In a move that reverses a key expansion of California’s health care safety net, Governor Gavin Newsom on Wednesday proposed pausing new enrollments of undocumented adult immigrants into Medi-Cal starting in 2026 due to a $12 billion budget deficit.
The decision, Newsom said, is driven by a higher-than-expected price tag on the program and growing economic uncertainty stemming from federal tariff policies.
“I am deeply disappointed by Governor Newsom’s decision to halt new Medi-Cal enrollments for low-income immigrants starting in 2026. This move undermines California’s longstanding commitment to equity and compassion, especially for vulnerable communities who already face immense barriers to healthcare,” said Nataly Santamaria, a Central Valley Promotora Network Senior Manager. “While budget constraints are real, balancing the books should not come at the expense of human dignity and public health. California has led the nation in inclusive healthcare policies — this reversal is a step backward.”
Under the proposal, Medi-Cal would stop accepting new undocumented adult enrollees age 19 and older beginning in 2026. However, the 1.6 million undocumented immigrants who are already enrolled in the program would keep their coverage, and undocumented children would still be allowed to enroll.
Even if the proposal is approved, undocumented Californians would continue to qualify for emergency and pregnancy-related care under “limited scope” Medi-Cal, which is funded by the federal government. But starting in January 2026, those who haven’t enrolled in full-scope Medi-Cal would be excluded from broader health services like doctor visits and prescription medications.
Newsom also proposed that, beginning in 2027, adults with “unsatisfactory immigration status” — a category that includes individuals with lawful presence who are still ineligible for federal Medicaid — would be required to pay a $100 monthly premium to remain covered. According to the governor’s office, this amount is lower than the average subsidized premium paid through Covered California, the state’s health insurance marketplace.
Advocates say the proposal would disproportionately harm the San Joaquin Valley’s large immigrant and farmworker population. Noe Páramo, legislative advocate with the California Rural Legal Assistance Foundation, said the proposed Medi-Cal freeze and $100 monthly premiums would negatively impact immigrant farmworkers, particularly in counties like Kern, Tulare, and Fresno — home to over 431,000 agricultural laborers. He emphasized that access to health care is a top priority in the region, where more than 40% of residents are Medi-Cal eligible.
“Our values center on protecting and safeguarding low-income rural immigrant farmworkers’ futures and well-being,” Páramo said. “Having healthy communities benefits everyone.”
The proposed changes still require approval from the California Legislature.
