Many illegal immigrants in California will become ineligible for Medi-Cal coverage in the new year, according to new guidance from state officials.
The Department of Health Care Services, which administers the state’s Medicaid program, called Medi-Cal, announced the move in August. The department stated on its website that immigrants with “unsatisfactory immigration status” will not be able to sign up for Medi-Cal on Jan. 1. That’s a reference to illegal immigrants.
“Federal cuts approved by Congress, Trump-era tariffs and ongoing attacks on our undocumented communities have created true fiscal strain for people in states like California,” said Assemblymember Dawn Addis, D-San Luis Obispo and chair of the Assembly Budget Subcommittee on Health.
“In response, the legislature acted to protect care by minimizing and postponing reductions in coverage,” Addis told The Center Square in an emailed statement on Tuesday. “The cost of the federal government’s erosion of healthcare is extremely high – both in tens of millions of dollars to our state and in real health consequences for Californians.”
Other Democratic and Republican legislators who sit on health-related committees in the state Assembly and Senate were not available to speak.
According to the new rules issued by the Department of Health Care Services, immigrants between ages 19 and 59 who are undocumented or have other immigration status deemed unsatisfactory, are not pregnant and do not have severe dental needs, like extreme pain or needing a tooth pulled, will not be able to sign up for Medi-Cal after Jan. 1. That category includes illegal immigrants.
“Current members can keep coverage if they renew on time and continue to meet eligibility requirements,” Anthony Cava, media relations manager for the Department of Health Care Services, wrote to The Center Square on Tuesday. “For those who lose coverage, emergency and pregnancy care (including coverage one year post birth) remain available.”
Illegal immigrants who currently have Medi-Cal can keep it, the Department of Health Care Services said on its website.
Adults over 19 years old who already have Medi-Cal will be able to keep their coverage, as long as they renew their policy during their renewal month, the Department of Health Care Services said on its website. Children and pregnant women will still be eligible for Medi-Cal regardless of their immigration status, the department said.
Starting on July 1, illegal immigrants will not be able to sign up for dental benefits through Medi-Cal. Pregnant women, children and anyone with severe dental needs will still be able to keep their Medi-Cal coverage if they already have it. Illegal immigrants with full Medi-Cal coverage on that date will have to start paying $30 a month to keep their Medi-Cal coverage, the Department of Health Care Services said.
The guidance follows the passage of a state budget in June that mandated a freeze on Medi-Cal enrollment by illegal immigrants, which is estimated to save $86.5 million from 2025-2026, more than $857 million in 2026-27, and $2 billion 2027-28, according to a budget analysis by the California Pan-Ethnic Health Network.
A report from the Legislative Analyst’s Office released in May 2025 shows that Medi-Cal spending for illegal immigrants amounts to 15% of general fund spending by the state. That report also shows that expanding Medi-Cal access to illegal immigrants and higher pharmacy spending have driven up the program’s costs.
The federal budget passed this year cut $1 trillion from Medicaid, according to the California Budget Policy Center. The state’s Medicaid program, called Medi-Cal, provides health insurance to an estimated 14.8 million people in the state in 2025-26, according to a report from the California Department of Health & Human Services.
