California Gubernatorial Race Centers on Immigrant Health Coverage

Democratic former HHS secretary Xavier Becerra and Republican commentator Steve Hilton are vying for California’s governorship while clashing over state-funded Medi-Cal coverage for low-income immigrants without legal status. Medi-Cal serves more than 14 million Californians, with roughly 1.4 million undocumented residents costing the state about $10 billion a year—more than double early estimates. The 2026-27 Medi-Cal budget totals $217 billion. Both candidates frame the issue as an economic choice: Becerra argues that excluding the poorest immigrants would shift costs to emergency rooms, while Hilton proposes ending the coverage and redirecting savings to lower premiums for citizens.

Times of San Diego

Over the past decade California expanded Medi-Cal to cover all low-income residents regardless of immigration status, a move championed by Gov. Gavin Newsom. Federal Medicaid cuts under the One Big Beautiful Bill Act have reduced federal funding, prompting lawmakers to roll back benefits and impose premiums. State analysts warn that maintaining full coverage without new revenue could jeopardize the long-term fiscal outlook. California’s immigrant population—about 2.3 million people without legal status, roughly 8 % of the labor force—includes many essential workers who lack employer-provided insurance, increasing reliance on Medi-Cal.

Times of San Diego

Becerra proposes new, stable revenue streams, such as higher taxes on corporations and the wealthiest Californians, and has pledged to “stop treating coverage as a budget variable that expands in good years and contracts when revenue dips.” Hilton, backed by former President Donald Trump, vows to eliminate undocumented coverage, arguing that the program unfairly burdens taxpayers and that savings would be used to lower health costs for other Californians.

Times of San Diego

Republican Assembly member Carl DeMaio questioned whether “illegal immigrant healthcare in the general fund would be at the top of their list.” A Public Policy Institute of California poll shows, for the first time in a decade, a majority of likely voters now oppose providing health insurance to undocumented residents, reflecting broader concerns about rising premiums after federal ACA subsidies expired. Democratic consultant Roger Salazar warns that the “us vs. them” messaging could sway voters despite evidence that preventive care reduces overall costs.

Times of San Diego

• “Becerra, former secretary of Health and Human Services under President Joe Biden, has said it would be “foolish” to exclude the poorest immigrants from routine care and push them into expensive emergency rooms on the taxpayer’s dime.” — Xavier Becerra, Democratic candidate

Times of San Diego

• “Stop taking money from California taxpayers who can barely afford their healthcare to give free healthcare to citizens of other countries who shouldn’t even be here,” — Steve Hilton, Republican candidate

Times of San Diego

• “Stop treating coverage as a budget variable that expands in good years and contracts when revenue dips,” — Xavier Becerra, written response

Times of San Diego

• “He will fight, he will push back, he will do all that he can,” — María Elena Durazo, state senator

Times of San Diego

• “People have become more selective about how they want to see those limited healthcare dollars spent.” — Mark Baldassare, PPIC survey director

Times of San Diego