In California, it is estimated that 1.8 million residents, or around 5% of the population, are immigrants without legal permission to live in the country. They carry out many works that native residents would never do. The financial challenge facing Sacramento is that thesis immigrants also include almost a quarter of the cost of the general fund of the state of medical care through the California program for low-income residents, Medi-Cal.
The State has achieved constant progress in the last nine years to provide measuring coverage in increasingly this population. In 2024, all these residents became eligible for Medi-Cal. This is a signature achievement for the government. Gavin Newsom and Legislative Democrats. But it can be short.
An explosion in the Costs of Medi-Cal is now testing this program until its limits, since President Donald Trump and the Congress led by Republicans have not yet made huge budget cuts necessary for partially many expected cuts in taxes. The cuts to the Federal Medicaid program (known as Medi-Cal in the State) are almost certainty. Here in Sacramento, where legislators are a couple of months of facing their deadline for budget for fiscal year 2025-26, something is about to give.
“It is impossible to know this point who could be affected,” he told The Bee Kristof Stremikis, director of market analysis and information at the California Medical Care Foundation. “What is clear is that reducing income requires to cover Feer people, reduce benefits or pay less to medical care providers.”
The Republican Delegation of Sacramento has been taking advantage of this previous period in the costs of Medi-Cal and blaming the Democrats’s decision to cover immigrants who lack legal permission. Analysts indicate a number or factors.
High costs
But the disproportionate cost of covering thesis residents to the State cannot be avoided. This is because the federal government, which provides more than 60% of the general money for this program, does not illegally cover immigrants in the country. California has intervened to pay these costs with his own money. In health, these Californians have a “state of unsatisfactory immigration.”
Medi-Cal is bleeding so much money that the Newsom administration has been to look for an immediate infusion of more than $ 3 billion simply to pay the invoices for this fiscal year. Michelle Baass, director of the California Health Services Department, recently told Legislatters that the increase in costs is due to “the highest registration of anticipated (including the undocumented population) and the costs of embedded pharmacy.” It is estimated that the total program will cost more than $ 188 billion to cover approximately 15 million Californians, approximately $ 42 billion from the General State Fund.
The health coverage of immigrants lacks legal status does not feel like a winning wedge problem for the Republican leadership of California. Surveys have shown that more than 60% support this coverage, with that percentage increasing over time.
Without a doubt, its popularity will not download to the government, since it is on an unknown political trip away from the “toxic” Democratic brand while taking new positions, such an opposition of transgender females in athletic competition. Newsom simply cannot flee from himself. He was the candidate for the governor who promised universal medical care for all Californians through a single payer system. Medical care is a central value; No Marin County podcast could expect to change that.
Too successful
The financial problem of Medi-Cal is due to its popularity, namely, more Californians enrolled this year of what was expected.
“It is very different to project what the helmet level will be,” said Jason Constantouro, fiscal analyst and main policies of the Office of Legislative Analysts of California, the group of non -partisan experts of the legislature.
If there is a single population to “blame” for the previous period in the costs of Medi-Cal, it can be older people. California has been particularly generous by allowing the elderly with low -income with considerable assets still qualify for the program, said Constantouro. That is another population that can be a goal for cuts.
The elimination of medi-Cal coverage for any Californian cattle won medical care costs. The medical visits scheduled in crimes to emergency rooms will change, where hospitals by law must be that care regarding insurance. And in one way or another, many of those costs are transmitted to the same contribution consumers.
Undocumented immigrants do not deserve a goal in their back this budget season that the rest of the state residents. Personally, I would prefer that state dollars go to medical care than to the reimbursements of electric vehicles, as promised by the governor if Trump ends the federal program.
But this feels like the most unpredictable budget season that faces Sacramento in a long time. The fall recently in the stock market, caused by the increase in Trump tariffs worldwide, only makes the side of the revenue of the biggest book without relief in Sacramento. It will prove the fiscal values of the Democrats and what they represent the most.
Tom Philp is Sacramento Bee columnist. © 2025 The Sacramento Bee. Distributed by Tribune Content Agency.
