California is Expected to Spend $3.1 Billion on Illegal Immigrants’ Health Care


Starting January 1, 2024, California will be the first state to provide free health care to all low-income immigrants living in the state illegally, regardless of age. The state anticipates that this expansion will cost around $3.1 billion per year and cover more than 700,000 people who are now uninsured.

Why is California Doing This?

California’s Democratic Governor Gavin Newsom and lawmakers agreed to the expansion in 2022 when the state had a record budget surplus. They contended that making health care available to all residents, regardless of immigration status, is a moral and economic obligation.

They claimed that this approach would promote public health, eliminate health inequities, and save money in the long term by avoiding expensive emergency department visits and chronic illnesses.

When Newsom suggested the modifications two years ago, he referred to them as “a transformative step towards strengthening the health care system for all Californians”. He also stated that the policy represents California’s ideals of diversity and inclusivity.

How Will This Impact the Healthcare System?

The expansion will be administered through the state’s Medicaid program, known as Medi-Cal, which currently provides coverage to low-income children, young adults, pregnant women, and undocumented elderly. The increased eligibility will cover persons aged 26 to 49, who account for the vast bulk of the state’s illegal population.

The state anticipates around 470,000 individuals to join in the first year, with the number increasing to 720,000 by 2027. The state will bear the whole expense of the extension, as the federal government does not compensate states for insuring unauthorized immigrants.

The growth will also boost demand for healthcare services, particularly basic and preventive care. The state intends to invest in increasing the size and quality of the healthcare workforce, particularly in underprivileged areas. The state would also offer incentives to providers that accept Medi-Cal patients, who sometimes face lengthy wait periods and restricted options.

What Are the Difficulties and Criticisms?

The expansion confronts several difficulties and objections, both within and beyond the state. Some of the major difficulties include:

The budget deficit: The expansion occurs at a time when the state is suffering a record $68 billion budget deficit as a result of the economic impact of the COVID-19 epidemic. Some politicians and experts have questioned the expansion’s viability and feasibility, arguing that the state should prioritize other expenditure requirements such as education, infrastructure, and social services.

The immigration issue: The expansion is expected to revive the national discussion over immigration and health care, particularly in light of the 2024 presidential race. Some critics claim that the increase is unjust and irresponsible since it rewards illegal activity and promotes additional immigration. They also allege that the increase will put pressure on the healthcare system and squeeze out citizens and legal residents.

Legal challenges: The federal government or other states may file legal challenges, alleging that the expansion violates federal law or the Constitution. Individuals or groups may file lawsuits against the expansion, claiming that it discriminates against them or hurts their interests.


In conclusion, California’s new plan to give low-income immigrants living in the state illegally free health care starting January 1, 2024, shows a dedication to moral and economic principles. Governor Gavin Newsom and politicians see it as a big step forward that will improve public health, fix health disparities, and keep costs from going up in the long run.

But problems like a big budget deficit worries about immigrants, and possible legal disputes make this ambitious growth even more difficult and controversial, and they make people wonder if it will be able to last and what other effects it will have.

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