Medi-Cal: Which migrants will not be able to apply for health insurance

Another blow for the migrant community in California is in the works. Tens of thousands of migrants without legal status in the state could be left out of the public health system in the coming years due to a budget agreement approved by the legislature. This new measure freezes access to Medi-Cal—the state program equivalent to Medicaid—for new undocumented applicants starting in 2026, and establishes monthly fees for those who are already enrolled.

This means that any undocumented migrant will be rejected from the program starting next year, while those already enrolled will have to pay a monthly premium of $30.

Legislators, with a Democratic majority, voted in favor of the plan last Friday with 57 votes in the Assembly and 26 in the Senate. Although the bill still needs to be negotiated with Governor Gavin Newsom before June 27, it represents a change of course for state policy, as in the past the goal was to expand access to healthcare for undocumented individuals.

Who will be affected?

The new proposal—stricter than the one presented by the governor in May—would extend the Medi-Cal freeze to all non-citizens with “unsatisfactory” immigration status, which would include some legal permanent residents.

Starting in 2027, those already enrolled will have to pay a monthly premium of $30 if they are between the ages of 19 and 59, although they will be able to re-enter the program if they temporarily lose coverage due to changes in their income. The legislative plan also delays the elimination of dental services for immigrants by two years and rules out cuts to the home care program.

“Healthcare for all”?

Currently, more than 1.6 million undocumented migrants receive public health services. In 2024 alone, the state spent $8.5 billion on their medical care, a figure that could exceed $12 billion next year.

But the cost of the program has exceeded initial projections, and budget pressures have caused priorities to be reevaluated. President Donald Trump’s economic policy, which includes tariffs that have reduced tax revenues, has been blamed in part. Senator Akilah Weber Pierson said the government was betting on “a miracle” in the next two years that would prevent further similar cuts.

Criticism from all sides

The decision has drawn strong criticism from both the right and progressive sectors. Republican leaders argue that continuing to fund healthcare for non-citizens is unsustainable and puts other services at risk. “Medi-Cal is falling apart,” said Republican Minority Leader James Gallagher. “It’s not fiscally feasible (to expand it to immigrants). It’s ballooning the budget out of control”.

Health organizations and Latino leaders said they consider this change a betrayal of immigrant communities. Amanda McAllister-Wallner, director of Health Access California, warned that the cuts could be exacerbated if federal reductions in health funding are approved.

Several Democratic lawmakers also spoke out. Senator Caroline Menjivar, removed from the budget health committee for her opposition to the cuts, abstained from voting and stated, “I need to be able to stand firm and tall for my constituents and say this is why I dissented”.

Despite the criticism, other Democrats defended the agreement, noting that those already enrolled will not lose coverage. “We are keeping the promises that we made,” Weber Pierson said in the Senate. “No one currently covered will automatically lose their healthcare coverage”.

On the other hand, the federal Congress could approve new penalties this year for states that offer services to undocumented immigrants, which will reduce the reimbursements California receives and affect the budget.

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