Pioneers of the past turn into retreatists
California, Illinois, and Minnesota had been the pioneers in offering health care to immigrants, even the undocumented ones. Those governments were praised for spreading health care among the public, among thousands who otherwise would have been denied. But today, however, they’re turning around—and not just the Republicans. Democratic governors in all three states now are supporting budget reductions that eliminate or curb some of the very same health programs that they used to stretch so glibly with such favor.
Those same people who were so hopeful before now are left feeling let down, and the reversals are especially poignant.
What’s going on in California
California led the way years ago by broadening Medi-Cal (California Medicaid) to include undocumented children, then young adults, and most recently seniors over the age of 50. It was a huge step towards healthcare coverage, and everybody was content.
But in 2025, Governor Gavin Newsom’s Government has reduced funding freezes and cuts on them. Some will be phased out or reduced. Others will no longer be funded. Though there will still be some protection, more will no longer be covered, and many will no longer be able to receive lifesaving treatments.
These budget cuts will impact hundreds of thousands of illegal immigrants, especially senior citizens who depend on Medi-Cal for the treatment of diabetes, mental health, and check-ups.
What’s happening in Illinois
Illinois also became part of history by embracing the Health Benefits for Immigrant Adults (HBIA) program. This offered essential health coverage to illegal immigrants 42 and older. But no longer.
In July of 2025, Governor JB Pritzker signed off on deep funding cuts to HBIA. The state enforced enrollment caps and waitlists and cut non-emergency care. In brief, fewer enroll, and even those who do still enroll receive less care.
The actions are characterized by officials as an attempt to balance the state budget, but the result is fewer options for those already struggling to access basic healthcare.
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Minnesota: The progress was delayed
Minnesota came on board a little later than California and Illinois. While Governor Tim Walz had promised to insure undocumented immigrants starting from 2025, that’s now been put on hold indefinitely.
Why? Officials say it’s too expensive at this time. Budget constraints have them putting the plan on hold, leaving thousands of impoverished immigrants within the state with no affordable health option.
Others were left in shock at this action. Minnesota is traditionally a liberal state on matters of health care and social welfare initiatives. The news is not good news for immigrant communities.
Why are these states backing down?
Although each state has its reasons, there are four overall concerns underlying the rollbacks:
1. Astronomical implementation costs
Operation of programs for illegal aliens requires increased coordination, increased personnel, and increased bureaucratic costs. That is a problem when states are budget-constrained.
2. Deficit budgets
All but one state have been operating with struggling budgets since the COVID-19 pandemic. They’re cutting programs willy-nilly, and healthcare coverage for illegal aliens is up on the list to be cut.
3. Political pressure
Even in blue states, however, everyone is not in agreement across the board on where tax dollars have to go. Some voters and lawmakers believe that healthcare dollars have to be given to citizens first, leaving Democratic leaders with no choice but to cut.
4. Immigration debate in an election year
As election season heats up, immigration begins to reheat. Taxpayers think tax money is being used to subsidize here illegally living residents. Even moderate Democrats are falling for such arguments.
What This Means for Real People
These are not budget abstractions—they have real-world consequences. People who were just starting to feel the system was worth trusting are being disenfranchised again.
Lucía M., a 58-year-old immigrant from California, said:
“First, they promised us care. Then they gave us hope. And now they’re shutting us out of the system again.”
She relies on Medi-Cal to manage her diabetes. Without it, she could become ill quickly, and she’s not alone. Tens of thousands of illegal aliens labor in backbreaking work, much of it without health care at all. When state public programs are cut, these workers have nowhere to turn.
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Community groups are fighting back
Organizations like the California Immigrant Policy Center, the Illinois Coalition for Immigrant and Refugee Rights, and the Immigrant Law Center of Minnesota are sounding the alarm. They say limiting healthcare for undocumented residents is short-sighted and inhumane when so many of them work, contribute to the economy, and pay taxes.
They’re appealing to lawmakers to rethink and hold on to what’s already been gained.
