Health4All Budget Request May 2026

Restore and Protect Health Care Access for Immigrant Californians

Background

As a result of the Health4All expansions, California now celebrates our lowest uninsured rate in history — approximately 6 percent, which has helped around 1.5 million undocumented Californians improve their health by providing access to Full-Scope Medi-Cal. As a result, undocumented Californians can access preventative care and no longer have to postpone treatment for chronic medical conditions Furthermore, the amount of immigrant children who reported being in excellent health increased by 10% after the expansion. Overall, expanding full-scope Medi-Cal coverage to immigrant Californians has helped the state create a more effective public health system and achieve a record low uninsurance rate.

Specific Budget Requests

We urge all legislators and the Governor to:

1. Delay last year’s FY2025-26 Budget cuts impacting immigrant Californians including:
   1. The removal of adult dental as a covered benefit for individuals with “Unsatisfactory Immigration Status” (UIS) starting in July 2026.
   2. The mandatory $30 monthly premium starting in July 2027 for adults with UIS, ages 19-59 (increased to $50 in the May Revise).
2. Reverse the Medi-Cal enrollment freeze for older adults, over age 50.
3. Reject the Governor’s proposal to subject all undocumented Californians to onerous work requirements beyond what federal law requires.
4. Reject stripping 200,000 humanitarian immigrants, including asylees and refugees, of full scope Medi-Cal and limiting them to emergency medical support only. We do appreciate the 9 month delay in the Governor’s May Revise.
5. Reject the harmful and punitive $2,000 asset limit that will restrict older adults and people with disabilities from having any savings, forcing them into deep poverty and disincentivizing enrollment for needed health and long-term care services.

Proposed Transition of People with Unsatisfactory Immigration Status (UIS) to Fee for Service Medi-Cal

The Governor’s May Revise includes a proposal to transition people with Unsatisfactory Immigration Status to Fee-for-Service Medi-Cal. Fee-for-Service (FFS) Medi-Cal, also called regular Medi-Cal, played a dominant role in the Medi-Cal system until the mid 2010s. By 2024, the Department Health Care Services transitioned nearly all beneficiaries into managed care. If you have Fee for Service Medi-Cal, you can go to any Medi-Cal provider who accepts it. For people in FFS Medi-Cal, benefits are usually not coordinated for you (as they would be through a managed care plan) nor do you have access to certain community supports that are only offered through managed care.

As the Legislature responds to the May Revise, and enters into final negotiations of the FY 26-27 Budget with the Newsom Administration, we encourage you to support a final budget solution includes the following principles around any transition to Fee-for-Service Medi-Cal for UIS Californians:

1. Ensure that any savings generated from the transition remain in Medi-Cal system
2. Ensure that people in transition can keep their doctor to the maximum extent feasible
3. Ensure that people will continue to have access to providers with appropriate language access
4. Ensure that people will continue to have access to speciality care, including gender affirming care

For comments, questions, or information on how to get involved, please contact:

• Christine Smith, Health Access California ([email protected])
• Chloe Hermosillo, California Immigrant Policy Center ([email protected])

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