In the governor’s race, voters face a stark choice on health care for immigrants

For decades, Californians have often said that immigrants, builders more than a quarter of the people of the state and the third time of its employees, are a benefit to the government and its economy. But budget instability and concerns about rising costs are resulting in a debate about the controversial and expensive rate consent policy low-income immigrants who do not have legal status to receive government-sponsored health care.

Now, Democrat Xavier Becerra and Republican Steve Hilton are presenting strong choices to voters in the race to become the next governor at a time when public support for the nation’s safety net is beginning to falter.

Both plan to choose as economy.

Becerra, who was the secretary of Health and Human Services under President Biden, went he said it would be “stupid” excluding the poorest immigrants from mainstream care and pushing them into expensive emergency rooms at the taxpayer’s expense. Hilton, a trusted analyst backed by President Trump, has promised to end their coverage and talk to national Republicans skewered increase in California to bolster their claims of fraud and abuse in the Medicaid program.

As voters across the country worry about inflation and the rising cost of living, some Californians may feel less inclined to provide full health care to those without legal status. What the state does next could have a big impact on its health care system and the growing economy.

Over the past decade, California lawmakers have used state dollars to expand Medi-Cal, giving all low-income residents full coverage regardless of immigration status. But enrollment exceeded initial estimates, as did costs. Medi-Cal coverage for immigrants without legal status costs the state approx $10 billion a yearaccording to the California nonpartisan Office of the Legal Examiner, more than double the initial estimates.

California lawmakers and Democratic Gov. Gavin Newsom, who said fight for the systembe a major recall authorized of the benefits of those residents. They said the state can’t afford ballooning health care costs among the majors federal cuts from the GOP tax and spending bill known as the One Big Beautiful Bill; The California Health and Human Services Agency reported that up to 3.4 million people are enrolled in Medi-Cal it can lose its spread and the state could lose more than $30 billion a year in federal funds under the law, causing major disruptions to the safety net health system. Medi-Cal’s budget for the 2026-27 fiscal year is $217 billion, and the program serves more than 14 million Californians.

Meanwhile, many legal US citizens and residents have seen their health care payments rise significantly this year after Congress allowed enhanced federal Affordable Care Act funding to expire at the end of December.

When the state faced a budget deficit last year, a majority of voters in California said — for the first time in nearly a decade — that they opposed providing health insurance to immigrants without legal status, according to the survey by the Public Policy Institute of California.

“The state is facing big challenges, and health care is one of the biggest costs,” said Mark Baldassare, the center’s research director. “People are very selective about how they want to see those limited health dollars spent.”

Hilton, who works in the area of ​​accessibility and lowering taxes, has held back, putting health care for immigrants without legal status. deeply wrong and a direct threat in the power of the state to help the citizens.

“Stop taking money from California taxpayers who can’t afford health care to provide free health care to citizens of other countries who shouldn’t even be here,” Hilton said in a statement. Facebook video morning of June 2 primary.

In the campaign’s graduation speeches, Hilton promised using savings lower health care costs to other Californians without explaining how. Hilton did not respond to KFF Health News’ requests for comment.

“Their message is very simple: Say it against them,” said Roger Salazar, a Democratic political consultant who represents a coalition of health care advocates who oppose providing care to people who can’t afford it. It strengthens the workforce and, as a result, the economy. “It’s just a question of convincing the average voter that it’s the best for the economy.”

A the son of immigrantsBecerra decades pushed to extend the benefits of the safety net in Congress and did the same in his campaign for governor. He did not respond to requests for comment.

“Immigrants, whether documented or not, work hard. They pay taxes, and sometimes they get hurt on the job or their children get sick,” Becerra said during the debate last month. “It would be foolish to tell the family that you can’t find a pediatrician or a family doctor.”

Becerra, who could become California’s first elected Latino governor, he argued last year when Newsom and legislative leaders decided to do so close Medi-Cal enrollment for seniors without legal status, reduced benefits, and set monthly premiums.

“Stop treating coverage as a budget variable that increases with good years and contracts when revenue dies,” Becerra wrote last month in response to the Orange County Register. candidate questionnaire. You did it he promised to follow new, stronger money to fund basic services, such as raising taxes on corporations and the wealthiest Californians.

In 2023, California was home to approximately 2.3 million people without legal status, representing about 8% of state employees, according to the Pew Research Center. Again 1 in 5 children in California live in a household that includes at least one member who does not have legal status, according to the California Department of Education. Health economists say that giving people access to health care saves taxpayers money in the long run to keep employees healthy and to relieve pressure on an overburdened system.

That, Baldassare said, was not a difficult argument to make during the COVID-19 crisis, when immigrants celebrated as important workers and the connection between individual well-being and community health it became clearer.

But Medi-Cal costs about 1.4 million immigrants they are beautifulaccording to the latest Department of Health Care Services estimates. Because only some legal immigrants are eligible for Federal Medicaid benefits, in states like California involving other people it should only do so with government funding.

California budget experts they have warned that full retention of Medi-Cal for immigrants without seeking additional funding would undermine the state’s long-term fiscal vision.

At a legislative hearing last year, Republican Congressman Carl DeMaio questioned whether California taxpayers would prioritize the expansion, saying he doubted “health care for illegal immigrants in the general fund would be at the top of their list.”

After lawmakers approved the cuts, health care support for immigrants dropped, Baldassare said. Now the lawmakers and Newsom negotiating more cuts.

David Hayes-Bautista, who has spent his career studying the economic contributions of Latinos and immigrants, said Californians lack legal standing. have a high role of workers and they tend to work in those industries and jobs do not offer employer-based health insurance. As a result, many are turning to Medi-Cal, binding the state for health care costs instead of employers.

“California, as a state, has the fourth largest GDP in the world, which is true because of Latinos,” said Hayes-Bautista, director of the Center for the Study of Latino Health and Culture at UCLA. Without contributions from Latinos, many of whom do not have legal status, it drops to eighth place, almost the largest of the Italian economyhe added.

Immigration advocates are hoping to have a more outspoken champion in Becerra, the favorite for governor in a district where Democrats outnumber Republicans by nearly 2 to 1.

“He will fight, he will retreat, he will do everything possible,” said Sen. María Elena Durazo, former labor leader who fought for the expansion of health care for immigrants. “That’s the most we could have hoped for.”

Mai-Duc writes KFF Health Newsa A national newsroom that produces in-depth journalism on health issues and is one of the active programs at KFF – an independent source for health policy research, polling, and journalism.