These Democratic governors are trying to curb health care for unauthorized immigrants
Democratic governors in states offering health insurance coverage for immigrants without legal status are proposing to roll back coverage that they signed into law.
As states grapple with budget holes, efforts to limit access to the programs are becoming a common thread. Debates about rolling back coverage or eliminating it entirely come as Congress considers a proposal that would reduce state Medicaid funds from 90% to 80% if they offer health insurance coverage to immigrants without proper authorization.
California
On Wednesday, Gov. Gavin Newsom announced that he wants to freeze new enrollments for unauthorized people 19 or older on Medi-Cal, California’s insurance plan for lower-income people, and charge a $100 monthly premium starting in January 2026. There would be exceptions for pregnant people and emergency care.
“I don’t want to be in this position, but we are in this position,” Newsom said.
California expanded Medi-Cal to include all adults without legal status in 2024, and 1.6 million immigrants in California currently receive health insurance through the program. Under the proposal, those already enrolled by year’s end would still be eligible for coverage, but other adults without legal status couldn’t enroll.
Republicans, who were against the program’s expansion from the start, have criticized Newsom for continuing to spend on coverage under his latest proposal.
“The governor showed his priorities,” said California Assembly Minority Leader James Gallagher, a Republican. “He wants to continue to spend on health care for illegal immigrants. Billions and billions of dollars.”
The Democratic governor also faces pushback from state lawmakers in his own party, including members of the Latino Caucus in the Legislature, who say they’ll fight to maintain some form of coverage for those without legal status during the final month of budget negotiations.
“We can look at options for budget cuts elsewhere,” said Democratic state senator Lena Gonzalez, who chairs the Legislative Latino Caucus. “We can be a little bit more mindful of how we do this without always having to look at our most underserved communities.”
Experts, lawmakers, and Newsom point out that the state pays for coverage either way. Those without health insurance often seek care in emergency rooms, so some lawmakers and advocates initially pushed for expanding access so people could have regular care, like doctor’s visits and prescription medications.
In states where lawmakers granted Medicaid access for undocumented immigrants, hospital administrators and faith groups, along with immigrant advocates, have helped push for the expansion of benefits.
Minnesota
That’s true in Minnesota, where the proposal to strip the state’s health insurance coverage for adults in the country without authorization emerged as part of a compromise budget framework.
That drew immediate opposition from some Democrats and immigrant advocates.
Thursday, a group of Democratic lawmakers banged on the door to the room where Gov. Tim Walz, a former vice presidential candidate, was laying out his budget plan with legislative leaders.
They yelled out, “You’re killing our communities,” and said they would vote against the provision to make adult immigrants without legal status ineligible for MinnesotaCare, the state’s Medicaid program, in 2026. Under the proposed budget, children would still be eligible for coverage.
In 2023, Democrats passed a bill granting all people in the country without legal status access to state-funded health coverage and Walz signed it. The program took effect in January, and more than 20,000 people without legal status have enrolled, including about 3,000 children.
Walz and Democratic legislative leaders said they opposed the change but had to accept it as part of a budget framework. The state Legislature is nearly split, with 101 Democrats and 100 Republicans, so they said they needed to accept the proposal that was a priority for GOP lawmakers.
“I’m not going to sugarcoat how difficult this was,” Walz said as lawmakers pounded on the door outside his news conference. “We didn’t expect everybody to be happy in this; I think many of us compromised.”
State House Speaker Lisa Demuth, a Republican, agreed that it was a compromise that could help plug a projected $6 billion budget deficit over the next four years.
“It’s not a measure of being uncaring. It’s a fiscal issue, and there are still opportunities,” Demuth said. “They can still join the private market, so it’s not that health care is being denied in any way,” she added. “We had to make hard decisions in that room, and when we looked at numbers and we looked going forward, this was a compromise that we were all able to come to any negotiation. No one walks out completely happy.”
Some Democratic lawmakers who fought for the program say they’ll oppose the rollback. Without their votes, the measure in a broader health budget bill could stall.
“Although we protected the children, which is a very noble thing to do, those children will lose moms, dads, grandfathers, aunts, uncles, siblings,” said Rep. Cedrick Frazier, a co-chair of the Minnesota People of Color and Indigenous Caucus. “That is what we are faced here with today.”
If Minnesota lawmakers can’t pass a budget before July 1, they could face a state government shutdown.
Transcript:
AILSA CHANG, HOST:
A handful of states, including California, Minnesota and Illinois, offer access to health insurance to low-income immigrants regardless of age or legal status. That amounts to millions of people covered. Well, now leaders of some of those states, including prominent Democrats, are attempting to change course. This week, Governor Gavin Newsom suggested cuts to California’s program while staring down a $12 billion deficit. And yesterday, Minnesota Democrats erupted in protest…
(SOUNDBITE OF ARCHIVED RECORDING)
UNIDENTIFIED PROTESTERS: One Minnesota, right?
