combination of both."

Another thing "complicating" Newsom's "political tightrope" is polling that shows programs which provide health care to undocumented migrants have "tepid support," CBS News said. Moreover, any serious budget trouble in California could "harm" Newsom's "political legacy" ahead of a potential 2028 presidential run.

Rightward tack in recent months

Costs associated with medical coverage for undocumented immigrants have become a "sensitive issue" for California's Democrats given both President Trump's "focus on deportations" and the "electorate's interest in scaling back illegal immigration" as a whole, The New York Times said. While the coverage for undocumented immigrants is "funded by state revenue," the San Francisco Chronicle said, "most of the program is funded through federal Medicaid dollars" now being targeted by congressional Republicans who have "singled out California for scrutiny."

In this broader political context, Newsom has begun "embracing policy positions Republicans have begged him to adopt," said California Globe. His attempt at a "reputation facelift" will "likely end up as a facelift gone wrong." The Medi-Cal budget battle comes as Newsom, with an eye toward 2028, has "tacked to the right on a series of notable policy issues in recent months," NBC News said, including a podcast interview with right wing operative Charlie Kirk and a push for California cities to remove all unhoused encampments "without delay."