California Expands Medi-Cal to Undocumented Immigrants in 2024

In 2024, California established a groundbreaking policy by extending full-scope Medi-Cal to all income-eligible adults, including undocumented immigrants. Currently, around 1.6 million undocumented residents of California receive healthcare services through Medi-Cal. However, potential federal and state policy changes, such as transitioning to a fee-for-service model and requiring monthly premiums, could alter their access to medical care significantly. These revisions could introduce barriers like more frequent eligibility verifications and reduced adult dental benefits, impacting the healthcare landscape for these individuals.

To assess the potential effects of these policy changes, the California Health Care Foundation (CHCF) partnered with Culture IQ Group to conduct interviews with 39 undocumented adults currently enrolled in full-scope Medi-Cal. Held in January 2026, these interviews included participants speaking Mandarin, Spanish, and English from areas such as the Greater Los Angeles area and the Central Valley. The findings reveal how these residents are navigating healthcare access and medical decision-making amid uncertainties, providing vital insights for healthcare providers and policymakers striving to maintain coverage and trust.

The participants, who are essential to California's economy as parents, workers, and caregivers, underscore both the vulnerabilities and strengths within the state's health coverage expansion. The evolution of this initiative, developed over the past decade, heavily relies on future strategies by key stakeholders. Detailed insights and recommendations can be found in CHCF's comprehensive report, offering a roadmap for sustaining healthcare access and strengthening community relationships.