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A 麻豆女优 Health News analysis found Medi-Cal lost almost 100,000 immigrants without legal status in the second half of 2025. California officials say it鈥檚 not clear if immigrants are losing coverage faster than other populations, but researchers said the most obvious driver is fear of the Trump administration鈥檚 immigration policies.
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Trump administration officials say the state allows rampant fraud and have promised to investigate, blaming the 鈥淩ussian, Armenian mafia鈥 in the hospice and home health care industry. But data shows hotbeds of health care fraud throughout the country, with California outperforming most other states in recovering fraud dollars.
Progressives are assailing Gov. Gavin Newsom for proposing to pull back coverage for some legal residents, such as refugees and asylum-seekers, while conservatives lambaste the California Democrat for using limited state funds on Medicaid coverage for immigrants without legal status.
Martha Santana-Chin, a daughter of Mexican immigrants, last year took the helm of L.A. Care, the nation鈥檚 largest publicly operated health plan. She warns that looming federal cuts will push up to 650,000 people off L.A. Care鈥檚 Medicaid rolls by the end of 2028.
Programs like Jamboree Housing Corp. have leveraged Medi-Cal funding to offer residents access to social services that experts say are key to keeping them off the streets. California intends to keep it that way, despite federal cuts.
Low-income Californians who use Wegovy and similar medications for weight loss lost their coverage at the start of the new year, with officials advising diet and exercise instead. California and other states say the drugs are too costly, even as the Trump administration announces plans to lower prices.
Even as President Donald Trump and GOP lawmakers say the One Big Beautiful Bill Act targets waste, fraud, and abuse, Medicaid health plans are hosting events across the U.S. to prevent low-income families from losing health insurance and food benefits next year.
During a California gubernatorial debate, candidates promised to protect people鈥檚 access to health care and fight back against Trump administration cuts. With the contest a year away, polling shows voters want the next governor to minimize out-of-pocket health care costs, increase mental health care, and expand caregiving services.
In a rural, largely Republican region of California, homegrown efforts to bolster the medical workforce face an uphill battle, in part because of federal health care cuts approved by the GOP Congress and signed by President Donald Trump in July, as well as a state budget deficit.
A statewide initiative to formalize the role of community health workers and expand their ranks was meant to improve the health of underserved communities, particularly Hispanic populations, who often experience higher rates of chronic illnesses. But years in, California has abandoned a certification program and rescinded public support.
Immigrants without legal status who live in the state are facing a Medi-Cal enrollment freeze next year. But the spate of immigration raids has raised fears that signing up before the deadline will put them on the radar of federal officials.
Republican proposals to tighten the use of special taxes to fund Medicaid programs could deprive states of billions of dollars for safety net health care. In California, any such limit would come on top of Medicaid cuts proposed by California Democrats in response to a $12 billion state deficit.
Bay Area senior Carol Crooks doesn鈥檛 know where congressional Republicans will land on Medicaid cuts as they look to fund a tax bill, but her health has already deteriorated as she worries about losing the help she needs to remain in her Oakland apartment 鈥 and out of a nursing home.
Gov. Gavin Newsom was elected to office in 2019 on a promise of universal health care. He dramatically expanded coverage, but after six years, the Democrat is forced to contemplate deep cuts 鈥 including to the nation鈥檚 largest health care expansion to immigrants living in the U.S. without legal permission.
As California鈥檚 budget deadline looms, state Sen. Akilah Weber Pierson, a physician-turned-lawmaker, says state leaders may soon have to make some tough decisions on health care spending. With the state鈥檚 Medi-Cal program billions of dollars short, California鈥檚 health care safety net is at risk 鈥 even without federal cuts to Medicaid.
Monica Soni, Covered California鈥檚 chief medical officer, oversees an effort to hold health plans financially accountable for the quality of care they provide, including childhood vaccination rates, which have fallen in California and nationwide. She worries federal spending cuts could soon bring turbulence to the state鈥檚 Affordable Care Act marketplace.
The state has in recent years embraced several initiatives recommended in an influential health care workforce report, including alternative payment arrangements for primary care doctors to earn more. Despite increasing residency programs, student debt forgiveness, and tuition-free medical school, California is unlikely to meet patient demand, observers say.
Federal law requires states to offer health insurance to many people with low incomes or disabilities. But some states, including California, are far more generous than what鈥檚 required. Budget pressures may force lawmakers to cut benefits that have led to a historic low in the uninsured rate.
As House Republicans mull a massive $880 billion cut from federal programs likely including Medicaid, constituents, disability advocates, and health care providers are joining forces to lobby GOP members in California 鈥 including those who represent rural, deeply conservative pockets that stand to lose the most.
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