TL/DR –
California, Illinois, and Minnesota are reducing or ending healthcare coverage for many immigrants without legal status in the US, due to significantly higher than expected costs. The new measures are anticipated to save Illinois $404 million, Minnesota almost $57 million, and California more than $3 billion over several years. In May, it was announced at the Centers for Medicare and Medicaid Services that federal oversight would increase to prevent states from using federal Medicaid funds to cover healthcare for undocumented immigrants, and data from Medicaid enrolment has been passed to the Immigration and Customs Enforcement agency.
Changes in Immigrant Health Coverage in California, Illinois, and Minnesota
California, Illinois, and Minnesota are cutting or restricting health insurance for thousands of undocumented immigrants, as reported by AP News. These three states, along with four others and the District of Columbia, have traditionally provided health coverage for immigrants since mainly 2020.
The programs have overshot budget projections, adding to the states’ massive deficits. Illinois has ceased healthcare for adult immigrants aged 42-64 without legal status, saving approximately $404 million. In Minnesota, adult immigrants are no longer eligible for the state program, saving close to $57 million. Whereas in California, while no one will automatically be disqualified, new adult enrollments will stop in 2026, saving over $3 billion in multiple years. California Governor Gavin Newsom approved a new budget last month, tackling a $12 billion deficit and limiting several initiatives, including healthcare expansion for undocumented immigrants.
Federal Oversight and Policy Changes
The Centers for Medicare and Medicaid Services (CMS) announced in May increased federal scrutiny to prevent states from using federal Medicaid money for undocumented immigrant healthcare. The Department of Health and Human Services (HHS) also recently declared it had rescinded a policy that extended some federal public benefits to immigrants without permanent legal status, making it harder for them to access these benefits.
Medicaid Data Handover and Immigration Raids
Additionally, AP News confirmed on July 17 that CMS has shared Medicaid enrollment data with ICE, leading to lawsuits from 20 states, including California, Illinois, and Minnesota. These lawsuits and increasing immigration raids have altered patient behaviors, with more patients opting for virtual appointments, skipping regular doctor visits, and neglecting to pick up chronic condition medications, as observed by healthcare providers.
Families USA’s Executive Director, Anthony Wright, criticised these measures, stating they spread negative and false narratives about immigrant families and hinder them from safely accessing necessary healthcare.
Washington’s Medicaid-style Program for Undocumented Immigrants
On the other hand, Washington state has set aside $150 million for a Medicaid-like program, providing healthcare to undocumented immigrants. According to a presentation by the Washington State Health Care Authority, the 2024 legislative session decided the funding for the Apple Health Expansion.
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