California will no longer accept new applications for Medicaid coverage for adults without permanent legal status starting January 1, marking a sharp reversal of Governor Gavin Newsom’s pledge to provide healthcare regardless of immigration status.
The state’s decision follows years of expanding Medi-Cal eligibility to include undocumented immigrants under the Democratic administration. However, soaring costs have prompted Sacramento to implement strict new rules that will end new enrollments for adults with “unsatisfactory” immigration status. Under the policy shift, individuals already enrolled in the program will face a $30 monthly premium beginning mid-2027. The change aims to save an estimated $10.6 billion over the next decade by reducing Medi-Cal spending.
Newsom previously championed universal healthcare access for low-income Californians “regardless of their immigration status” as part of his administration’s moral commitment. But with costs projected to exceed $197 billion this fiscal year—nearly double pre-expansion levels—the state has turned toward cost containment measures.
Republican State Senate leader Brian W. Jones stated, “We warned him,” after Newsom announced the policy reversal. California’s Legislative Analyst’s Office projects that approximately one million undocumented immigrants could be removed from Medi-Cal rolls by mid-2030 under the new rules. Supporters warn such cuts risk pushing more individuals into emergency rooms—a significantly more costly form of care.
The state has also aligned with federal regulations requiring stricter immigration verification for healthcare programs.
