Newsom championed Medicaid for immigrants in California illegally. Now he wants to cut it back

In an effort to rein in expenses, California Gov. Gavin Newsom announced a plan to cut into an immigrant health care benefit that he has long advocated for.

Newsom said May 14 he wants the state to stop enrolling adults age 19 and older who are in the U.S. illegally in free Medicaid in 2026 and add monthly premiums the following year to save billions of dollars.

The Democratic governor proposed freezing comprehensive Medi-Cal enrollment among people who have what the state calls "unsatisfactory immigration status," no sooner than Jan. 1, 2026. Medi-Cal is the state’s Medicaid coverage for people with low-incomes." In 2027, enrollees who are immigrants in the country illegally would pay $100 a month. 

Newsom acknowledged the change was a departure from years of supporting Medi-Cal’s expansion to cover immigrants without lawful status.

"Governor Newsom championed these expansions," the Governor’s Office wrote in a May 14 fact sheet, before blaming President Donald Trump’s tariff policies for weakening state revenues.

California is facing a budget shortall, ballooning Medicaid costs and potential federal cuts alongside higher-than-anticipated health care usage, Newsom’s office said. The state projected Newsom’s Medi-Cal proposed changes would save more than $5 billion in 2028 and 2029. Coverage for children would be unaffected, and adults would still be able to access pregnancy and emergency care coverage. 

On occasion, PolitiFact uses its Flip-O-Meter to measure politicians’ consistency on issues. The rating is not a value judgment about a politician who changes positions on an issue. Some people say changing positions shows inconsistent principles; others say it shows pragmatism and willingness to compromise given new information.

Newsom spokesperson Izzy Gardon told PolitiFact in an email that Newsom made "no position change." Newsom’s proposal would "continue providing health insurance to undocumented Californians, but with new rules in place to curtail costs," Gardon said before Newsom’s May 14 budget press conference. 

But we found that Newsom’s proposal represents a partial change in his position on Medi-Cal, as immigrants in the state illegally after Jan. 1 will be unable to access the program if they are not already enrolled. The proposal is now in the hands of the California State Assembly, which must pass a budget bill by June 15. Newsom will then have 12 working days to sign the bill.

1.6 million immigrants without legal status are on Medi-Cal

California’s $174.6 billion Medicaid program provides health care coverage for about 15 million children and adults with low incomes or disabilities. That includes about 1.6 million immigrants in the U.S. illegally, including about 221,000 children.

Immigrants receive free Medi-Cal coverage under current rules, California Department of Health Care Services spokesperson Anthony Cava said.

Immigrant enrollees receive comprehensive coverage for medical, dental, mental health, vision, substance use treatment services and prescription drugs. The state also has an option covering emergency and pregnancy-related services. Newsom’s proposal included cutting long-term care and non-emergency dental care for immigrants in the U.S. illegally.

Longtime federal law allows people to receive emergency or labor and delivery services regardless of their immigration status, and that would remain unchanged under Newsom’s proposal. However, California pays for other Medi-Cal costs for immigrants without lawful status. 

When it comes to adding a monthly premium, Newsom’s proposal would mean that the state "would no longer provide health insurance for free to all low income Californians," said Andrew S. Kelly, California State University, East Bay, associate professor of public health.

Under the changes that would take effect in 2027, a person earning at the federal poverty level of $15,650 would have to spend $1,200 a year, or roughly 7.5% of their income, to maintain Medi-Cal benefits. "That would be unaffordable and would likely lead to people dropping coverage," Kelly said.

Newsom long supported health care for immigrants in the U.S. illegally

Extending health coverage to Californians regardless of legal status predated Newsom, who has also long supported it.

In October 2015, then-Gov. Jerry Brown signed a bill to extend Medi-Cal to all children, regardless of immigration status. Most children of immigrants are U.S. citizens; about 167,000 undocumented children were enrolled as of September 2023, wrote the Public Policy Institute of California, a nonpartisan research group.

Within hours of taking office as governor in 2019, Newsom called to insure immigrants in the U.S. illegally.

"Every person should have access to quality, affordable health care," Newsom said in his inaugural speech. 

Under Newsom, Medi-Cal expanded regardless of immigration status in phases between 2020 and 2024.

In a December 2023 statement to ABC News, Newsom’s office said, "In California, we  believe  everyone  deserves  access  to  quality,  affordable  healthcare  coverage  —  regardless  of  income  or  immigration  status. 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."

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Donald Trump

stated on April 29, 2025 in an interview

“If people come into our country illegally, there’s a different standard” for due process.

The expansion came with a cost. 

Medi-Cal spending for immigrants without legal status grew because of higher-than-expected enrollment and increased pharmaceutical spending, the state said in late 2024.

In March, Newsom’s administration borrowed $3.4 billion to cover an overrun, and lawmakers in April appropriated an additional $2.8 billion for the rest of the fiscal year. 

In a May 14 press conference about his budget proposal, Newsom said that he has long supported universal health care, regardless of immigration status, while also stating he believed the cuts necessary to respond to budgetary pressures.

"It's my value. It's what I believe I hold dear. I believe it's a universal right," Newsom said.

In 2006, as San Francisco mayor, Newsom announced a proposal for taxpayer-subsidized health care for adult uninsured residents regardless of immigration status. The plan was not  health insurance; it called for allowing access to care only in San Francisco and included monthly premiums. 

Our ruling

Newsom has long supported providing affordable health care to Californians regardless of their immigration status. His May budget proposal blocks access beginning in 2026 to new Medi-Cal enrollees who are in the country illegally and adds a 2027 $100 monthly premium charge for current beneficiaries to continue accessing health benefits.

These changes represent a departure from his advocacy on this issue.

Newsom has not entirely walked away from health coverage for immigrants without lawful status: Children are still eligible for full coverage. And adults can still enroll in Medi-Cal’s more limited coverage option for emergency and pregnancy services. 

However, Newsom’s proposal represents a partial change in position.

We rate his change in position a Half Flip.

PolitiFact researcher Caryn Baird contributed to this fact-check.