California cut healthcare for undocumented immigrants. One lawmaker wants it back

Only two Democratic lawmakers voted against Gov. Gavin Newsom’s budget proposal last year curtailing healthcare for undocumented immigrants. Sen. Maria Elena Durazo was one them.

Now, Durazo, a Democrat from Los Angeles, is proposing legislation that would reverse many of those immigrant healthcare cuts and reinstate Medi-Cal eligibility for all income-qualifying residents regardless of citizenship.

Senate Bill 1422 would ensure that all immigrant adults age 19 and older could enroll in Medi-Cal. It would not reverse limits placed on dental benefits that last year’s state budget included, nor would it eliminate the $30 monthly premium required of the same population starting in July 2027. The state budget last year did not cut benefits for children without legal status.

“We are no healthier as a community than the person least able to access care. When we accept a two-tier healthcare system, we borrow trouble,” Durazo said Monday.

Durazo argues that immigrants without legal status contribute billions in taxes each year and many of them now cannot benefit from programs those dollars support. The state spends about $12 billion annually on immigrant health care.

A shrinking budget, a growing fight

Whether Newsom will sign such a measure is unclear but seemingly unlikely. Grappling with a deficit for the fourth straight year — even as revenue grows — Newsom has already proposed cuts to other programs. Marissa Saldivar, a spokesperson for the governor, said his office would not comment on Durazo’s legislation.

His January budget proposal made few changes to the state’s Medi-Cal program, which enrolls more than 14 million Californians, but it underscored the ongoing fiscal challenges. One major threat comes from President Donald Trump’s federal tax reform package, which imposed new limits on the provider taxes that nearly every state uses to support their low-income healthcare programs. California’s tax on health insurers is particularly large, generating about $7 billion annually for the general fund — a figure that the state finance department estimates will decrease to about $6 million next year.

Medi-Cal spending has nearly doubled to $200 billion during Newsom’s two terms, adding to the state’s structural deficit, according to the nonpartisan Legislative Analyst’s Office. That amount includes about $119 billion in federal dollars.

Both Democrats and Republicans criticize Newsom’s handling of healthcare for immigrants without legal status. Republicans blame Newsom’s gradual expansion of Medi-Cal eligibility to immigrants for the program’s growing costs. Democrats are angry he partially reversed course, and some also take issue with his most recent budget proposal, which they say would needlessly extend some federal Medicaid cuts.

Assemblymember Mia Bonta, a Democrat from Oakland, has introduced a bill that would bar the state from imposing federal work requirements on enrollees whose healthcare is paid for solely with state funds, a group that includes immigrants without legal status. State officials estimate work requirements will cause roughly 2 million Californians to lose Medi-Cal largely due to administrative hurdles.

The fight over healthcare spending has become one of the defining issues heading into this fall’s elections.

The state’s largest healthcare labor union is pushing a billionaire’s tax to raise revenue for healthcare, a measure that has drawn opposition from Silicon Valley’s wealthy elite and divided state Democrats. Meanwhile, party leaders are also trying to unseat a number of vulnerable congressional Republicans, including Rep. David Valadao whose Central Valley district has the highest share of Medicaid recipients in the country.