As record-high numbers of migrants flood the country, California is rolling out an expansion of healthcare coverage to more than 700,000 illegal immigrants that is expected to cost taxpayers between $2.6 billion and $3.4 billion a year.

Though California’s state healthcare program for low-income individuals, Medi-Cal, already covered services for children and adults aged 50 and older regardless of their immigration status, the latest expansion will cover all ages. 

The roll-out of the expansion this week is sparking further conversation in a years-long debate about the use of taxpayer-funded services for unauthorized migrants. It comes as Border Patrol’s December migrant encounters reached more than 300,000, the highest month on record. 

11 states and Washington D.C. provide healthcare insurance to more than 1 million low-income immigrants, data compiled by KFF Health News indicate, and enrollment could nearly double by the end of this year as more states, including Utah, New York, and Washington, expand or begin covering migrants. 

Supporters of the program say it is a historic moment for California, as it becomes the first state in the country to provide comprehensive care to low-income migrants despite their legal status. 

“By removing immigration status as an eligibility barrier to Medi-Cal, California is building a more universal, efficient, and equitable health care system for all who call California home,” a policy advocate at Health Access California, Jose Torres, said when the expansion passed in 2022. “Health care is a human right, and our health system is stronger when everyone is included.”

California’s policy, however, is already facing fierce opposition and calls for its reversal. The mayor of one city of more than 100,000 residents issued a public statement over the weekend about the “dire consequences of California’s broken immigration system and the burden it places on our local communities.” 

“Our state faces an array of challenges, but instead of focusing on the needs of taxpaying citizens, it is placing illegal immigrants at the front of the line,” wrote the El Cajon mayor, Bill Wells, who is a Republican. “California’s failed policies have rolled out the welcome mat for migrants and illegal immigrants, providing them with whatever they need.” 

Citing the county of San Diego — home to El Cajon — spending about $1 million monthly on migrant services and the arrival of thousands of migrants, “not including those who evaded Border Patrol,” Mr. Wells noted the state’s new healthcare plan is a “failure of leadership and an insult to our citizens.” He called on citizens of California to demand that leaders stop the program and “prioritize the security of our borders and the well-being of our citizens.” 

A congresswoman from Georgia, Marjorie Taylor Greene, took the issue up on X, asking whether a “tax revolt” could stop it. “California is going to give illegals free healthcare, but nothing is free, the California taxpayers have to pay for it,” she wrote ahead of the policy going into effect on Monday. 

California is facing a crippling $68 billion budget deficit due to “severe revenue decline,” the state’s Legislative Analyst’s Office declared in December. The expansion has caused concerns among the California Senate Republican caucus that it will further strain the state’s healthcare system. 
“Medi-Cal is already strained by serving 14.6 million Californians — more than a third of the state’s population,” the group said in a statement. “Adding 764,000 more individuals to the system will certainly exacerbate current provider access problems.”