The California governor, Gavin Newsom, wants his state to stop enrolling more low-income immigrants without legal status in a state-funded healthcare program starting in 2026 and begin charging those already enrolled a monthly premium the following year.
The decision is driven by a higher-than-expected price tag on the program and economic uncertainty from federal tariff policies, Newsom said in a Wednesday announcement. The Democratic governor’s move highlights his struggle to protect his liberal policy priorities amid budget challenges in his final years on the job.
California was among one of the first states to extend free health care benefits to all poor adults regardless of their immigration status last year, an ambitious plan touted by Newsom to help the nation’s most populous state to inch closer to a goal of universal healthcare. But the cost for such expansion ran $2.7bn more than the administration had anticipated.
Newsom in March suggested to reporters he was not considering rolling back health benefits for low-income people living in the country illegally as the state was grappling with a $6.2bn Medicaid shortfall. He also repeatedly defended the expansion, saying it saves the state money in the long run. The program is state-funded and does not use federal dollars.
Under Newsom’s plan, low-income adults without legal status will no longer be eligible to apply for Medi-Cal, the state’s Medicaid program, starting in 2026. Those who are already enrolled won’t be kicked off their plans because of the enrollment freeze, and the changes won’t impact children. Newsom’s office didn’t say how long the freeze would last.
Starting in 2027, adults with “unsatisfactory immigration status” on Medi-Cal, including those without legal status and those who have legal status but aren’t eligible for federally funded Medicaid, will also have to pay a $100 monthly premium. The governor’s office said that is in line with the average cost paid by those who are on subsidized heath plans through California’s own marketplace. There’s no premium for most people currently on Medi-Cal.
In total, Newsom’s office estimated the changes will save the state $5.4bn by 2028-2029.
The Medi-Cal expansion, combined with other factors such as rising pharmacy costs and larger enrollment by older people, has forced California to borrow and authorize new funding to plug the multibillion hole earlier this year. California provides free healthcare to more than a third of its 39 million people.
Newsom’s proposal come ahead of his scheduled presentation on the updated budget. Recovery from the Los Angeles wildfires, changing federal tariff policies and the expensive healthcare expansion are putting a strain on California’s massive state budget. Lawmakers are expecting a multibillion dollar shortfall this year and more deficits projected for several years ahead.
Newsom is expected to blame Donald Trump’s tariff policies for the shortfalls, estimating that the polices have cost the state $16bn in tax revenues. California is also bracing for major budget hits if Republicans in Congress follow through with a plan to slash billions of dollars in Medicaid and penalize states for providing health care to immigrants without legal status.
Newsom now opens budget negotiations with lawmakers and it’s unclear how Democrats who control the legislature will react to his plan to freeze new Medi-Cal enrollment for some immigrants. A final budget proposal must be signed by June. California’s budget is by far the largest among states.
The budget proposals presented this week will build in some of the impacts from federal policies, but many unknowns remain.
The governor already said he’s planning to scale back on baseline spending this year. Analysts and economists also warn that California will face bigger deficits in the tens of billions of dollars in coming years due to economic sluggishness and stock market volatility brought on by the tariff war.
