Newsom Tries To Thread Needle on Immigrant Health as Ambitions Turn National
While Gov. Gavin Newsom battles with President Donald Trump and draws national attention to a possible presidential bid, at home he’s facing criticism from the left and right on health care.
The California Democrat came to power promising to fight for “guaranteed health care for all,” and he almost succeeded. Really close. But it turns out that’s easier said than done when juggling chronic budget deficits, rising health care costs and dwindling federal support.
He now finds himself walking a fine line between keeping his original promises to progressives and being branded a reckless state leader who pushed California’s spending beyond its means.
After years of political infighting, Newsom and the Democratic-controlled Legislature in 2024 expanded California’s Medicaid program, Medi-Cal, to all income-eligible children and adults, regardless of immigration status.
Today, he is reversing these expansions in the name of “fiscal prudence.”
This year, California froze Medi-Cal enrollment for most adults without legal status, just two years after making them all eligible. On July 1, immigrants ineligible for federal Medicaid – whether legal or unauthorized residents – will lose access to state dental coverage. Next year, they will have to start paying monthly premiums.
Last month, Newsom proposed letting about 200,000 legal immigrants — asylum seekers, refugees and others — be excluded from Medi-Cal after Sept. 30, when the federal government stops paying for them.
The defenders are furious.
Progressives say Newsom’s policy ambitions — and perceived need to distance himself from the polarized topic of immigrant health care — run counter to his early promises.
“You’re confused by what Arkansas is going to think, or what Tennessee is going to think, whereas what California is going to think is something completely different,” said California state Sen. Caroline Menjivar, chairwoman of the Health and Human Services budget subcommittee.
Meanwhile, Republicans and fiscal hawks have portrayed Newsom as a tax-and-spend Democrat, prioritizing the use of limited state funds for free health care for noncitizens. And Newsom has come under fire from the Trump administration, accusing California of “gaming the system” to use federal funds for immigrant health services.
He’s not the only governor grappling with this dilemma. And the 50 states, which are currently required to provide health coverage to refugees, asylum seekers and others, will have to decide whether to boost that coverage for some 1.4 million legal immigrants starting Oct. 1, when a provision of the One Big Beautiful Bill Act takes effect that leaves states without federal reimbursement for their care.
