Progressive Democratic governors in several states, including California, Illinois and Minnesota, have extended state-funded healthcare to illegal immigrants with a goal of universal insurance coverage.
Medicaid programs are funded by a mix of state and federal dollars. But states are barred by law from using federal funds to cover illegal immigrants, placing the entire burden for covering them on states.
Some blue states ambitiously expanded health programs to noncitizen migrant adults during the COVID-19 pandemic when buoyed by federal dollars.
Now, they are being forced to roll back or freeze programs because of unanticipated high enrollment resulting in state budget woes for programs such as Medi-Cal in California, Medicaid in Illinois and MinnesotaCare in Minnesota.
Officials in California, Illinois and Minnesota reported the cost of providing healthcare to illegal immigrants have exceeded initial projections.
California’s costs were $2.7 billion higher than expected, Illinois’ program cost 286% more than estimated and MinnesotaCare’s projected cost nearly tripled.
Governors Gavin Newsom of California, Illinois’ J.B. Pritzker and Minnesota’s Tim Walz are possible candidates for the 2028 Democratic presidential nomination.
Walz, the 2024 Democratic vice-presidential nominee, said in March he wouldn’t rule out a presidential run in 2028.
Billionaire Pritzker’s presidential ambitions are reported as “the worst-kept secret in Illinois.”
As for Newsom, his presidential ambitions have been on full display in his willingness to take on President Trump whenever possible.
California is spending more than it expected on Medi-Cal, the state’s program for the poor and disabled. Medi-Cal went $6.2 billion over budget this year.
Newsom acknowledges more people enrolled in the program than the state anticipated, and California is spending $2.7 billion more than it planned on coverage expansions for illegal immigrants.
His administration borrowed $3.4 billion from the state’s general fund to cover the unexpected cost increase.
The Medi-Cal expansion cost for noncitizens is expected to grow to $10.8 billion next year.
In a June budget deal, California will stop enrolling new adult noncitizen immigrants in Medi-Cal starting in 2026. Instead of receiving free coverage, a $30 monthly premium will be implemented in July 2027 for noncitizens remaining on the program. Newsom hopes to close a $12 billion budget deficit.
About 1.7 million illegal immigrants are among 14.9 million people enrolled in Medi-Cal.
Pritzker “believes that healthcare is a right” and in 2020 championed Illinois allowing illegal immigrants over 65 to qualify for the state’s Medicaid coverage and in 2023 expanded eligibility to anyone older than 42.
Like California, participation in the program grew faster than expected. An Illinois Auditor General report found the total cost was 286% higher than anticipated. The program initially expected 33,500 enrollees, but 69,767 immigrants signed up last fiscal year.
Pritzker signed a state budget in June ending the program for noncitizen adults ages 42-64, effective July 1. The Illinois program was initially expected to cost $112 million annually but quickly ballooned to a projected $800 million a year.
In 2023, with Minnesota Democrats controlling both legislative chambers, MinnesotaCare was expanded to provide coverage for illegal immigrants, fulfilling a key priority of Walz. The state had an $18 billion surplus, but this year was facing a long-term deficit of $6 billion.
The state originally estimated 7,700 noncitizens would enroll when the MinnesotaCare expansion went into effect Jan. 1,2025. Over 20,000 signed up. What was anticipated to be a $220 million program was revised upward to exceed $600 million.
Republicans won a Minnesota House majority in 2025 and pushed Democrats and Walz to end the program. A compromise budget adopted in June will remove noncitizen adults enrolled in MinnesotaCare at the end of 2025. Walz takes credit for exempting children from the cuts.
Providing free, taxpayer-funded healthcare make states like California, Illinois and Minnesota magnets for illegal immigrants while incurring unsustainable costs on their state’s U.S.-citizen taxpayers.
