California, other Democratic-led states roll back Medicaid access for people lacking legal status
She didn't have legal status, so she couldn't get health insurance and skipped routine exams, relying instead on home remedies and, at times, getting inhalers from Mexico. She insisted on using only her first name for fear of deportation.
Things changed for Maria and many others in recent years when some Democratic-led states opened up their health insurance programs to low-income immigrants regardless of their legal status. Maria and her husband signed up the day the program began last year.
'It changed immensely, like from Earth to the heavens,' Maria said in Spanish of Medi-Cal, California's Medicaid program. 'Having the peace of mind of getting insurance leads me to getting sick less.'
At least seven states and the District of Columbia have offered coverage for immigrants, mostly since 2020. But three of them have done an about-face, ending or limiting coverage for hundreds of thousands of immigrants who aren't in the U.S. legally — California, Illinois and Minnesota.
The programs cost much more than officials had projected at a time when the states are facing multibillion-dollar deficits now and in the future. In Illinois, adult immigrants ages 42 to 64 without legal status have lost their healthcare to save an estimated $404 million. All adult immigrants in Minnesota no longer have access to the state program, saving nearly $57 million. In California, no one will automatically lose coverage, but new enrollments for adults will stop in 2026 to save more than $3 billion over several years.
Cuts in all three states were backed by Democratic governors who once championed expanding health coverage to immigrants.
The Trump administration this week shared the home addresses, ethnicities and personal data of all Medicaid recipients with U.S. Immigration and Customs Enforcement officials. Twenty states, including California, Illinois and Minnesota, have sued.
Healthcare providers told the Associated Press that all of those factors, especially the fear of being arrested or deported, are having a chilling effect on people seeking care. And states may have to spend more money down the road because immigrants will avoid preventive healthcare and end up needing to go to safety-net hospitals.
'I feel like they continue to squeeze you more and more to the point where you'll burst,' Maria said, referencing all the uncertainties for people who are in the U.S. without legal permission.
People who run free and community health clinics in California and Minnesota said patients who got on state Medicaid programs received knee replacements and heart procedures and were diagnosed for serious conditions like late-stage cancer.
CommunityHealth is one of the nation's largest free clinics, serving many uninsured and underinsured immigrants in the Chicago area who have no other options for treatment. That includes the people who lost coverage July 1 when Illinois ended its Health Benefits for Immigrants Adults Program, which served about 31,500 people ages 42 to 64.
One of CommunityHealth's community outreach workers and care coordinator said Eastern European patients she works with started coming in with questions about what the change meant for them. She said many of the patients also don't speak English and don't have transportation to get to clinics that can treat them. The worker spoke to the AP on condition of anonymity to protect patients' privacy.
Health Finders Collective in Minnesota's rural Rice and Steele counties south of Minneapolis serves low-income and underinsured patients, including large populations of Latino immigrants and Somali refugees. Executive director Charlie Mandile said his clinics are seeing patients rushing to squeeze in appointments and procedures before 19,000 people age 18 and older are kicked off insurance at the end of the year.
Free and community health clinics in all three states say they will keep serving patients regardless of insurance coverage — but that might get harder after the U.S. Department of Health and Human Services decided this month to restrict federally qualified health centers from treating people without legal status.
CommunityHealth Chief Executive Stephanie Willding said she always worried about the stability of the program because it was fully state funded, 'but truthfully, we thought that day was much, much further away.'
'People are going to die. Some people are going to go untreated,' Alicia Hardy, chief executive officer of CommuniCARE+OLE clinics in California, said of the state's Medicaid changes. 'It's hard to see the humanity in the decision-making that's happening right now.'
A spokesperson for the Minnesota Department of Health said ending the state's program will decrease MinnesotaCare spending in the short term, but she acknowledged healthcare costs would rise elsewhere, including uncompensated care at hospitals.
Minnesota House Speaker Lisa Demuth, a Republican, said the state's program was not sustainable.
'It wasn't about trying to be non-compassionate or not caring about people,' she said. 'When we looked at the state budget, the dollars were not there to support what was passed and what was being spent.'
Demuth also noted that children will still have coverage, and adults lacking permanent legal status can buy private health insurance.
Healthcare providers also are worried that preventable conditions will go unmanaged, and people will avoid care until they end up in emergency rooms — where care will be available under federal law.
One of those safety-net public hospitals, Cook County Health in Chicago, treated about 8,000 patients from Illinois' program last year. Dr. Erik Mikaitis, the health system's CEO, said doing so brought in $111 million in revenue.
But he anticipated other providers who billed through the program could close, he said. 'Things can become unstable very quickly,' he said.
State lawmakers said California's Medi-Cal changes stem from budget issues — a $12-billion deficit this year, with larger ones projected ahead. Democratic state leaders last month agreed to stop new enrollment starting in 2026 for all low-income adults without legal status. Those under 60 remaining on the program will have to pay a $30 monthly fee in 2027.
States are also bracing for impact from federal policies. Cuts to Medicaid and other programs in President Trump's massive tax and spending bill include a 10% cut to the federal share of Medicaid expansion costs to states that offer health benefits to immigrants starting October 2027.
California health officials estimate roughly 200,000 people will lose coverage after the first full year of restricted enrollment, though Gov. Gavin Newsom maintains that even with the rollbacks, California provides the most expansive healthcare coverage for poor adults.
