How many undocumented are on Medi-Cal?

Editorial team Published on

Roughly 1.6 million undocumented immigrants are enrolled in California's Medi-Cal program, though enrollment numbers have fluctuated due to recent policy shifts and disenrollments.

Key Details

  • Federal Rules: Under federal law, undocumented immigrants do not qualify for standard federally funded Medicaid or Affordable Care Act marketplace coverage.
  • State Programs: California is the primary exception, using state-only funds to progressively expand full-scope Medi-Cal to low-income residents regardless of immigration status (culminating in the adult age 26–49 expansion in January 2024).
  • Recent Trends: Following a peak after the 2024 expansion, enrollment among undocumented adults has seen noticeable declines amid state-level enrollment adjustments, funding constraints, and heightened fears related to federal immigration data policies.

How much of Medi-Cal goes to undocumented immigrants?

California is spending roughly $8.4 billion to $8.5 billion annually on taxpayer-funded health benefits for undocumented immigrants through the Medi-Cal program.

Cost and Enrollment Details

  • Total Spending: According to state budget estimates reported by the California Department of Finance via the House Budget Committee, expenditures for this expansion rose significantly higher than original projections, driven by higher-than-expected enrollment.
  • Enrollee Count: The expansion covers approximately 1.6 million undocumented immigrants across various limited and full-scope categories.
  • Tax Contributions: According to analysis by CalMatters, undocumented immigrants contribute roughly $8.5 billion in annual state and local taxes.

Recent Policy Changes

  • Enrollment Freeze: Facing budget deficits, California enacted policy rollbacks freezing full-scope enrollment for new undocumented adult applicants aged 19 and older.
  • Future Premiums: Under recent budget adjustments, a $30 to $50 monthly premium is scheduled for implementation for certain enrolled adults starting in July 2027, alongside planned rollbacks of certain dental and clinic benefits.

Can illegals get on Medi-Cal?

Medi-Cal provides full coverage for undocumented children aged 18 and under, but new full-scope enrollment is frozen for undocumented adults aged 19 and older as of January 1, 2026.

Current Rules for Adults (Ages 19+)

  • New Enrollments: Undocumented adults cannot newly enroll in full-scope Medi-Cal.
  • Existing Enrollees: Adults who were already enrolled in full-scope Medi-Cal before January 1, 2026, can keep their coverage as long as they complete their annual renewals on time.
  • Emergency and Pregnancy Care: Anyone who does not qualify for full-scope coverage can still receive restricted-scope or Emergency Medi-Cal, which covers life-threatening emergencies, labor and delivery, and pregnancy-related care.

Rules for Children (Ages 0–18)

  • Children continue to receive full-scope Medi-Cal coverage regardless of their immigration status, provided they meet standard income and residency rules.

Upcoming Changes

  • Dental Care: Non-emergency dental benefits for adults (ages 19+) with unsatisfactory immigration status are scheduled to end July 1, 2027 (updated from previous timelines), though emergency dental services will remain.
  • Premiums: Enrolled adults aged 19 to 59 with unsatisfactory immigration status will be charged a $30 monthly premium starting July 1, 2027 to maintain full-scope coverage.

What race is the highest on Medicaid?

In raw numbers, White (non-Hispanic) individuals make up the largest share of total Medicaid enrollees, but people of color are disproportionately enrolled relative to their share of the U.S. population.

Total Enrollment Distribution

According to national Medicaid data and KFF State Health Facts, the breakdown of total non-elderly enrollees by race and ethnicity is approximately:

  • White (non-Hispanic): ~36% to 43%
  • Hispanic / Latino: ~28% to 31%
  • Black (non-Hispanic): ~19% to 21%
  • Asian / Pacific Islander: ~4% to 5.5%
  • American Indian / Alaska Native (AIAN): ~1.3%

Disproportionate Representation

While White enrollees represent the plurality of total users due to the larger size of the total U.S. White population, minority groups rely on Medicaid at much higher rates relative to their share of the general population:

  • Hispanic people make up roughly 19.5% of the total U.S. population, but nearly 30% of Medicaid enrollees.
  • Black Americans make up about 13.7% of the U.S. population, but roughly 20% of Medicaid enrollees.
  • American Indian and Alaska Native individuals experience some of the highest reliance and coverage rates, particularly in specific categories such as coverage at the time of birth (64.6%), compared to 27.3% for White women.

Is Trump cutting Medi-Cal?

President Donald Trump's 2025 tax and budget legislation enacted federal cuts to Medicaid, which is leading to significant funding reductions and new restrictions for California's Medi-Cal program.

Impact on Medi-Cal

  • Funding Reductions: Federal legislation is projected to cut Medicaid spending by roughly $1 trillion nationally over a decade, translating to an estimated loss of around $30 billion per year for Medi-Cal in California.
  • Work and Eligibility Rules: The changes impose new 80-hour monthly work or community engagement requirements, more frequent six-month verification rules, and reduced retroactive coverage limits.
  • Coverage Loss: Policy analysts and state reports (such as those from CalMatters) estimate that millions of residents could lose coverage or face stricter qualification limits due to these federal shifts and related administrative changes.
  • Immigrant Eligibility: Federal rules have narrowed full-scope Medicaid definitions for certain non-citizens, though state adjustments have attempted temporary stopgap coverage for some impacted groups.

Further administrative actions by the Centers for Medicare & Medicaid Services (CMS) continue to roll out rules that expand these federal cuts.

