Gavin Newsom Proposes Health Coverage for All Illegal Immigrants in California by 2024

California Governor Gavin Newsom proposed Monday providing health care coverage to all immigrants, legal and illegal.

This move is part of a statewide effort to reduce its number of uninsured residents, which has shown success. The largest group of people that remains insured by the state's Medicaid program is people of lower incomes in the United States illegally.

According to a legislative analysis, filling this gap would cost the state $2.4 billion annually. Newsom plans to use a surplus in the state's $286.4 billion budget to cover this.

While the California Legislative Analyst's Office estimated the surplus to be at least $31 billion, Newsom's proposal has an even larger estimate due to his office's broader definition of what constitutes a surplus.

The state began providing health coverage to immigrants age 26 and under in 2019, then began covering immigrants age 50 and over in 2021. Newsom wants the rest covered by the beginning of 2024.

Detailed plans for introducing and paying for this expansion are not currently clear.

Newsom's administration called the lack of health insurance for some immigrants one of the "existential threats" it must tackle. Others include the COVID-19 pandemic, wildfires, drought, homelessness and public safety.

Gavin Newsom, California, governor
California Governor Gavin Newsom proposed using a budget surplus to provide health coverage to the state's illegal immigrants. Here, Newsom speaks during a news conference at Kingston 11 Cuisine on October 8, 2021 in Oakland, California. Photo by Justin Sullivan/Getty Images

Covering immigrants age 50 and up, the most recent expansion, will eventually cost taxpayers about $1.3 billion per year.

Newsom's budget address kicks off months of haggling with his fellow Democrats, who control the state Legislature, talks that will intensify when Newsom presents an updated spending proposal in May.

Some progressive legislative Democrats last week proposed creating in California the nation's first universal health care system, backed by steep tax hikes that would have to be approved by voters.

Newsom also has pledged to spend $300 million on boosting law enforcement efforts to combat retail theft and another $2.7 billion to spend on things like coronavirus testing and hospital staffing.

He additionally on Monday proposed spending $648 million to back wildland firefighters and buy more helicopters and bulldozers, plus another $1.2 billion on top of the current budget year's $1.5 billion for forest management.

Another $750 million would go to drought relief, on top of the current budget year's $5.2 billion water package.

Also on the environmental front, he pledged to keep reducing California's reliance on fossil fuels.

To confront the state's seemingly intractable homelessness problem, he proposed spending $2 billion for mental health services, housing, and clearing homeless encampments. That's on top of last year's $12 billion package. The combination would create a projected 55,000 new housing units and treatment slots.

To help with the ever-growing cost of living in California, Newsom proposed "doubling down" on the state's existing plan to provide free universal pre-kindergarten; adding thousands of child care slots and boosting to before, after and summer school programs.

He also proposed continued aid to small businesses hit hard by the pandemic by waiving fees and providing hundreds of millions in grants and tax breaks.

Newsom's massive projected budget and surplus brings the state a long way from the gloom of 2020, when Newsom and state lawmakers cut spending, raised taxes and pulled money from the state's savings accounts to cover what they feared would be a pandemic-fueled $54 billion deficit.

That deficit never happened. Instead, state revenues soared like never before. In September, collections from the state's three largest taxes—personal income, sales and corporation—were 40 percent higher than September 2020 and nearly 60 percent higher than September 2019, before the pandemic hit, according to the Legislative Analyst's Office.

Newsom has also promised to substantially increase spending on infrastructure, including things like roads and bridges. These types of projects are good ways to spend surplus money—which is only available for one year—because they don't have recurring costs that must be funded every year. Another advantage is infrastructure spending does not count toward the state's constitutionally-set spending limit, meaning it can offset other spending to help lawmakers stay under that cap.

Nationally, people will be watching closely to see how Newsom wants to spend money to increase access to abortion. The U.S. Supreme Court is considering whether to overturn or significantly weaken Roe v. Wade, the landmark decision that forbids states from outlawing abortion. If that happens, as many as two dozen other states could pass laws outlawing or restricting access to abortion.

Last year, Newsom convened a group of more than 40 abortion providers and advocacy groups to ask for their ideas on what to do should that happen. In December, the group released 45 recommendations. They include spending money to help clinics hire more workers and funding to reimburse abortion providers for patients who can't afford to pay—including those who travel to California from other states.

In an interview with the Associated Press last month, Newsom indicated some of the report's recommendations will be included in his budget proposal.

The Associated Press contributed to this report.