Context:

Governor Gavin Newsom of California proposed reducing health care benefits for undocumented immigrants to address a $12 billion state budget deficit. His plan includes freezing enrollment in Medi-Cal for undocumented adults, charging a $100 monthly premium starting in 2027, and eliminating long-term care and dental benefits for noncitizens. These measures aim to save $6.5 billion by the 2028-29 fiscal year amid rising costs due to higher than anticipated Medi-Cal enrollments and prescription expenses. The proposal reflects a complex fiscal necessity rather than a shift in philosophy, as California Democrats have long supported providing health care to low-income residents as a moral and cost-effective strategy. The plan has sparked debate, with Republicans warning against the costs of expanding benefits for undocumented immigrants and Democrats defending the need to provide health coverage for all residents, though public support has waned since the expansion in 2021.

Dive Deeper:

• Governor Newsom's proposal seeks to freeze Medi-Cal enrollment for undocumented adults by January and introduce a $100 monthly premium starting in 2027, eliminating certain benefits to manage the state’s financial shortfall.

• California's budget deficit, worsened by economic volatility and a drop in tax revenue partly due to trade wars, necessitates cutting costs, with undocumented immigrant health care being a significant expense.

• The Medi-Cal program, serving 15 million people, including 1.6 million undocumented immigrants, has exceeded budget expectations, with undocumented care costing $2.7 billion more than anticipated.

• While providing health care to low-income individuals is seen as a moral obligation by California Democrats, critics argue the expansion of benefits to undocumented immigrants has been financially unsustainable.

• Public support for health coverage of undocumented immigrants has declined since its peak in 2021, with recent surveys showing a preference for prioritizing child over adult coverage among undocumented populations.

• Governor Newsom’s fiscal measures highlight the tension between progressive health care ambitions and economic realities, influencing other Democratic states to reconsider their budgeting for undocumented immigrant coverage.

• Despite political challenges and reduced public support, the proposal underscores California's ongoing experiment with universal health care, balancing ideals with the practicalities of fiscal management.