Children’s health advocates are raising concerns about Governor Gavin Newsom’s plan to freeze enrollment in public health insurance for undocumented adults. They warn this could harm the health and well-being of those adults’ children.
California has been expanding Medi-Cal, the state’s health program for low-income people, to include undocumented immigrants over several years. The state first added undocumented children in 2016. Then, in 2019, it expanded coverage to young adults aged 19 to 25. Seniors aged 50 and older were included in 2022. Most recently, in January 2024, the program was extended to adults aged 26 to 49.
Before these changes, undocumented immigrants could only use Medi-Cal for emergencies, pregnancy care, or long-term care. California pays for this expansion entirely on its own, without federal funding.
Now, facing a budget shortfall, Governor Newsom proposes to stop new undocumented adults from enrolling in Medi-Cal. He also plans to charge a $100 monthly fee to those already enrolled, starting in 2027.
The Trump administration and some Republicans in Congress have pressured states like California to stop giving benefits to undocumented immigrants. They argue tax money should not pay for people who are in the country without legal permission.
Newsom said the budget changes are necessary to balance the state’s finances. He stressed that his support for health care access regardless of immigration status remains strong. As mayor of San Francisco and governor of California, he has long promised to expand health care for all.
“It’s my value. It’s what I believe,” Newsom said. “I believe it’s a universal right. I have championed that for six years. This is a tough budget in that respect.”
Currently, about 1.6 million undocumented adults are enrolled in Medi-Cal. They make up roughly 5.3% of the total program enrollment.
“Our goal is not to kick people off or undo the expansion,” Newsom said. “We want to balance what we can and cannot do.”
Although the changes would not directly affect undocumented children, advocates worry that cutting health coverage for their parents will harm the children’s health. Most children in these families are U.S. citizens. According to the National Center for Children in Poverty, about 1 in 10 California children have at least one parent who is undocumented or has temporary deportation protections.
“We are disheartened,” said Avo Makdessian, executive director of the First 5 Association of California. The group supports programs for children under five years old. “When adults without legal status lose Medi-Cal coverage, their children suffer. Research clearly shows that healthy parents lead to healthy kids.”
Ted Lempert, president of the nonprofit Children Now, also voiced concern.
“We urge the governor and Legislature to remember that when parents lose coverage, kids are less likely to get the health care they need,” Lempert said. “Hurting parents hurts kids.”
Mayra Alvarez, president of The Children’s Partnership, which works to promote health equity for children, pointed to research showing that when parents qualify for Medi-Cal, they learn more about health care options for their children and are more likely to enroll them.
“This ‘welcome mat’ effect means more children get covered, even if their eligibility does not change,” Alvarez explained. “On the other hand, when parents or family members are sick and cannot work or care for children, the kids suffer.”
Dolores, a 65-year-old grandmother, shared how Medi-Cal helped her after she enrolled under the undocumented adult expansion. She asked to keep her last name private out of fear of immigration enforcement.
Three years after enrolling, Dolores had a stroke.
“If I didn’t have Medi-Cal, I don’t know how I would have gotten care,” she said in Spanish. “It helped me then, and it still helps me a lot.”
Her Medi-Cal coverage also benefits her family. She lives with her grandchildren. At a health center in Victorville, she attends nutrition classes and Zumba. She learned to cook healthier meals for her family. Her 4-year-old granddaughter even exercises with her.
“Children are like sponges — they absorb everything they see,” Dolores said.
She added that she cannot afford the proposed $100 monthly fee. She has lived in the U.S. for over 30 years but has not been able to return to work since her stroke.
Alvarez warned that when people lose health insurance, it raises other costs for emergency care.
“Cutting Medi-Cal for undocumented immigrants is unfair,” Alvarez said. “It will just shift costs elsewhere.”
She urged lawmakers to find other ways to balance the budget. Alvarez suggested closing corporate tax loopholes, asking the wealthy to pay more, using state reserves set aside for hard times, and reducing spending in less critical areas like the state prison system.