TIM WALZ: Get anything done and shut down…
CHANG: …After former vice presidential candidate and Minnesota Governor Tim Walz proposed a rollback to his state’s program.
(SOUNDBITE OF ARCHIVED RECORDING)
WALZ: On the issue of Medicaid…
UNIDENTIFIED PROTESTERS: One Minnesota, right?
WALZ: …That’s exactly right. The cuts at…
UNIDENTIFIED PROTESTERS: One Minnesota, right?
WALZ: …The federal level, specifically dealing with Medicaid…
UNIDENTIFIED PROTESTERS: Trump kills immigrants.
CHANG: We are joined now by two reporters following the story where they are, Laura Fitzgerald at CapRadio in Sacramento and Dana Ferguson at Minnesota Public Radio in St. Paul. Hello to both of you.
DANA FERGUSON, BYLINE: Hello.
LAURA FITZGERALD, BYLINE: Hello. Thanks for having us.
CHANG: So let’s start with you, Dana. Obviously, there are some people with very strong feelings about this in Minnesota, given those very loud protests yesterday. To the extent that you can understand, why are these states reversing course on these programs, you think?
FERGUSON: Yeah. There are a couple factors at play here. The first is state budgets. States are in a tough place financially. Revenues in many places were already down, and Congress is eyeing big cuts to states as they negotiate spending. So leaders just don’t have a lot of wiggle room. The other thing is considered sort of the elephant in the room, and that’s that Republicans in Congress are proposing additional cuts directed at states that provide health care to people without legal status, so Minnesota could face financial penalties.
CHANG: Right. But are Democrats in Minnesota even saying this is about getting ahead of those kinds of federal penalties?
FERGUSON: No. Walz and legislative leaders say that wasn’t a factor. We have a really unique situation right now where our legislature is just about split down the middle, 101 Democrats and a hundred Republicans, so there had to be bipartisan compromise. The proposal in Minnesota right now says kids can stay in the program, but Republicans here wanted to eliminate the health care program entirely – that would mean everyone without legal status – citing concerns about higher-than-expected enrollment and costs. There are about 20,000 people enrolled now, and 3,000 of those are kids. Governor Walz talked about how tough this deal was at the news conference where lawmakers protested outside.
(SOUNDBITE OF ARCHIVED RECORDING)
WALZ: I’m not going to sugarcoat how difficult this was. Then these lawmakers are there. They have their voice heard. We’ll vote on this. We didn’t expect everybody to be happy in this. I think many of us compromised.
FERGUSON: And I should note, it still needs to get voted on by the legislature. It’s not a sure thing yet.
CHANG: OK. Well, Laura, let’s go to you in California because Governor Newsom came out just Wednesday and announced a $12 billion deficit in this state and cuts to this program. What’s been the reaction since then?
FITZGERALD: Yeah. Well, Democratic lawmakers out here aren’t having quite the reaction that they did in Minnesota, at least not yet. Some members of the legislature’s Latino Caucus are pushing back on the freeze and say the state should look for other areas to cut. The program out here would stop enrolling new immigrants without legal status in January next year and would also begin charging a $100-a-month fee for each individual. But also like Minnesota, kids could stay on Medi-Cal. That’s what we call Medicaid. Republicans are actually using those details against Newsom. They’re saying that his budget proposal actually allows the state to keep spending on coverage for these individuals by allowing them to enroll through the end of the year. Republican Assembly Minority Leader James Gallagher had this to say.
(SOUNDBITE OF ARCHIVED RECORDING)
JAMES GALLAGHER: And the governor showed his priorities yesterday. He wants to continue to spend on health care for illegal immigrants – billions and billions of dollars.
CHANG: I mean, Laura, we are talking about a lot of immigrants in the state on this program, right? So what could this mean for healthcare overall in California?
FITZGERALD: It’s not exactly clear how many folks will end up leaving the program, for instance, if the $100 copay ends up being cost-prohibitive for them. But Newsom says he thinks these rollbacks will lead to around $86 million in savings this year, and that’ll grow to about $3.3 billion in savings moving forward. We do know that 1.6 million people signed up for Medi-Cal under the expansion to those without legal status, and that’s more than the state expected. Some experts and lawmakers, including Newsom – they’ve pointed out that the state ends up paying for coverage either way because those without health insurance end up seeking care in emergency rooms. So some lawmakers and advocates, mainly hospitals and immigrant rights advocates – they pushed for this expansion to increase access to regular care for this community, like doctors’ visits and prescription medications.
CHANG: That is Laura Fitzgerald at CapRadio in Sacramento and Dana Ferguson at Minnesota Public Radio in St. Paul. Thank you to both of you.
FERGUSON: You’re welcome.
FITZGERALD: Thank you.
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