Immigrants lacking permanent status contribute approximately $8.5 billion in state and local taxes a year, according to an analysis by the California Budget and Policy Center, a nonprofit research group. That’s about the same amount it’s costing the state to give them Medi-Cal.
State lawmakers first allowed undocumented children to enroll in Medi-Cal in 2016 under Gov. Jerry Brown. Since then Newsom has approved adding young adults up to age 25 in 2020 and older adults and seniors in 2022. Adults ages 26–49 were the final group added in 2024. Throughout those years, even some Republican lawmakers supported covering this population.
“The Republicans need to take a better and keen-eyed look at the timeline associated with those expansions,” said Assemblymember Mia Bonta, an Oakland Democrat who leads the Health Committee. “For them to just try to play the blame game and put it all at the feet of California values to ensure that we have universal health coverage for all with this particular age group being included is just specious.”
Billions more in potential Medicaid cuts
Assemblymember Dawn Addis, who chairs a budget subcommittee on health, said she will be questioning Newsom officials closely about the spending increase in an upcoming hearing.
“We really need to understand the details of what the Department of Finance is saying, what the executive is seeing, and how they’re calculating this information,” Addis, a Democrat from San Luis Obispo, said.
Addis emphasized that the biggest threat to Medi-Cal right now is coming from the federal government.
House Republicans recently voted to advance a proposal that could result in cuts of $880 billion to a group of programs, largely Medicaid, over the next 10 years. The California Budget and Policy Center has estimated that the proposals currently at play in Congress could translate into annual losses of $10 billion to $20 billion a year for the state.
“The reason why it’s so important for us to fight back against cuts at the federal level to Medicaid is because there is no easy or painless solution to fill that budget hole,” said Amanda McAllister-Wallner, interim executive director of Health Access California.
Health Access California along with the California Immigrant Policy Center spearheaded the campaign nearly a decade ago to insure all immigrants in the state.
McAllister-Wallner said it was unfair and unreasonable to pin the state budget shortfall on the immigrant expansions. Over the same time period, the state has added benefits, such as doula services and family therapy (PDF), and invested heavily in reforming the system through a multibillion-dollar initiative called CalAIM.
“Those changes that we’ve made in Medi-Cal made the program stronger (and) have made the state healthier,” McAllister-Wallner said.
CalMatters reporter Alexei Koseff contributed to this story.