Christine Mai-Duc
California Gov. Gavin Newsom, who’s eyeing a presidential bid, has incensed each Democrats and Republicans over immigrant well being care in his dwelling state, underscoring the fragile political path forward.
For a second yr, the Democrat has requested state lawmakers to roll again protection for some immigrants within the face of federal Medicaid spending cuts and a roughly $3 billion budget deficit that analysts warn could worsen if the synthetic intelligence bubble bursts. Newsom has proposed that the state not step in when, beginning in October, the federal authorities stops offering well being protection to an estimated 200,000 authorized residents — comprising asylees, refugees, and others.
Progressive legislators and activists stated the cost-saving measures are a departure from Newsom’s “health for all” pledge, whereas Republicans proceed to skewer Newsom for utilizing public funds to cowl any noncitizens.
Newsom’s newest transfer would save an estimated $786 million this fiscal yr and $1.1 billion yearly in future years in a proposed price range of $349 billion, in line with the Department of Finance.
State Sen. Caroline Menjivar, one in every of two Senate Democrats who voted towards Newsom’s immigrant well being cuts final yr, stated she apprehensive the governor’s political ambition may very well be getting in the best way of doing what’s greatest for Californians.
“You’re clouded by what Arkansas is going to think, or Tennessee is going to think, when what California thinks is something completely different,” stated Menjivar, who stated earlier criticism acquired her temporarily removed from a key price range subcommittee. “That’s my perspective on what’s happening here.”
Meanwhile, Republican state Sen. Tony Strickland criticized Newsom for glossing over the state’s structural deficit, which state officers say might balloon to $27 billion the next yr. And he slammed Newsom for persevering with to cowl California residents within the U.S. with out authorization. “He just wants to reinvent himself,” Strickland stated.
It’s a political tightrope that may proceed to develop thinner as federal help shrinks amid ever-rising well being care bills, stated Guian McKee, a co-chair of the Health Care Policy Project on the University of Virginia’s Miller Center of Public Affairs.
“It’s not just threading one needle but threading three or four of them right in a row,” McKee stated. Should Newsom run, McKee added, the priorities of Democratic main voters — who largely mirror blue states like California — look very completely different from these in a much more divided common citizens.
Americans are deeply divided on whether or not the federal government ought to present well being protection to immigrants with out authorized standing. In a KFF poll final yr, a slim majority — 54% — had been towards a provision that will have penalized states that use their very own funds to pay for immigrant well being care, with huge variation by get together. The provision was unnoticed of the ultimate model of the invoice handed by Congress and signed by President Donald Trump.
Even in California, help for the concept has waned amid ongoing price range issues. In a May survey by the Public Policy Institute of California, 41% of adults within the state stated they supported offering well being protection to immigrants who lack authorized standing, a pointy drop from the 55% who supported it in 2023.
Trump, Vice President JD Vance, other administration officials, and congressional Republicans have repeatedly accused California and different Democratic states of utilizing taxpayer funds on immigrant well being care, a red-meat difficulty for his or her GOP base. Centers for Medicare & Medicaid Services Administrator Mehmet Oz has accused California of “gaming the system” to obtain extra federal funds, releasing up state coffers for its Medicaid program, often called Medi-Cal, which has enrolled roughly 1.6 million immigrants with out authorized standing.
“If you are a taxpayer in Texas or Florida, your tax dollars could’ve been used to fund the care of illegal immigrants in California,” he stated in October.
California state officers have denied the costs, noting that solely state funds are used to pay for common well being companies for these with out authorized standing as a result of the legislation prohibits utilizing federal funds. Instead, Newsom has made it a “point of pride” that California has opened up protection to immigrants, which his administration has famous keeps people healthier and helps them keep away from expensive emergency room care usually lined at taxpayer expense.
“No administration has done more to expand full coverage under Medicaid than this administration for our diverse communities, documented and undocumented,” Newsom advised reporters in January. “People have built careers out of criticizing my advocacy.”
Newsom warns the federal authorities’s “carnival of chaos” handed Trump’s One Big Beautiful Bill Act, which he stated places 1.8 million Californians prone to dropping their well being protection with the implementation of labor necessities, different eligibility guidelines, and limits to federal funding to states.
Nationally, 10 million individuals might lose protection by 2034, in line with the Congressional Budget Office. Health economists have said increased numbers of uninsured sufferers — notably those that are comparatively wholesome — might focus protection amongst sicker sufferers, doubtlessly rising premium prices and hospital costs total.
Immigrant advocates say it’s particularly callous to go away residents who could have fled violence or survived trafficking or abuse with out entry to well being care. Federal guidelines presently require state Medicaid packages to cowl “qualified noncitizens” together with asylees and refugees, in line with Tanya Broder of the National Immigration Law Center. But the Republican tax-and-spending legislation ends the protection, affecting an estimated 1.4 million authorized immigrants nationwide.
With many state governors but to launch price range proposals, it’s unclear how they may deal with the funding gaps, Broder stated.
For occasion, Colorado state officers estimate roughly 7,000 authorized immigrants might lose protection as a result of legislation’s adjustments. And Washington state officers estimate 3,000 refugees, asylees, and different lawfully current immigrants will lose Medicaid.
Both states, like California, expanded full protection to all income-eligible residents no matter immigration standing. Their elected officers are actually within the awkward place of explaining why some authorized immigrants could lose their well being care protection whereas these with out authorized standing might preserve theirs.
Last yr, spiraling well being care prices and state price range constraints prompted the Democratic governors of Illinois and Minnesota, potential presidential contenders JB Pritzker and Tim Walz, to pause or finish protection of immigrants with out authorized standing.
California lawmakers final yr voted to get rid of dental protection and freeze new enrollment for immigrants with out authorized standing and, beginning subsequent yr, will cost month-to-month premiums to those that stay. Even so, the state is slated to spend $13.8 billion from its common fund on immigrants not lined by the federal authorities, in line with Department of Finance spokesperson H.D. Palmer.
At a press convention in San Francisco in January, Newsom defended these strikes, saying they had been crucial for “fiscal prudence.” He sidestepped questions on protection for asylees and refugees and downplayed the importance of his proposal, saying he might revise it when he will get an opportunity to replace his price range in May.
Kiran Savage-Sangwan, government director of the California Pan-Ethnic Health Network, identified that California handed a legislation within the Nineteen Nineties requiring the state to cowl Medi-Cal for legal immigrants when federal Medicaid {dollars} gained’t. This consists of green-card holders who haven’t but met the five-year ready interval for enrolling in Medicaid.
Calling the governor’s proposal “arbitrary and cruel,” Savage-Sangwan criticized his option to prioritize wet day fund deposits over sustaining protection and stated blaming the federal authorities was deceptive.
It’s additionally a significant departure from what she had hoped California might obtain on Newsom’s first day in workplace seven years in the past, when he declared his help for single-payer health care and proposed extending medical insurance subsidies to middle-class Californians.
“I absolutely did have hope, and we celebrated advances that the governor led,” Savage-Sangwan stated. “Which makes me all the more disappointed.”