Can California Afford Its $2.6 Billion Healthcare Investment for Undocumented Immigrants?

By: Alyssa Miller | Published: Feb 23, 2024

California is taking a step to ensure that everyone in the state has healthcare. With its newest plan, the state is becoming the first to offer health insurance for all undocumented immigrants.

The new plan went into action on January 1, 2024, immediately qualifying all undocumented immigrants, regardless of age, for Medi-Cal, California’s version of the federal Medicaid program for people with low incomes. But some critics worry the state can afford this new plan.

What Is California’s New Healthcare Plan? 

The $2.6 billion healthcare plan extends the existing healthcare coverage for those under 26 years old to undocumented residents aged 26-49 years. California Governor Gavin Newsom calls this expansion a milestone moment in enhancing the state’s healthcare system.

A woman with brown hair and a white mask getting her temperature checked by a person wearing a blue glove

Source: Ketut Subiyanto/Pexels

California has been pioneering free healthcare insurance for young undocumented immigrants since 2015.

Healthcare Expands to Older Undocumented Immigrants

Undocumented immigrants were not qualified to receive comprehensive health insurance before this latest healthcare plan. While Medi-Cal provided access to emergency and pregnancy care for undocumented immigrants, strict eligibility requirements remained in place.

Two healthcare professionals shaking hands in a medical center

Source: Gratis Graphics

Among these requirements, undocumented immigrants need to meet the income limits and have residency in the state since 2014.

Medi-Cal Has Provided Health Coverage to Undocumented Children

However, undocumented children have been luckier in the state. In 2015, the former California Gov. Jerry Brown signed a bill that allowed undocumented children to join Medi-Cal. Since then, Newsom expanded the scope of access to young adults, aged 19 to 25.

Healthcare worker with a patient

Source: Thirdman/Pexels

Older adults gained access to full healthcare benefits, covering them regardless of their immigration status.

Donald Trump Criticizes California’s Healthcare Plans

When California expanded health care coverage in 2019, former President Donald Trump blasted the state, saying it didn’t “treat their people as well as they treat illegal immigrants,” and called the bill “Very unfair to our citizens.”


Source: Wikimedia Commons

“If you look at what they’re doing in California, how they’re treating people, they don’t treat their people as well as they treat illegal immigrants,” Trump told reporters at the time. “So, at what point does it stop? It’s crazy what they’re doing. It’s crazy. And it’s mean, and it’s very unfair to our citizens.”

The Historic Investment Pushes Human Rights

This latest expansion will make approximately 700,000 undocumented residents between 26 and 49 years old eligible for full coverage for the first time in the United States, according to California State Sen. María Elena Durazo.

A doctor with a hair net on sitting next to a patient's head as they undergo surgery

Source: Jonathan Borba/Pexels

“This historic investment speaks to California’s commitment to health care as a human right,” Durazo said in a statement in May.


A Model for Universal Healthcare

According to From Frugal to Free, Dr. Mark Ghaly, California’s Health and Human Services Secretary, believes that California is creating a model on which the United States can base a reformed healthcare system.

A white sign with red bold letting under a woman's arm on the side of the road

Source: Cobalt123/Flickr

This push for a fair system includes enhancing access, reducing costs, and bridging the gaps of equity in healthcare services.


Removing Healthcare Barriers for Almost Everyone

“In California, we believe everyone deserves access to quality, affordable health care coverage—regardless of income or immigration status,” Gov. Newsom’s office said in a statement (via ABC News).

California Gov. Gavin Newsom wearing sunglasses and a white button up shirt

Source: Wikimeida Commons

The statement continued: “Through this expansion, we’re making sure families and communities across California are healthier, stronger, and able to get the care they need when they need it.”


Critics Question Whether California Can Afford This Investment

While this is a step in making healthcare accessible to all, California’s coverage plan has some critics who wonder if the state has the budget to make this plan work. “Medi-Cal is already strained by serving 14.6 million Californians – more than a third of the state’s population,” the California Senate Republican Caucus wrote.

A doctor in blue scrubs putting their hands on the back of a woman with blonde long hair

Source: Karolina Grabowska/Pexels

The statement, which analyzed the governor’s 2022-23 budget, continued: “Adding 764,000 more individuals to the system will certainly exacerbate current provider access problems.”


A Call to Freeze the Medi-Cal Expansion

Senate Minority Leader Brian Jones believes that the annual $6.5 billion bill to provide Medi-Cal to all undocumented immigrants would strain an already unbalanced budget. “Given the fact that over 300,000 undocumented migrants have crossed into California at the Mexico border in 2023 alone, the costs for this program are only going to increase from here,” Jones tells ABC News.

Three healthcare professionals looking at an x-ray on a white board

Source: EVG Kowalievska/Pexels

“If Democrat politicians are the responsible leaders they claim to be,” Jones said, “they should work with Republicans to freeze the Medi-Cal expansion for undocumented immigrants while we balance the budget.”


California’s Major Financial Crises

California’s financial woes have escalated since the COVID-19 pandemic, with a budget deficit swelling to four times its normal size in just a few months. The strain is coming from the revenue declines due to the recent inflation and the mass exodus of residents and businesses from the state.

A white building with a dome top surrounded by trees

Source: Wikimedia Commons

These financial trends do not seem to be affecting the state’s spending as they continue to push ahead to give undocumented immigrants health insurance. Maybe the state is cutting back on certain programs, like its tiny house program for the unhoused, to fund this healthcare program.


Will Undocumented Immigrates Use the New Healthcare Program?  

While studies show that undocumented immigrants use fewer healthcare resources than non-immigrants, critics fear that California is biting off more than it can chew.

A nurse injecting a patient with a needle in the arm to take blood

Source: Pranidchakan Boonrom/Pexels

It is unclear if undocumented immigrants who are eligible for Medi-Cal will face other barriers while seeking coverage, including eligibility, language challenges, and fear of manipulation and exploitation.