In combination with Trump’s crackdown on immigration and the pending tax and spending bill–officially named the One Big Beautiful Bill Act–migrants’ access to Medicaid and healthcare is on the chopping block in several Democratic states. Democratic Governors, including California’s Gavin Newsom, Illinois’s JB Pritzker, and Minnesota’s Tim Walz, have previously extended state-funded health care measures to undocumented immigrants in a bid to achieve universal insurance coverage. However, due to budget woes and unprecedented levels of enrollment in the programs, these states are being forced to reverse or freeze their earlier initiatives.
In California, Governor Newsom proposed freezing enrollment for undocumented immigrants in the state’s Medicaid program for the poor and disabled. Instead of free coverage, those already enrolled would pay a $100 monthly premium starting in 2027. This idea was proposed after the state’s program, Medi-Cal, was $6.2 billion over budget this year.
Similarly, in Illinois, Governor JB Pritzker recently signed off on a state budget that cut funding for health coverage of undocumented adults. The program was initially projected to cost $112 million annually, but quickly spiralled to an estimated $800 million a year. Minnesota faces a similar reality, as Governor Tim Walz agreed to end a health insurance program for undocumented adults in a deal with state Republicans, in order to pass a new budget this month.
Though none of these states have changed their policy goals regarding access to healthcare and a vision for universal insurance coverage, the reality of the situation reveals dwindling budget reserves and fragile healthcare systems that are not even able to provide adequate access for state citizens.
The COVID-19 pandemic resulted in increased access and expanded health care programs for undocumented adults, yet the programs have resulted in unexpected fallout that states must grapple with now. The reversal of some of these programs reflects calls Republican lawmakers have been making. California Assembly member Carl DeMaio said, “We simply can’t afford it, and it’s certainly not just to put the health coverage of poor Californians, elderly, disabled, young children at risk because California politicians want to give free handouts to people who are not even citizens.”
Representative Jeff Backer, the Republican co-chair of the Minnesota House’s health finance and policy committee, also stated, “Our healthcare system in Minnesota, just like a lot of states, is fragile. We need to prioritize our law-abiding, taxpaying Minnesotans first.”
Medicaid programs are funded by a mix of state and federal dollars. However, states are prevented by law from using federal funds to cover undocumented immigrants, which places the entire burden of covering them on the individual states. Illinois Governor, JB Pritzker, explained the difficulty in creating a health care program that works for everyone, “passing a balanced budget required the difficult decision that reflects the reality of Trump and Republicans tanking our national economy and attempting to strip away healthcare.” Despite the differences in opinion policy-wise, the current situation in many Democratic states reaffirms that access to healthcare is the right way to go, one that all humans are entitled to, regardless of immigration status.
