Federal health care cuts hit East Bay immigrants 29%
By Vanessa G. Sánchez50% El Tímpano50%
7/22/2026, 3:57:00 PM
BS Summary: This article contains 24 faulty reasoning types, including Negativity Bias, Pessimism Bias, and Post Hoc (False Cause), with Anecdotal as the most egregious example at 11.7% saturation with 231 hits. Analysis detected 2,006 faulty-reasoning hits from 1,970 analyzed words, generating a BS Score of 39.6% and a BS Rank of 29% (15,081 of 21,230 articles). This article is better (less manipulative) than 71.00% of the article peer group.
This story was produced by El Tímpano, which serves and covers the Bay Area’s Latino and Mayan immigrant communities.
Lea la versión en español.
California became the first state in the country to open Medi-Cal to all low-income residents, regardless of immigration status, an achievement that, over the past decade, brought an estimated 1.6 million immigrants into state-funded health coverage.
For the first time, many gained access to primary and specialty care, as well as mental health and dental benefits that had long been out of reach.
Health experts and providers praised the state for an expansion that helped reduce the uninsured rate to a record low 7.7% in 2024, down from 17.6% in 2012.
But state and federal budget cuts are threatening to unravel the progress.
This year, California froze new Medi-Cal enrollments, citing ballooning program costs and a fiscal deficit.
And President Donald Trump’s “Big Beautiful Bill Act,” signed into law last year, imposed additional hurdles to Medicaid, such as work requirements.
It also included federal funding cuts to Medicaid that will cost the state $30 billion annually.
Now, immigrants face a new era of uncertainty as access to care narrows once again.
On Monday, June 29, Gov.
Gavin Newsom signed next year’s budget, which will delay some of the proposed cuts to healthcare.
Dental benefits for undocumented immigrants, which were scheduled to be eliminated beginning July 2026, have been extended until July 2027.
The budget also funds Medi-Cal coverage for refugees, asylees and those with humanitarian protections for another year instead of cutting those benefits this October, like the H.R.1 “Beautiful Bill” law would have mandated.
While Newsom wanted to increase a monthly premium for Medi-Cal for immigrants from $30 to $50, the final decision will now be up to the next governor.
Patients and providers across the East Bay are now grappling with what these changes mean on the ground.
The end of programs helping with transportation and housing insecurity
In a windowless office on the third floor at La Clínica de la Raza in the Fruitvale neighborhood in Oakland, Verónica Maza, a community health educator, spends her day helping the clinic’s most vulnerable patients stay out of the emergency room.
There are mainly undocumented patients who have chronic diseases such as diabetes or liver disease.
Many didn’t have health insurance most of their lives and, as a result, have lost limbs, toes, and other parts of their body in the late stages of the disease.
“We see this quite often,” said Maza, who handles these types of cases every year.
While they can’t receive government benefits like disability, CalFresh, or Social Security because of their immigration status, all of them now have Medi-Cal after the state expanded the program to cover all low-income Californians who are eligible.
The health coverage pays for their medical care as well as for special programs to address non-medical needs that directly affect their physical health.
California launched an ambitious program in 2022 to transform Medi-Cal into a health insurance and social services provider, one that improves the health of vulnerable patients and saves taxpayers money on costly medical procedures by addressing social determinants of health.
Through programs called Enhanced Care Management and Community Supports, Maza’s clients can access a food program that delivers weekly fresh foods to diabetic patients, transportation services for medical appointments, and rent assistance while patients recover from surgery.
They also have access to in-person care management.
Maza’s patients access these services through Alameda Alliance for Health, the insurance plan managing Medi-Cal in Alameda County.
But starting Jan. 2027, most of Maza’s clients will lose access to these services.
This is because California will change the way undocumented and some lawfully present immigrants with Medi-Cal receive health care services to avoid losing federal funding.
The decision comes after the Centers for Medicare & Medicaid Services announced a policy that prohibits states from using federal dollars to pay for services in “risk-based managed care delivery systems” for this population.
The state will move 2 million immigrants out of a health insurance plan like Alameda Alliance for Health or Kaiser to a system where their care is no longer coordinated or supported by health navigators like Maza.
Services to address food insecurity, housing instability, or lack of transportation for patients with chronic conditions will no longer be available.
The system is called fee-for-service, a payment model where the state pays health providers directly for each individual service.
Anthony Cava, a spokesperson for the California Department of Health Care Services, said the state will pay providers for each service and patients won’t have to pay a copayment or fee.
“Instead of having a Medi-Cal managed care plan that helps coordinate care, affected members can see any doctor, clinic, or hospital that accepts [Fee-For-Service] Medi-Cal,” said Cava in an email.
Cava said DHCS is still finalizing details of this transition and will notify all affected members in the coming months on how to navigate this change.
Len Finocchio, an expert on Medicaid and programs for the uninsured, said under this system immigrant patients will receive a type of care that is fragmented and doesn’t address the multiple needs they have, compromising health care outcomes.
While coordinated care with a health plan offers a comprehensive approach to someone’s health and well-being, he said the fee-for-service system is episodic.
“It is very minimal.
It just pays for the single service,” said Finocchio, who was appointed by Gov.
Jerry Brown to help California implement the Affordable Care Act expansion.
