Amid statewide immigration crackdowns, undocumented immigrants now face another threat: losing their health care.
Governor Gavin Newsom announced a proposal in mid-May that would significantly change Medi-Cal access for undocumented immigrants aged 19 and older, starting in 2026. The plan includes a freeze on new enrollments, the introduction of a $100 monthly premium and the elimination of dental and long-term care coverage.
The measure, which is expected to save the government over $5 billion, must be included in the state budget and approved by the California Legislature before it can take effect.
For Daniela and her husband, Jose (we are not using their real names to protect their privacy) — both undocumented immigrants living in the U.S. over 30 years and currently residing in San Bernardino with their two children — Medi-Cal is a lifeline.
In 2018, Jose received a diagnosis of sleep apnea so severe that his oxygen levels dropped dangerously low, landing him in the hospital for two weeks. For a year after his discharge, he had to use an in-home oxygen concentrator at all times.
During that time, Medi-Cal made it possible for the couple to access specialists, medications, essential equipment maintenance and a weekly home visit from a nurse for checkups on Jose’s recovery — care that would have been out of reach otherwise.
That support didn’t end with Jose’s recovery.
Today, he depends on a CPAP machine to breathe properly while sleeping at night, and during daytime naps. The machine, vital to his health, requires regular maintenance including monthly filter changes and replacement of hoses and masks.
Medi-Cal continues to cover these ongoing expenses — in addition to regular doctor check-ups and medications to manage his high blood pressure, diabetes and cholesterol — easing an otherwise insurmountable financial burden for the family.
If the upkeep of Jose’s CPAP machine were unaffordable and the device were to stop working due to a lack of maintenance, for instance, it could compromise his breathing, putting his life in danger and undoing years of progress in his recovery.
“God keeps me alive with this machine right now,” said José in Spanish. “We have to live with what God lends us, but if he lends us things and they want to take them away, what are we going to do?”
When asked about the possibility of having to pay a $100 monthly premium each, the couple didn’t hesitate to share their concern.
“We couldn’t afford it. We either eat or we pay, because it’s too much to pay $200 a month,” said Daniela.
Jose added that just keeping up with rent and utilities is already a struggle, and if required to pay the premium, they “would have to go without Medi-Cal.”
“For many, a hundred dollars might not seem like much,” said Luz Gallegos, executive director of TODEC, in Spanish.
She explained that for families living paycheck to paycheck, every penny counts — that $100 can provide a week’s worth of groceries, a tank of gas or a crucial part of their rent.
For farmworkers and other immigrant laborers performing tough jobs in extreme conditions for the lowest wages, this amount is not just a number; it can mean survival, continued Gallegos.
“Economic and community well-being must go hand in hand,” she said. “Without healthy men and women, we will not have a healthy economy.”
Mireya Suarez, a community organizer at CHIRLA in San Bernardino, believes that the most effective approach to healthcare involves investing in prevention instead of waiting for conditions to worsen.
“It will always be much cheaper for the state to prevent chronic diseases instead of providing care when the person already has a chronic disease, which will last for a long time,” she said in Spanish.
A single emergency room visit can cost the government thousands of dollars — far more than a routine check-up or preventive treatment.
Gallegos has observed this dynamic at play, as TODEC has documented cases of patients who have gone to the ER only when their illnesses are already very advanced, or when about to die.
“We have serious cases of people whose diabetes wasn’t detected in time, and they end up blind. Imagine that — men we know who have gone blind at 30, 33, another one at 40-something years old,” she said.
“These are young men who were working in the fields and started to feel sick, and there was no other option,” Gallegos continued. “They were taken to the emergency room, and by then, their diabetes was already very advanced.”
Another health condition that Jose must manage is hyperuricemia, an excess of uric acid in the blood that causes severe swelling in his feet, knees, hands and fingers, often making it nearly impossible for him to stand or walk.
Before the couple had Medi-Cal, flare-ups would leave him bedridden for weeks. Without any affordable treatment available, they had to rely on friends traveling to Mexico to bring back just enough medication to ease his symptoms for a few days — barely enough to get him back to work and provide for Daniela and their two young children.
Now, with Medi-Cal, as soon as Jose begins to feel the early symptoms of a flare-up, he seeks immediate attention, preventing the swelling from immobilizing him and wreaking long-term damage to his joints.
With looming statewide cuts, those benefits could be put in jeopardy.
In Gallegos’ opinion, it is not the time to restrict access, but rather to expand it.
In her day-to-day work on the ground, she witnesses the harsh reality that many immigrant families, especially undocumented workers, are facing more than ever.
They live in fear, she described, and without the mental health resources they desperately need, depression can take hold.
With anti-immigrant rhetoric escalating at the federal level, meanwhile, the consequences have been devastating.
“We’ve recently documented several suicide cases, particularly among men,” said Gallagos. “Imagine living with this situation and not having access to health care.”
For her, this is a critical moment for the state to stand firmly with the community and offer real, sustained support.
