Introduction to Medicaid Rollbacks
For nearly 20 years, Maria would call her sister — a nurse in Mexico — for advice on how to manage her asthma and control her husband’s diabetes instead of going to the doctor in California.
She didn’t have legal status, so she couldn’t get health insurance and skipped routine exams, relying instead on home remedies and, at times, getting inhalers from Mexico. She insisted on using only her first name for fear of deportation.
Expansion of Medicaid Programs
Things changed for Maria and many others in recent years when a handful of Democrat-led states opened up their health insurance programs to low-income immigrants regardless of their legal status. Maria and her husband signed up the day the program began last year.
“It changed immensely, like from Earth to the heavens,” Maria said in Spanish of Medi-Cal, California’s Medicaid program. “Having the peace of mind of getting insurance leads me to getting sick less.”
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’t in the U.S. legally in California, Illinois and Minnesota.
Reasons for Medicaid Rollbacks
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 to save an estimated $404 million. All adult immigrants in Minnesota no longer have access to the state program, saving nearly $57 million. In California, no one will automatically lose coverage, but new enrollments for adults will stop in 2026 to save more than $3 billion over several years.
Cuts in all three states were backed by Democratic governors who once championed expanding health coverage to immigrants.
Impact of Medicaid Rollbacks
Health care providers told The Associated Press that everything, especially the fear of being arrested or deported, 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.
“I feel like they continue to squeeze you more and more to the point where you’ll burst,” Maria said, referencing all the uncertainties for people who are in the U.S. without legal permission.
Consequences of Medicaid Rollbacks
‘People are going to die’
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.
CommunityHealth is one of the nation’s 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 when Illinois ended its Health Benefits for Immigrants Adults Program, which served about 31,500 people ages 42-64.
One of CommunityHealth’s 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’t speak English and don’t have transportation to get to clinics that can treat them. The worker spoke to the AP on condition of anonymity to protect patients’ privacy.
Monthly Fees and Federal Policies
State lawmakers said California’s Medi-Cal changes stem from budget issues — a $12 billion deficit 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.
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 starting October 2027.
Conclusion
The rollback of Medicaid for undocumented people in California, Illinois, and Minnesota has significant consequences for the health and well-being of these individuals. The fear of deportation and the lack of access to healthcare services will lead to a decline in health outcomes and an increase in healthcare costs in the long run. It is essential for policymakers to consider the human impact of their decisions and work towards finding solutions that balance budget constraints with the need to provide essential healthcare services to all individuals, regardless of their immigration status.
FAQs
Q: Which states have rolled back Medicaid for undocumented people?
A: California, Illinois, and Minnesota have rolled back Medicaid for undocumented people.
Q: Why have these states rolled back Medicaid?
A: The states have rolled back Medicaid due to budget constraints and the high cost of providing healthcare services to undocumented immigrants.
Q: What are the consequences of rolling back Medicaid for undocumented people?
A: The consequences include a decline in health outcomes, an increase in healthcare costs, and a chilling effect on people seeking care due to fear of deportation.
Q: What can be done to address the issue of providing healthcare services to undocumented immigrants?
A: Policymakers can work towards finding solutions that balance budget constraints with the need to provide essential healthcare services to all individuals, regardless of their immigration status. This can include exploring alternative funding sources, increasing efficiency in healthcare delivery, and advocating for federal policies that support healthcare access for all.
