California became the first state on Monday to offer comprehensive health insurance to all undocumented immigrants, a plan expected to expand to roughly 700,000 residents living in the Golden State.
Gov. Gavin Newsom (D-CA) and state lawmakers agreed in 2022 to expand the state’s Medicaid program, known as Medi-Cal, to include people of all immigration statuses and ages. But it also comes when the state is at a record budget deficit, sparking sharp criticism from Republicans and other conservative groups that fear the expansion will further strain California’s existing healthcare coverage.
The expansion is expected to cost the state roughly $1.2 billion for the first six months, before increasing to around $3.1 billion per year, according to estimates released last year. It will include undocumented immigrants between the ages of 26 and 49, helping put California Democrats closer to delivering on their goal to achieve universal healthcare in the state.
It is also California’s largest insurance expansion since President Barack Obama’s Obamacare. That plan allowed participating states to expand Medicaid coverage to adults living below 138% of the federal poverty level. California also took steps in 2015 and 2019 to expand coverage further to undocumented children and undocumented adults over 50, respectively. The current step addresses the last age group of undocumented adults, who, until Monday, only had access to emergency care services and pregnancy-related services under the state program.
The new expansion has been hailed by Democrats and immigration advocates as a win-win solution that can help keep communities healthier and incentivize people of all immigration statuses to seek out preventive care options, instead of turning to emergency rooms or other forms of healthcare that can often be more expensive in the long run.
“In California, we believe everyone deserves access to quality, affordable healthcare coverage — regardless of income or immigration status,” Newsom’s office told ABC News in a statement.“Through this expansion, we’re making sure families and communities across California are healthier, stronger, and able to get the care they need when they need it.”
Still, critics, including California Republicans, have attacked the Medi-Cal expansion as fiscally irresponsible, especially when the state is already staring down a $68 billion budget deficit.
The California Senate Republican Caucus blasted the plan in a 2022-2023 analysis of Newsom’s budget plan, noting that the more than 700,000 illegal immigrants expected to be covered by the expansion will “certainly exacerbate current provider access programs.”
“Regardless of what your position is on this, it doesn’t make sense for us to be adding to our deficit,” California Republican Sen. Roger Niello, the vice-chairman of the Senate Budget and Fiscal Review Committee, told the Associated Press.