Today, nearly 9 out of 10 Medi-Cal beneficiaries, including undocumented immigrants, receive health care services through a managed care plan like Kaiser or Alameda Alliance for Health.
Maza said the coordinated care and additional social support has been life-changing for many of her clients who struggled to navigate the health care system and find a doctor or social support services on their own.
“It means patients don’t have to undergo dialysis or have their feet amputated,” she said.
Now she worries they will fall ill without any help.
“We are the only people they turn to for support,” said Maza.
Meeting new work requirements will be 'difficult’
For most of her 22 years living in San Leandro, María V. didn’t have health insurance coverage.
The 59-year-old relied sometimes on the ER and a county-run primary care clinic to control her diabetes.
María, who is undocumented and low-income, was finally eligible to apply for state-sponsored Medi-Cal health insurance two years ago, when she saw a specialist for the first time.
“I now have an endocrinologist who manages my diabetes and is always looking out for me,” said María, who has asked to be identified by first name and first initial due to fears of deportation.
She is concerned about next year, when Trump’s work requirements take effect.
Starting January 2027, Medicaid recipients will need to prove they’re working, volunteering, or completing other qualifying activities for at least 80 hours a month to keep coverage.
People with disabilities, mental health conditions, or substance use disorder as well seniors, children, and pregnant people are exempted from the work rules.
“It’s going to be a difficult situation because I don’t have social security, and I’m paid in cash,” said María, who works cleaning houses for a few hours every week.
Health providers have said that immigrants who don’t have a work permit will find it more challenging to show documentation to prove employment status, especially those who are paid in cash or work under the table.
“It satisfies a political need, but it doesn’t really help with healthcare,” said Kishore Nath, the medical director of the John Muir Health Mobile Health Clinic, which serves uninsured people in Contra Costa county.
Work requirements will be one of the biggest drivers in the increase of the uninsured, according to the UC Berkeley Labor Center.
In a study released in May, they found that the rate of uninsured among undocumented immigrants between 0 and 64 years old will double from 25% to 50.4% by 2030.
“This is really eroding a lot of the progress that the state has made in covering everyone,” said Miranda Dietz, director of the Health Care Program at the Center and co-author of the research.
She said the state can still reverse its decision to apply work requirements to immigrants with state-funded Medi-Cal.
The work requirements apply only to federally funded parts of the Medi-Cal program, but California is applying it to state-funded recipients as well.
“That choice doesn’t really live up to the rhetoric from state officials about trying to implement H.R.1 in the least harmful way possible,” Dietz said.
State Assembly member Mia Bonta, who represents Oakland and chairs the Assembly’s Health Committee, introduced legislation to apply the work requirement rules only to what federal law demands.
This means that immigrants whose Medi-Cal is paid for with state funds could be exempted from complying with the federal work requirements mandate.
The bill passed the Assembly and is now in the State’s Senate.
It’s unclear whether Newsom will sign the bill into law this fall.
“I fundamentally believe that the work requirements were established to kick people off of Medi-Cal, to burden them with paperwork, to keep them from being able to have the dignity of health care,” Bonta said in an interview.
Mobile clinics may fill the gap
Every Wednesday morning, nurse and supervisor Juliana Rodriguez and her team park a free mobile health clinic outside the Ellis Lake Park parking lot in Concord, an area with a large Latino, immigrant, and uninsured population.
“The community need is very high,” said Rodriguez, standing outside the purple tent of the John Muir Health Mobile Health Clinic, where uninsured patients can register to see a primary care doctor for free.
Mobile clinics and other safety-net programs offering free or low-cost medical care are anticipating a surge in uninsured patients and scrambling to serve them as the Medi-Cal freeze for immigrant adults continues and restrictions under Trump’s H.R.1 or “Big Beautiful Bill Act” take effect in January 2027.
Jamie Elmasu, director of community health improvement at John Muir Health, the largest not-for-profit health care provider in Contra Costa, said they are expanding the free mobile health clinic to Antioch in July to provide primary care services to the growing number of uninsured.
Although many of the patients are immigrants, Elmasu said they are seeing a larger number of citizens who can’t afford to purchase their own health insurance.
As state and federal policies take effect next year, Elmasu said mobile clinics and other safety net programs will increasingly become the sole provider of care.
“They’re supposed to be one-offs, but it’s not becoming that, it’s becoming essential care,” said Elmasu.
Some uninsured immigrants are already finding it challenging to find timely medical care.
After California’s freeze took effect, uninsured farmworkers in Brentwood turned to a free mobile clinic run by the county with hopes of seeing a primary care provider.
But the demand has already outpaced what’s available.
“They’re so busy, and they don’t have enough appointments to take care of the people,” said Hijas del Campo community health worker Arely Carranza, who helps farmworkers barred from Medi-Cal find other ways to see a doctor.
Every Tuesday, a mobile clinic run by Contra Costa Health stations itself at Hijas del Campo’s office in Brentwood between 1 and 3 pm, but, Carranza said, many farmworkers who work in the tomato fields are still working during those hours.
On days the clinic is not operating or is too busy, farmworkers go to the emergency room, or forgo medical care to pay for other urgent needs.
“Unfortunately they will put their health towards the back burner because they have their families to support,” said Vilma Bocanegra, health initiative manager of Hijas del Campo.
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