CA budgets $12B for health care for illegal migrants despite opposition

(The Center Square) - California is moving forward with a budget that will provide $12.1 billion for illegal immigrant health care this year. But a new poll from the Public Policy Institute of California found 58% of Californians oppose that allocation.

California first expanded eligibility for Medi-Cal, the state’s taxpayer-funded health care program for low-income households, to illegal immigrants in 2016 for minors. Then the state expanded it in 2020 for those up to 25 years old, in 2020 for those 50 or older and in 2024 for all illegal immigrants. While the federal government reimburses most Medicaid expenditures, it does not reimburse states for illegal immigrant health care beyond pregnancy-related and emergency care.

“In recent months, the state has had to borrow more than $3 billion to cover unexpected increases in Medi-Cal expenses — largely attributed to this expansion. When asked if they favor or oppose providing healthcare coverage for undocumented immigrants in California, 58 percent of adults oppose (41% favor),” wrote PPIC. “In surveys from 2015 to 2023, majorities favored this idea.”

While the budget bill does include Gov. Gavin Newsom’s proposal to pause new illegal immigrant enrollment on Jan. 1, 2026 for Medi-Cal, the bill cuts Newsom's proposed premiums for illegal immigrants from $100 per month starting on Jan. 1, 2027, to $30 per month.

According to Assemblyman Carl DeMaio, R-San Diego, advancing federal changes - which could reduce some Medicaid reimbursement rates by 10% to states that allow for the enrollment of illegal immigrants - would cost the state $11.2 billion per year. That's more than twice the governor’s estimate of $4.4 billion per year.

The change would not impact federal funding for illegal immigrants’ pregnancy or emergency care.

“[This budget] will result in a $11.2 billion cut in Medicaid funding from the federal government to the State of California, and that is for citizen services, and you are knowingly doing that, you are recklessly doing that,” said DeMaio in an Assembly floor speech urging legislators to vote against the bill. “And when the cut comes due, when we’re penalized, you’re like the drunk driver blaming the cop who pulled you over and gave you the ticket.”

“Why are you doing it? So you can give $12.1 billion in a gift of public funds to illegal immigrants, prioritizing illegal immigrants over your own citizens,” continued DeMaio.

California leaders have not ruled out new taxes to fund the program, especially as additional federal changes to the state’s managed care organization tax — which taxes Medicaid providers a higher rate, and puts that money back into Medi-Cal to qualify for higher federal reimbursements — could cut into the state’s $7 to $8 billion in annual MCTO tax revenue, and cost the state $2 billion in related federal reimbursements.

“We’re looking at a variety of different things,” said Sen. Lena Gonzalez, chairwoman of the California Latino Legislative Caucus, D-Long Beach, when asked at an earlier press conference about means of funding the state’s health care coverage for illegal immigrants.

“We’re looking at all — across the picture — everything related to our budget," said Gonzalez, who's also the Senate majority leader.