Medi-Cal Immigrant Enrollment Plummets Amid Lingering Fear from Trump-Era Policies

California’s Medi-Cal program is hemorrhaging immigrant enrollees, with nearly 100,000 undocumented immigrants disenrolling between June and December 2025. This group accounts for a quarter of all Medi-Cal disenrollments despite representing only about 11 percent of total enrollees. Experts tie this alarming trend directly to the Trump administration’s aggressive immigration policies, including the infamous “public charge” rule and plans to share Medicaid data with Immigration and Customs Enforcement (ICE).

The “public charge” rule, first expanded under Trump, penalized immigrants who used public benefits like Medicaid, food assistance, or housing aid when applying for legal residency. Even though courts blocked the rule and the Biden administration officially rescinded it, the damage lingers. Immigrant communities remain gripped by fear, with many avoiding enrollment or renewal of Medi-Cal coverage for themselves and their U.S.-born children.

María González, a community health worker in San Bernardino—a city with nearly 25 percent foreign-born residents—reports that many clients are too scared to even leave their homes. “Many people don’t want to apply,” González says. “There are people who say they don’t even want to go outside and water their plants.”

This fear-driven disenrollment reverses a steady increase in immigrant enrollment that began when California expanded Medi-Cal eligibility to all low-income residents regardless of immigration status in January 2024. While some decline in Medi-Cal enrollment is attributed to the resumption of eligibility checks paused during the COVID-19 pandemic, researchers say that does not explain the sharp drop among immigrants.

Leonardo Cuello of Georgetown University and Susan Babey of UCLA highlight that federal policy changes under Trump, including the “One Big Beautiful Bill Act” and related executive orders, have intensified immigrant disenrollment beyond routine eligibility verifications.

National surveys reinforce this trend. A KFF/New York Times poll found immigrant adults increasingly avoid government programs that could help with food, housing, or healthcare, fearing immigration enforcement repercussions. This avoidance extends to lawful residents and naturalized citizens, with parents particularly reluctant to enroll their children—despite one in four U.S. children having at least one immigrant parent.

The consequences are dire. Reduced enrollment threatens not only individual health but also public health, as uninsured populations face barriers to care. The decline in Medi-Cal participation among immigrant children in California—down 5.6 percent in 2025—is especially troubling.

The Trump administration’s policies have left a lasting scar on immigrant communities, undermining trust in public programs designed to support vulnerable populations. As the federal government cuts health care funding and tightens eligibility, California faces urgent pressure to protect immigrant access to Medi-Cal and counteract the chilling effects of past federal overreach.

If these trends continue, millions more immigrants and their families risk losing essential health coverage, compounding health disparities and eroding the social safety net. The fight to reverse these damaging policies and restore confidence in public benefits is far from over.