Immigrants Value Medi-Cal Coverage, But New Rules Risk Cutting Them Off

Getting your Trinity Audio player ready…

Editor’s note: The names of undocumented immigrants in this article have been changed to protect their identities.

José, a 46-year-old undocumented immigrant from Mexico, had been seeing a doctor regularly since enrolling in Medi-Cal four years ago. The coverage provided checkups, dental visits, and a measure of stability he hadn’t had before. Now that is over.

After he saw immigration agents working in his neighborhood, the idea of sitting in a clinic for an hour or two now feels like a risk he can’t control. Worried that being visible might carry consequences far beyond his health, he canceled all his appointments. José said he was afraid of Immigration and Customs Enforcement (ICE), especially after two cousins in Texas were deported.

“It scares you to go out,” he said. “If you go to the clinic, you may be there one or two hours. What if they get there and take you away?”

Restrictive Medi-Cal eligibility rules for undocumented people are rolling out now, sowing confusion about his access to the program and stoking fears about his immigration status. Now José wonders whether he should ever seek that care again.

Many others are grappling with similar concerns. Since Jan. 1, 2026, undocumented adult enrollees have been unable to sign up for first-time full-scope Medi-Cal benefits. While undocumented current enrollees may continue their coverage, things will change starting on July 1, 2027. They will face a $30 to $50 monthly premium as well as work requirement reporting and formal eligibility reviews every six months instead of annually. They also are at risk of losing full dental benefits in the long run.

Silence Instead of Guidance

Guadalupe, a 55-year-old Medi-Cal enrollee in Southern California, has found public information about the new rules to be ineffective. “The news about these changes has been hard to find,” she said. “There should have been more announcements and TV ads, or there should have been information in the clinics… Many people will just lose their coverage.”

A study funded by the California Health Care Foundation found that undocumented Medi-Cal enrollees have only heard vague secondhand information about new eligibility policies so far. The lack of reliable information leads many study participants to dismiss conversations and announcements as untrustworthy and possibly inaccurate. That stirs fear, uncertainty, and anxiety, they say.

“Sometimes all they hear is a one-minute piece on TV saying undocumented immigrants no longer qualify for Medi-Cal, and they automatically disqualify themselves,” said Maria, an undocumented immigrant who works as a promotora assisting Latino/x community members in Northern California.

While some will be pushed out by the new eligibility requirements, others may leave in the mistaken belief that they have become ineligible. Still others fear being targeted for immigration enforcement actions, hurting their immigration status for using public benefits, or being damaged by local and state governments sharing data with federal immigration agencies. Recent Medi-Cal data show that enrollment in the immigrant expansion population totaled 1.4 million people in March 2026, down from nearly 1.7 million in June 2025. Many thousands of them will certainly lose their benefits.

The UCLA Center for Health Policy Research and the UC Berkeley Labor Center project that by 2028, approximately 550,000 undocumented immigrants will have lost their Medi-Cal benefits due to the state enrollment freeze. Another 95,000 will lose coverage because of the monthly premiums. Altogether, about 3 million Californians are expected to lose Medi-Cal benefits due to the new policies enacted by both the federal and the state governments. 

What the Interviews Uncovered

The study of the impact of Medi-Cal’s new policies on undocumented Californians was undertaken in January 2026 by Culture IQ Group, a market research and strategic communications firm focused on diverse communities. Culture IQ interviewed 39 undocumented individuals, including Chinese-speaking people and Latino/x people (Spanish- and English-speaking) enrolled in full-scope Medi-Cal. Most had heard no news about upcoming changes to the program, while others with some knowledge believed the state would eliminate their coverage.

Diana Camacho, a senior program officer with the California Health Care Foundation’s Improving Access team, said the study helps inform state policymaking by spreading understanding of what Medi-Cal means to people, the impact of losing coverage, and the role of communications in successful implementation of new policies. “This is important data because the changes are still rolling out,” she said. “How undocumented Californians receive care and coverage is an unresolved issue.” 

Participants said they highly value their Medi-Cal coverage and benefits. Some called the program a “blessing” and said that being able to get needed care without regard to their finances gave them peace of mind. Without Medi-Cal, they would delay or cancel needed health care services because higher costs would force them to prioritize food, rent, and other essentials.

The researchers found that Medi-Cal usage is uneven among the undocumented. While people with chronic conditions seek and receive care regularly, others do not make use of their eligibility. Many said they were not aware of covered services, especially dental and mental health care, and they tried to avoid taking advantage of benefits unless they had a dire situation and had a provider convenient to home or work.

When Enrolling Feels Dangerous

Some individuals said they are afraid of being deported if they enroll, do not feel comfortable providing information they believe will be shared with immigration officials, and are concerned about being considered a public charge.

Juan, a 31-year-old Mexican man with full Medi-Cal coverage, told researchers he learned about the changes by word of mouth and made the effort to find more details.

“I could have lost my coverage,” said Juan. He tried to convince friends and family to join him in participating in the Culture IQ study so they could learn how to protect their benefits. “They trust me, they have always trusted me, but out of 10 people I reached out to, only three agreed to participate. They are afraid.”  

Maria, the promotora, had a similar experience while educating people about new Medi-Cal requirements. “Many didn’t even want to open the door,” she said. “They are afraid of being considered a public charge if they use government services.”

The administrative complexity of the altered policies will create barriers that could lead people to lose coverage, one participant told researchers. “Having to re-enroll every six months can be challenging,” said Mario, an Ecuador native who has used Medi-Cal services for six years.

An Obstacle Course of Paperwork and Premiums

Many immigrants fear missing deadlines and losing their benefits unintentionally. Reporting hours from irregular work, providing backup documentation, and re-enrolling twice a year could become major barriers.

Interviewees also worry that the new monthly premiums would strain their budgets, especially for large families. Yet several said they would be willing to pay. Guadalupe has chronic conditions that require visits to multiple doctors and prescription medications. She had emergency surgery recently as well.

The most effective messaging, interviewees said, is likely to be delivered multiple times, on multiple fronts, and in plain language that explains what is changing and what is not. Trusted messengers include county and state Medi-Cal agencies, health care providers, clinics, community-based organizations, and promotoras.

For enrollees like Guadalupe, the stakes are measured in care she could not otherwise afford. “How much would I have had to pay for all that without Medi-Cal?” she said.