\u201cIt changed immensely, like from Earth to the heavens,\u201d Maria said in Spanish of Medi-Cal, California\u2019s Medicaid program. \u201cHaving the peace of mind of getting insurance leads me to getting sick less.\u201d<\/p>\n
<\/p>\n Maria, who requested to use only her first name out of fear of deportation, is photographed Thursday, June 26, 2025, in Sacramento. (AP Photo\/Godofredo A. V\u00e1squez)<\/p>\n Maria, who requested to use only her first name out of fear of deportation, is photographed Thursday, June 26, 2025, in Sacramento. (AP Photo\/Godofredo A. V\u00e1squez)<\/p>\n Read More<\/p>\n At least seven states and the District of Columbia have offered coverage for immigrants since mostly 2020. But three of them have done an about-face, ending or limiting coverage for hundreds of thousands of immigrants who aren\u2019t in the U.S. legally in California, Illinois and Minnesota. <\/p>\n The programs cost way more than officials had projected at a time when the states are facing multibillion-dollar deficits now and in the future. In Illinois, adult immigrants ages 42-64 without legal status have lost their health care<\/a> to save an estimated $404 million. All adult immigrants in Minnesota no longer have access<\/a> to the state program, saving nearly $57 million. In California, no one will automatically lose coverage, but new enrollments for adults will stop<\/a> in 2026 to save more than $3 billion over several years. <\/p>\n Cuts in all three states were backed by Democratic governors who once championed expanding health coverage to immigrants. <\/p>\n The Trump administration this week shared the home addresses, ethnicities and personal data of all Medicaid recipients<\/a> with U.S. Immigration and Customs Enforcement officials. Twenty states, including California, Illinois and Minnesota<\/a>, have sued. <\/p>\n Health care providers told The Associated Press that everything, especially the fear of being arrested or deported<\/a>, is having a chilling effect on people seeking care. And states may have to spend more money down the road because immigrants will avoid preventive health care and end up needing to go to safety-net hospitals. <\/p>\n \u201cI feel like they continue to squeeze you more and more to the point where you\u2019ll burst,\u201d Maria said, referencing all the uncertainties for people who are in the U.S. without legal permission. <\/p>\n \u2018People are going to die\u2019<\/p>\n People who run free and community health clinics in California and Minnesota said patients who got on state Medicaid programs received knee replacements and heart procedures, and were diagnosed for serious conditions like late-stage cancer. <\/p>\n CommunityHealth is one of the nation\u2019s largest free clinics, serving many uninsured and underinsured immigrants in the Chicago area who have no other options for treatment. That includes the people who lost coverage July 1<\/a> when Illinois ended its Health Benefits for Immigrants Adults Program, which served about 31,500 people<\/a> ages 42-64. <\/p>\n One of CommunityHealth\u2019s community outreach workers and care coordinator said Eastern European patients she works with started coming in with questions about what the change meant for them. She said many of the patients also don\u2019t speak English and don\u2019t have transportation to get to clinics that can treat them. The worker spoke to the AP on condition of anonymity to protect patients\u2019 privacy. <\/p>\n Health Finders Collective in Minnesota\u2019s rural Rice and Steele counties south of Minneapolis serves low-income and underinsured patients, including large populations of Latino immigrants and Somali refugees. Executive director Charlie Mandile said they\u2019re seeing patients rushing to squeeze in appointments and procedures before 19,000 people age 18 and older are kicked off of insurance at the end of the year.<\/p>\n Free and community health clinics in all three states say they will keep serving patients regardless of insurance coverage \u2014 but that might get harder after the U.S. Department of Health and Human Services decided this month to restrict federally qualified health centers from treating people without legal status<\/a>.<\/p>\n CommunityHealth CEO Stephanie Willding said she always worried about the stability of the program because it was fully state funded, \u201cbut truthfully, we thought that day was much, much further away.\u201d<\/p>\n \u201cPeople are going to die. Some people are going to go untreated,\u201d Alicia Hardy, chief executive officer of CommuniCARE+OLE clinics in California, said of the state\u2019s Medicaid changes. \u201cIt\u2019s hard to see the humanity in the decision-making that\u2019s happening right now.\u201d<\/p>\n A spokesperson for the Minnesota Department of Health said ending the state\u2019s program will decrease MinnesotaCare spending in the short term, but she acknowledged health care costs would rise elsewhere, including uncompensated care at hospitals.<\/p>\n Minnesota House Speaker Lisa Demuth, a Republican, said the state\u2019s program was not sustainable. <\/p>\n \u201cIt wasn\u2019t about trying to be non-compassionate or not caring about people,\u201d she said. \u201cWhen we looked at the state budget, the dollars were not there to support what was passed and what was being spent.\u201d<\/p>\n Demuth also noted that children will still have coverage, and adults lacking permanent legal status can buy private health insurance. <\/p>\n <\/p>\n Medical assistant Citlalli Llamas, top, administers a round of vaccines to a 16-month-old boy at a CommuniCARE+OLE clinic Thursday, June 26, 2025, in Davis, Calif. (AP Photo\/Godofredo A. V\u00e1squez)<\/p>\n Medical assistant Citlalli Llamas, top, administers a round of vaccines to a 16-month-old boy at a CommuniCARE+OLE clinic Thursday, June 26, 2025, in Davis, Calif. (AP Photo\/Godofredo A. V\u00e1squez)<\/p>\n Read More<\/p>\n Health care providers also are worried that preventable conditions will go unmanaged, and people will avoid care until they end up in emergency rooms \u2013 where care will be available under federal law. <\/p>\n One of those safety-net public hospitals, Cook County Health in Chicago, treated about 8,000 patients from Illinois\u2019 program last year. Dr. Erik Mikaitis, the health system\u2019s CEO, said doing so brought in $111 million in revenue. <\/p>\n But he anticipated other providers who billed through the program could close, he said, adding: \u201cThings can become unstable very quickly.\u201d <\/p>\n Monthly fees, federal policies create barriers<\/p>\n State lawmakers said California\u2019s Medi-Cal changes stem from budget issues \u2014 a $12 billion deficit<\/a> this year, with larger ones projected ahead. Democratic state leaders last month agreed to stop new enrollment starting in 2026 for all low-income adults without legal status. Those under 60 remaining on the program will have to pay a $30 monthly fee in 2027. <\/p>\n States are also bracing for impact from federal policies. Cuts to Medicaid and other programs in the recently signed massive tax and spending bill include a 10% cut to the federal share of Medicaid expansion costs to states that offer health benefits to immigrants<\/a> starting October 2027. <\/p>\n California health officials estimate roughly 200,000 people will lose coverage after the first full year of restricted enrollment, though Gov. Gavin Newsom maintains that even with the rollbacks, California provides the most expansive health care coverage for poor adults. <\/p>\n Every new bill requires a shift in Maria\u2019s monthly calculations to make ends meet. She believes many people won\u2019t be able to afford the $30-a-month premiums and will instead go back to self-medication or skip treatment altogether. <\/p>\n \u201cIt was a total triumph,\u201d she said of Medi-Cal expansion. \u201cBut now that all of this is coming our way, we\u2019re going backwards to a worse place.\u201d<\/p>\n<\/p>\n
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