Fear of enforcement caused undocumented immigrants to miss Medi-Cal renewals
“For me it was more about fear,” Laura said in Spanish. “I didn’t write the letter and I didn’t take it back…We didn’t know if [the news about data sharing] was true or what they could do.”
Fear of immigration enforcement and data-sharing agreements caused many undocumented immigrants in California to miss renewal deadlines for Medi-Cal, leaving them unable to regain their healthcare coverage after the state changed its rules amid a growing budget deficit and federal Medicaid cuts.
Loss of Coverage and the Impact of Fear
Laura, an undocumented immigrant from Mexico living in the San Francisco Bay Area, relied for years on Medi-Cal to cover doctor visits, tests, and medication for her Type 2 diabetes. Last winter, she received a notice that her coverage was set to expire and she needed to renew it. At the time, she rarely left her home, scared of getting caught up in an immigration enforcement operation. When she eventually went to the enrollment office, the reviewer stated that her family members, some of whom were paid under the table, needed to make and sign attestations of income. Her husband hesitated due to news of Medicaid’s data-sharing agreement with ICE. They decided the risk was too great, the deadline passed, and she could not get her coverage back.
On January 1, California began denying full Medi-Cal benefits to undocumented adults. Now, only those enrolled before 2026 can keep their coverage as long as they do not roll off. From May 2025 to March 2026, around 244,000 immigrants disenrolled from California-funded expansion programs.
Deportation Fears Drive Immigrants to Avoid Medical Care
Since the beginning of the second Trump administration, healthcare providers and public policy analysts nationwide have sounded alarms about immigrants steering clear of medical treatment due to the constant threat of deportation impacting their everyday routines. For example, a study by researchers revealed that missed medical appointments among Spanish-speaking households rose by over 80 percent throughout last winter’s Operation Metro Surge in Minnesota.
While Medicaid does not fund full coverage for undocumented immigrants, provisions of the GOP’s July 2025 budget bill—known as the “One Big Beautiful Bill”—scaled back coverage this October for many immigrants with legal status who were previously eligible. Many immigrants are choosing to drop out of programs they remain eligible for, such as state-funded coverage, risking their medical support as blue states like California, Colorado, and Washington roll back and cap enrollment due to funding constraints.
“What past research has shown us is that just the chilling effect and the fears and uncertainty around these policies lead many more immigrants to disenroll from coverage than those who are directly impacted,” said Drishti Pillai, director of immigrant health policy at KFF. Pillai added that with the implementation of more federal policies, such as new eligibility provisions and changes to the federal public charge rule penalizing some green card applicants for using non-cash public benefits like Medicaid, the share of immigrants avoiding healthcare will likely keep increasing.
Laura, who used a pseudonym, shared her experience to raise awareness because the situation has also happened to her friends and acquaintances. “I know I’m not the only person who is going through this,” she said.