For almost 20 years, Maria has called her sister, who is a nurse in Mexico, to ask for advice on how to control her asthma and the diabetes of her husband, instead of going to the doctor in California.
Without legal status, Maria could not obtain medical insurance and skipped the routine exams, trusting home remedies and, sometimes, getting inhalers from Mexico. The woman asked to use only her first name for fear of being deported.
Things changed for Maria and many others in recent years, when a group of states led by Democrats opened their medical insurance programs to low -income immigrants, regardless of their legal status. She and her husband enrolled on the day the program began last year.
“It changed greatly, as from earth to heaven,” Maria on Medi-Cal, the California Medicaid program said. “The tranquility of having insurance makes me get less.”
At least seven states and the Columbia district have offered coverage to immigrants since 2020. But three of them, California, Illinois and Minnesota, have taken a 180 -degree turn, ending or limiting coverage to hundreds of thousands of immigrants who have no legal status in the United States.
The programs cost much more than the authorities had planned at a time when states face multimillionaire deficits. In Illinois, adult immigrants between 42 and 64 without legal status have lost their health coverage, to save about 404 million dollars.
All Adult immigrants in Minnesota have ceased to have access to the state program, which represents a saving of almost 57 million dollars. In California, no one will automatically lose coverage, but new adult inscriptions will stop at 2026 to save more than 3,000 million dollars in several years.
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The cuts in the three states were backed by Democratic governors who once defended the extension of sanitary coverage to immigrants.
This week, Donald Trump’s government shared the addresses, ethnicities and personal data of all Medicaid beneficiaries with the officials of the Immigration and Customs Control Service. Twenty states, including California, Illinois and Minnesota, have filed a lawsuit to fenate it.
Medical care providers told that everything, especially the fear of being arrested or deported, is having a paralyzer effect on people looking for medical care. And it is possible that states have to spend more money in the future because immigrants will avoid preventive medical care and end needing to go to hospitals in the security network.
“I feel that they press you increasingly, to the point where Stalls,” said Maria on all the uncertainties suffered by people in the United States without legal permission.
“There are people who are going to die”
People who run free and community clinics in California and Minnesota said that patients who accepted the state programs of Medicaid received knee prostheses and heart operations, and were diagnosed with serious diseases such as terminal phase cancer.
Communityhealth is one of the largest free clinics in the country, which serves many immigrants without insurance or insufficient insurance in the Chicago area, which do not have other treatment options. This includes people who lost coverage on July 1, when Illinois ended their health benefits program for immigrant adults, which served about 31,500 people between 42 and 64 years old.
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One of the social workers and care coordinators of Communityhealth said that Eastern Europe patients who work began to go with questions about what the change meant for them. He said that many of the patients do not speak English either and have no transport to go to the clinics that can treat them. The worker spoke with the AP on condition of anonymity to protect the privacy of patients.
Health Finders Collective, in the rural counties of Rice and Steele, to the south of Minneapolis, in Minnesota, serves patients with low income and without medical insurance, among which are a large population of Latin immigrants and somali refugees. The executive director, Charlie Mandile, said they are seeing how patients are rushed to arrange appointments and undergo procedures before 19,000 people over 18 losing their insurance at the end of the year.
Free and community health clinics of the three states claim that they will continue to attend to patients regardless of their medical coverage, but this could be more difficult after the Department of Health and Human Services decided this month to restrict the health centers accredited at the federal level care for people without legal status.
Stephanie Willding, executive director of Communityhealth, said she had always worried the stability of the program, since she was fully financed by the State, “but, honestly, we thought that day was much further.”
“There are people who are going to die. Some people will not receive treatment,” said Alicia Hardy, executive director of the Communicare+OLE clinics in California, in reference to changes in the State Medical Program. “It is difficult to see humanity in decision -making that is taking place at this time.”
A spokeswoman for the Minnesota Health Department said that ending the state program will reduce Minnesotacare spending in the short term, but acknowledged that health costs will increase in other areas, including unpaid care in hospitals.
The president of the Chamber of Representatives of Minnesota, Lisa Demuth, a republican, said the state program was not sustainable.
“It was not about being little compassionate or not worrying about people,” he said. “When we analyzed the state budget, there was no money to finance what had been approved and what was being spent.”
(Parents of children with cancer report the “terror” that Trump cuts medical and stays without medical insurance)
Demuth also pointed out that children will continue to have coverage and that adults who lack permanent legal status can hire private medical insurance.
Medical care providers also fear that preventable diseases are not treated and that people avoid going to the doctor until they end up in the emergency department, where they will receive attention according to the federal law.
One of those public hospitals of the security network, Cook County Health in Chicago, attended about 8,000 patients from the Illinois program last year. Erik Mikaitis, executive director of the Health System, said this generated 111 million dollars in revenue.
However, he anticipated that other suppliers that invoiced through the program could close, and added: “The situation can become unstable very quickly.”
Pesuvued problems
State legislators said that the changes in California medi-Cal are due to budgetary problems: a deficit of 12,000 million dollars this year, with even greater deficits forecasts in the future. Democratic state leaders agreed last month to stop the new inscriptions from 2026 for all low -income adults without legal status. Those under 60 years of age who remain in the program will have to pay a monthly fee of $ 30 in 2027.
States are also preparing for the impact of federal policies. The cuts to Medicaid and other programs in the recent Tax and Expenses bill include a 10 % cut in the federal part of Medicaid expansion costs for states that offer health benefits to immigrants from October 2027.
California health authorities estimate that about 200,000 people will lose coverage after the first full year of restricted registration, although Governor Gavin Newsom argues that, even with cuts, California offers the largest health coverage for poor adults.
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Each new bill requires a change in Mary’s monthly calculations to reach the end of the month. She believes that many people will not be able to pay premiums of $ 30 a month and will return to self -medication or will stop being completely.
“It was a total triumph,” he said about the extension of Medi-Cal. “But now that all this comes to us, we are going back to a worse situation.”
Fear and tension due to immigration rags are also changing patient behavior. Suppliers told the AP that, as immigration raids increased, their patients requested more virtual appointments, did not go to routine medical visits and did not collect recipes for their chronic diseases.
Maria has the option of maintaining coverage. But he is weighing his family’s health against the risk of losing what they have built in the United States.
“It will be very difficult,” Maria said about her decision to remain in the program. “If the time comes when my husband gets sick and his life is in danger, then we obviously have to choose his life.”