Every new bill requires a shift in Maria's monthly calculations to make ends meet. She believes many people won't be able to afford the $30-a-month premiums and will instead go back to self-medication or skip treatment altogether.
'It was a total triumph,' she said of Medi-Cal expansion. 'But now that all of this is coming our way, we're going backwards to a worse place.'
Fear and tension about immigration raids are changing patient behavior, too. Providers told the AP that, as immigration raids ramped up, their patients were requesting more virtual appointments, not showing up to routine doctor's visits and not picking up prescriptions for their chronic conditions.
Maria has the option to keep her coverage. But she is weighing the health of her family against risking what they've built in the U.S.
'It's going to be very difficult,' Maria said of her decision to remain on the program. 'If it comes to the point where my husband gets sick and his life is at risk, well then, obviously, we have to choose his life.'
Nguyễn and Shastri write for the Associated Press and reported from Sacramento and Milwaukee, respectively. AP journalist Godofredo Vasquez in San Francisco contributed to this report.
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Los Angeles Times
an hour ago
- Los Angeles Times
As Trump's raids ramp up, a Texas region's residents stay inside — even when they need medical care
WESLACO, Texas — These days, Juanita says a prayer every time she steps off the driveway of her modest rural home. The 41-year-old mother, who crossed into the United States from Mexico more than two decades ago and married an American carpenter, fears federal agents may be on the hunt for her. As she was about to leave for the pharmacy late last month, her husband called with a frantic warning: Immigration enforcement officers were swarming the store's parking lot. Juanita, who is prediabetic, skipped filling medications that treat her nutrient deficiencies. She also couldn't risk being detained because she has to care for her 17-year-old daughter, who has Down syndrome. 'If I am caught, who's going to help my daughter?' Juanita asks in Spanish, through an interpreter. Some people quoted in this story insisted that the Associated Press publish only their first names because of concerns over their immigration status. 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Those agents are even combing through the federal government's largest medical record databases to search for immigrants who may be in the United States illegally. Deportations and tougher restrictions will come with consequences, says Mark Krikorian, the director of the Center for Immigration Studies, a think tank that favors restrictive immigration policies. 'We shouldn't have let it get out of hand the way we did,' Krikorian says of the previous administration's immigration policies. 'Some businesses are going to have difficulties. Some communities are going to face difficulties.' Federal agents' raids began reaching deeper into everyday life across the Rio Grande Valley in June, just as the area's 1.4 million residents began their summer ritual of enduring the suffocating heat. This working-class stretch of Texas solidly backed Trump in the 2024 election, despite campaign promises to ruthlessly pursue mass deportations. 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USA Today
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- USA Today
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Newsweek
2 hours ago
- Newsweek
Petition to 'Release Trump's FULL Medical Records' Grows
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"This also must include cognitive, memory, and related tests, given the rapidly worsening symptoms Trump has been showing on that front as well (including an utterly bizarre public rant about the Unabomber and Trump's uncle). "This man has his finger on the nuclear button, which is already frightening. But if he's falling apart physically and mentally, that takes it to a whole other level. And we need to know that, so we can act accordingly." The White House announced Trump's diagnosis in a memo from Sean Barbabella, the president's physician. "The president underwent a comprehensive examination, including diagnostic vascular studies. Bilateral lower extremity venous Doppler ultrasounds were performed and revealed chronic venous insufficiency, a benign and common condition, particularly in individuals over the age of 70," the memo said. 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This occurs when the one-way valves inside the leg veins—responsible for keeping blood flowing upward—become damaged or weakened. As a result, blood can pool in the lower extremities, leading to swelling, discomfort and a range of other symptoms. The condition is most often caused by factors such as aging, obesity, prolonged periods of sitting or standing, a history of blood clots (such as deep vein thrombosis), or the presence of varicose veins. Over time, the increased pressure from trapped blood can lead to visible changes in the skin and even open sores, particularly around the ankles. Symptoms of CVI include leg swelling, aching or cramping, heaviness, visible varicose veins, skin discoloration, and in more advanced cases, ulcers around the ankles. These symptoms often worsen after long periods of standing or sitting and improve with leg elevation. President Donald Trump's foot and swollen ankle as he sits with Bahrain's Crown Prince Salman bin Hamad Al Khalifa in the Oval Office of the White House on July 16. President Donald Trump's foot and swollen ankle as he sits with Bahrain's Crown Prince Salman bin Hamad Al Khalifa in the Oval Office of the White House on July 16. AP What People Are Saying Sean Barbabella, the president's physician, shared the following details from a physical in a memo shown to Newsweek in April: "President Trump remains in excellent health, exhibiting robust cardiac, pulmonary, neurological, and general physical function. His active lifestyle continues to contribute significantly to his well-being. "President Trump's days include participation in multiple meetings, public appearances, press availability, and frequent victories in golf events. President Trump exhibits excellent cognitive and physical health and is fully fit to execute the duties of the Commander-in-Chief and Head of State." Then-Vice President Kamala Harris said in October: "I put out my medical records. He won't put out his medical records. And you have to ask, why is this staff doing that? And it may be because they think he's just not ready, and [is] unfit and unstable and should not have that level of transparency for the American people." What Happens Next It remains to be seen how the administration will respond to concerns about Trump's health and the ongoing push for transparency.
