Republicans’ Harmful Budget Cuts and Attacks Are Undermining Immigrants’ Health Care

Immigrant Communities Receive the First of Many Blows as States Tackle Federal Funding Cuts

As states grapple with implementing the health care funding cuts passed in HR1, many immigrants are losing their health coverage, including people who have been working, paying taxes, and building strong communities at church and in rural areas in the United States for decades. These coverage losses are occurring as states are adopting rollbacks in health care coverage due to budget concerns amidst the loss of essential federal health care dollars. For some states, this means pulling back state-funded health care coverage expansions that provide immigrants with access to affordable and life-saving care.

These rollbacks will have ripple effects across families and communities. For mixed status families, or families who have some members who are citizens or legally present and other members who are undocumented, family members may forgo health coverage they qualify for due to fear for the safety of their undocumented family members. This loss of coverage will make people across the community sick and leave many essential workers without access to care and coverage. These cuts to immigrant services are the first of many that will impact people across the country as states address cuts to federal funding.

California, Illinois, Minnesota, Washington and D.C., longtime pioneers in extending health care coverage to immigrants, have all announced rollbacks in their health care coverage for immigrants, regardless of status. Under law, federal dollars are barred from funding health care coverage for undocumented immigrants and stipulations like the 5-year bar, a law that prevents lawfully present immigrants from accessing federal programs for 5 years, exist that limit coverage for lawfully present immigrants. These states utilize their own tax dollars to fund immigrant health coverage programs. However, as the federal government limits funding to Medicaid, hospitals, and public health due to HR1, states are forced to make difficult choices to make up lost funds and prevent huge coverage losses. Unfortunately, immigrant health coverage programs are first on the chopping block, despite their leadership in expanding access to health care coverage.

California

Since 2015, California has implemented a multi-step expansion of Medi-Cal to cover all undocumented immigrants in the state. First, the state expanded coverage under its Medicaid program, Medi-Cal, to all eligible children up to age 18, regardless of immigration status. Next, the state phased in Medi-Cal coverage to all undocumented adults in the state, first to young adults, aged 19 to 25 (in 2020), then to adults aged 50 and older (in 2022) and, finally, to the remaining adults aged 26 to 49 (in 2024). By January 1, 2024, all eligible adults and children, regardless of immigration status, were able to enroll in Medi-Cal, extending coverage to an estimated 1.16 million people.

However, in June 2025, Gov. Newsom signed a budget that would scale back the existing Medi-Cal immigrant coverage expansions. As part of the final budget deal, adults between the ages of 19 and 59 who were already enrolled will have to pay a new $30 monthly premium beginning in 2027. In addition, the state will eliminate dental care in July 2026 for undocumented adults and other noncitizens. Medi-Cal will also pause enrollment for any new undocumented beneficiaries aged 19 or older but will maintain coverage for existing enrollees.

Illinois

Illinois offers several options to provide immigrant children with health care coverage. The state opted into the Immigrant Children's Health Improvement Act option, which extends Medicaid and Children's Health Insurance Program (CHIP) coverage to lawfully present immigrant children without the 5-year waiting period. Additionally, the state established the Illinois All Kids program, which offers comprehensive health care coverage to children regardless of status, sometimes with a small premium or copay.

In 2020, Illinois launched the Health Benefits for Immigrant Seniors program, which offers Medicaid coverage for qualified individuals age 65 or older. In 2021, the state launched the Health Benefits for Immigrant Adults (HBIA) program, a companion program which offers Medicaid coverage to qualified individuals aged 42 to 64.

Effective July 1, 2025, the state ended Medicaid coverage for immigrant adults aged 42 to 64, due to administrative rules set by the Illinois Department of Healthcare and Family Services. The program covered an estimated 30,000 adults. However, the state continues to operate its programs that extend Medicaid coverage to immigrant children and seniors.

Minnesota

Since January 1, 2025, Minnesota has provided state-funded 'MinnesotaCare', the state's Medicaid program, to all low-income adults, regardless of citizenship status. The state will continue to provide health care coverage for children up to 18 years old, regardless of citizenship status.

Washington

Washington incrementally expanded health care coverage options for undocumented residents in the state, first, in 2023, to allow undocumented residents to purchase a non-federally subsidized qualified health and/or dental plan from Washington Healthplanfinder. Then, starting in 2024, the state expanded coverage under its Medicaid program, AppleCare, to low-income, undocumented residents under an expansion of the program's coverage eligibility.

Although the Washington state legislature has extended funding for AppleCare immigrant coverage, the funding is capped to only cover about 13,000 enrollees. When the program launched, within the first few days of enrollment, an additional 17,000 people signed up for the program's waiting list. There are concerns from advocates that the state legislature will further limit this funding and the expansion of the program in years to come.

D.C.

The DC Healthcare Alliance was established in 2001 after the closure of a local hospital, and provides health insurance to low-income residents that don't qualify for Medicaid, including undocumented immigrants. Undocumented immigrants who earn at or below 210% of the federal poverty level can qualify for health coverage under the program. However, as a result of the 2026 budget bill, all people 26 or older will no longer be eligible for the DC Healthcare Alliance program, impacting many undocumented adults who rely on the program to access health coverage.

These rollbacks will endanger the health and wellness of immigrant communities and as a result the socioeconomic wellbeing of these states. Across the country immigrants contribute nearly a hundred billion tax dollars annually and an estimated 5.5 million undocumented immigrants work in essential fields such as health care, construction, or agriculture. These state coverage rollbacks mean that the undocumented immigrants across our communities who grow our food, care for our elderly, or build our infrastructure have less access to the health care that they need to stay healthy and continue to be important contributing members of our communities.

As states enter their legislative sessions and consider their future budgets, advocates and community members should urge their state lawmakers to protect and reinstate immigrant coverage expansions.