A Majority of Californians Support Affordable Health Care for Undocumented Immigrants, Polls Show

Amid an escalating federal crackdown on undocumented immigrants, a majority of Californians support extending Medicaid benefits to immigrants without legal status, according to two recent polls.

This broad public backing in the state contrasts sharply with the increasingly dehumanizing rhetoric emanating from Washington. Advocates hope the findings will shape how California navigates its budget shortfall and looming federal cuts to Medicaid. The state has gradually expanded coverage to undocumented residents since 2016, with notable health improvements among those populations.
 

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As Gov. Gavin Newsom prepares to unveil a revised budget in the face of growing fiscal pressures and increased national attention on immigration, these poll results add a crucial dimension to the debate over who gets access to healthcare in California, said Miguel Santana, president and CEO of the California Community Foundation, which conducted one of the recent polls. 

“There’s a disconnect between the dominant narrative and reality,” Santana said. “Efforts to do mass deportations, to deny immigrants services, to marginalize them further, are out of step with how Californians think about these issues.”

In March, the California Community Foundation surveyed 800 Californians who voted in the 2024 election and found that 57% of respondents were in favor of allowing all income-eligible residents, regardless of immigration status, access to Medi-Cal, the state’s Medicaid program. In addition, 68% of respondents favored allowing undocumented residents to purchase health insurance through the state’s Affordable Care Act-created Covered California health exchange, which is currently prohibited under federal law. 

Most Californians understand the varied and critical roles immigrants play in the state’s communities and industries, according to Santana. 

“[Californians] are worried that mass deportations and limiting access to basic services like health care will actually impact all of us,” Santana said. “The pandemic showed us that when one person gets sick, it doesn’t matter what their legal status is, it impacts all of us.”
 

Some 1.6 million undocumented immigrants are now enrolled in Medi-Cal, costing the state $2.7 billion more than what was budgeted.

 
Another poll conducted by the POLITICO-UC Berkeley Citron Center showed similar findings, with a “slim majority” of California voters supporting state-funded health coverage for undocumented residents.

Over the last decade, the state has gradually expanded Medi-Cal eligibility to undocumented immigrants — first by covering children in 2016, then young adults, followed by individuals 50 and older in 2022 and finally all undocumented immigrants at the start of 2024. 

The expansions have been more successful — and expensive — than expected. In 2023, state officials estimated that the final expansion would see about 700,000 undocumented immigrants gain health coverage. Instead, some 1.6 million immigrants without legal status are now enrolled in Medi-Cal, costing the state $2.7 billion more than what was budgeted. Those additional expenses contributed to California’s budget deficit and led Newsom to take out a multibillion dollar loan to cover Medi-Cal shortfalls in March.  

Agricultural communities that rely heavily on immigrant labor have benefited from the state’s efforts to expand access to Medi-Cal, said Ana Lie Álvarez, a campaign organizer with Health Access California, who grew up in Gonzales, a small farming community in Monterey County. 

That expansion “really exploded [coverage] everywhere,” said Álvarez, who works to expand access to health care to immigrants across the state. “Folks are just really excited to have access to health care.” 

Before eligibility expansions, injury or illness often destabilized undocumented or mixed-status households in agricultural areas, according to Álvarez. Without the ability  to afford proper health care, primary income earners sometimes become too sick or hurt to continue working.

Álvarez said some residents were initially wary of taking advantage of their newly gained eligibility for Medi-Cal. Over the past year, though, undocumented immigrants have grown more trusting of the health care program, which has helped California’s least insured group gain coverage. 

Those coverage gains have led to significantly improved health outcomes for the undocumented, according to a report from the California Budget & Policy Center. Between 2013 and 2019, the proportion of non-citizen children who reported being in “excellent health” increased from 20% to 30%, while citizen children saw an increase of less than one percentage point. The report’s authors, Monica Saucedo and Adriana Ramos-Yamamoto, attribute that change directly to increased access to health coverage.
 

“Cutting benefits for one population isn’t going to backfill these massive tax cuts.”

~ Monica Saucedo, California Budget & Policy Center

 
“When people don’t have access to health coverage or health insurance, they are more likely to skip or delay their care, which is really harmful to their overall health,” Ramos-Yamamoto said.

Those improvements may be at risk of being clawed back, however. When Gov. Gavin Newsom released his proposed annual budget in January, no cuts to Medi-Cal were included, but since then, the Republican-controlled U.S. House of Representatives passed a budget resolution that calls for cutting up to $880 billion from Medicaid over the next 10 years. Those drastic  spending reductions could pressure states to alter their health care programs and put Medi-Cal expansions for the undocumented “very much at risk” when Newsom releases his revised budget in May, according to Ramos-Yamamoto.

The massive Medicaid cuts are being proposed to offset tax cuts which would disproportionately benefit wealthy Americans — a prospect that Saucedo said is misguided.

“Cutting benefits for one population isn’t going to backfill these massive tax cuts. We should all be uniting against those federal cuts rather than finding a small population in our state that is getting amazing health care benefits through these expansions,” Saucedo said. 

Some experts, like UCLA Center for Health Policy Research Senior Fellow Gerald Kominski, say cutting Medicaid would worsen health outcomes and result in higher health care costs across the board. Even so, he expects congressional Republicans to deliver a bill to President Trump’s desk that makes the cuts. 

“This is not an administration that cares about what the majority of Americans think. They are hellbent on exercising their power, regardless of what anybody thinks,” Kominski said. 

Advocates have worked to expand access to health coverage in California for over 30 years, according to Kominski, with organizations like Health Access California cropping up in the 1980s. Since then, the state has been one of the most proactive in terms of expanding Medicaid eligibility. 

Today, California is one of just five states that offers health insurance coverage for all income-eligible adults regardless of their immigration status — a distinction that health care advocates and experts hope it maintains despite impending pressures. 

“My hope is that we are able to preserve these health-for-all expansions because the need is not going to go away,” Álvarez said. “It doesn’t matter if there’s a difficult budget or other things going on. It doesn’t change the fact that people need and deserve [health care].”

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Jeremy Lindenfeld is a California Local News Fellow.