For the undocumented shut out of Medi-Cal, Newsom’s health insurance for all plan could be a godsend

9 related questions found

Can illegal immigrants get welfare in California?

Undocumented immigrants cannot receive standard federal welfare cash assistance, but California provides access to specific state-funded health, food, and family support programs.

Federal Welfare Restrictions

Under federal law, undocumented immigrants are ineligible for major means-tested public assistance programs. These restricted programs include:

  • Temporary Assistance for Needy Families (TANF) (cash welfare)
  • Supplemental Security Income (SSI)
  • Supplemental Nutrition Assistance Program (SNAP) / Food Stamps
  • Non-emergency Medicaid

California State-Funded Benefits

While federal aid is barred, California operates state-funded and specialized programs that allow undocumented residents to qualify for certain types of assistance:

  • Medi-Cal: Low-income residents regardless of immigration status have historically qualified for state-funded health coverage, though adult enrollment rules and certain non-emergency benefits have seen adjustments.
  • Food and Nutrition: Undocumented individuals can access the Women, Infants, and Children (WIC) program and school meal programs. Undocumented parents may also apply for CalFresh benefits on behalf of citizen or eligible children.
  • Disability and Family Leave: Undocumented workers who pay into California's state payroll taxes can access State Disability Insurance (DI) and Paid Family Leave (PFL).

According to an analysis by City Journal, critics characterize these state-level additions as a "shadow welfare system" providing billions in services, while supporters argue the programs protect public health and support local workers and children.

Does ICE have access to Medicaid?

Yes, Immigration and Customs Enforcement (ICE) has limited access to certain basic state Medicaid enrollment data following federal agreements and court rulings.

What Data ICE Can Access

  • Basic Information: Federal agencies can share names, home addresses, phone numbers, dates of birth, and immigration status.
  • Enforcement Use: ICE uses this contact information to locate individuals for immigration enforcement.

What Data Is Prohibited

  • Medical Records: Courts block access to sensitive health histories, treatment notes, and specific medical claims.
  • Citizens and Legal Residents: In states that sued the federal government, a judge barred ICE from viewing data on U.S. citizens and lawfully present immigrants.

Recent Legal Status

The data-sharing arrangement between the Centers for Medicare and Medicaid Services (CMS) and the Department of Homeland Security led to major lawsuits from multiple state attorneys general. Federal courts have allowed limited basic data sharing to resume while legal battles continue, and investigations have scrutinized how data was handled, as reported by NPR.

What percent of immigrants get welfare?

About 53 percent of immigrant-headed households use at least one major welfare or public assistance program, compared to 37 percent of U.S.-born households, according to data from the Center for Immigration Studies.

However, measuring "welfare use" depends heavily on how the data is analyzed, whether the focus is on households or individuals, and which programs are included.

Household Participation vs. Per Capita Cost

  • Household Rates: According to the Center for Immigration Studies, 52.7% of all immigrant households (including naturalized citizens, legal residents, and undocumented immigrants) use at least one major program (such as Medicaid, SNAP, or the EITC). For non-citizen households alone, the rate is 58.6%.
  • Per Capita Spending: According to an analysis by the Cato Institute, immigrants consume about 24% fewer welfare and entitlement benefits on a per capita basis than native-born Americans. Non-citizen immigrants consume 53% less than native-born Americans.

Reasons for Program Usage

  • Eligible Family Members: Undocumented immigrants are largely barred from directly receiving major federal welfare benefits. However, many live in mixed-status households where they receive benefits on behalf of U.S.-born children who have full citizenship eligibility.
  • Work-Based Credits: A significant portion of program usage involves refundable tax credits like the Earned Income Tax Credit (EITC), which require individuals to be authorized workers and pay taxes.
  • Demographics: Naturalized citizens sometimes show higher utilization of programs like Medicare and Social Security simply because they tend to be older.

Did California give illegals driver's licenses?

Yes, California gives driver's licenses to undocumented immigrants.

The Law (AB 60)

  • California passed Assembly Bill 60 (the Safe and Responsible Drivers Act) in 2013, and the law took effect on January 1, 2015.
  • The law allows any California resident to apply for a standard driver's license regardless of their immigration status.
  • Applicants must still prove their identity and California residency (using documents like a foreign passport or birth certificate), pass vision and written tests, and complete a behind-the-wheel driving test.

License Features and Limitations

  • Distinct Markings: AB 60 licenses state "federal limits apply" on the front and are "not acceptable for official federal purposes" (such as boarding commercial domestic flights or entering federal buildings) on the back.
  • No Federal Identification: These cards are non-Real ID driving privilege cards.
  • Statistics: Over one million undocumented residents have obtained driver's licenses through this program since its launch.

Is the self-deportation stipend $3,000?

Yes, the Department of Homeland Security (DHS) offered a temporary $3,000 "holiday stipend" or exit bonus for undocumented migrants who registered to self-deport through the CBP Home app.

Program Details

  • Stipend Amount: The standard $1,000 self-deportation incentive was tripled to $3,000 for those who registered by December 31, 2025.
  • Additional Benefits: Participants also received a free flight home and the forgiveness of civil fines or penalties related to remaining in the U.S. illegally.
  • Requirements: Eligible individuals had to submit their intent to depart and complete vetting through the CBP Home mobile application.
  • Enforcement Context: According to announcements from DHS Secretary Kristi Noem, the limited-time holiday incentive was designed to reduce government removal costs, with non-participants facing arrest and bars on reentry.