The NPR Politics Podcast - Immigrants Without Legal Status May Lose Health Care In States

Episode Date: May 22, 2025

Democratic governors in California and Minnesota are proposing to roll back health insurance coverage for immigrants without legal status that they signed into law. We look at what's going on. This podcast: voting correspondent Miles Parks, Minnesota Public Radio senior politics reporter Dana Ferguson, and CapRadio statehouse & politics reporter Laura Fitzgerald.This podcast was produced and edited by Casey Morell. Our executive producer is Muthoni Muturi.Listen to every episode of the NPR Politics Podcast sponsor-free, unlock access to bonus episodes with more from the NPR Politics team, and support public media when you sign up for The NPR Politics Podcast+ at plus.npr.org/politics.Learn more about sponsor message choices: podcastchoices.com/adchoicesNPR Privacy Policy

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but I'll be looking for the flowers following these spring showers. Enjoy the show. I feel like I just started using a white noise machine to sleep and now I'm, the vibes are, okay, waking up. Hey there, it's the MPR Politics podcast. I'm Miles Parks, I cover voting. And today on the show, healthcare for migrants who are in the US without legal status. So in recent years, we've seen some blue states expand coverage for those folks. But now, we're

seeing a rollback. And I'm joined today by reporters from two of the states where this is playing out right now. And I'm joined here by reporters from two of the states where this is playing out now. Cap Radio's Laura Fitzgerald in California and Minnesota Public Radio's Dana Ferguson in St. Paul. How do you both? Hello. Thanks for being here. So Dana, let me start with you. Walk me through exactly what's happening in Minnesota and also the reasoning that Governor Tim Walz is giving for the proposed changes. Sure. Just to give folks a sense of what's going on here,

we're in the midst of some negotiations about the state budget. Our legislative session closed up on the 19th, and there's still some work to be done in a special session. The biggest pieces of the budget aren't resolved yet. And also, just to give folks a sense, it's about as evenly divided here in our legislature as you can be.

There are 101 Democrats, 100 Republicans. And so compromise is a big part of what's going to get us out of here. And Republicans came into negotiations for a budget with a condition that they wanted to see coverage, MinnesotaCare, which is the public health insurance program for low-income people, changed so that it no longer includes coverage for immigrants in the country without legal status. Specifically, what they landed on is taking away coverage for adults. So we're just waiting for something to get buttoned up, but that's been a big part of it. And Governor Walz has said he doesn't like this idea, but they really want to get a budget passed. That's what I was gonna say. So this is not something that Democrats

are in favor of now too. It's not like they've changed their mind on this issue. It's just basically the budget is top priority. That's exactly right. The governor and other Democrats have said if they had it their way, this would not be part of the conversation. But they recognize that they're in a nearly evenly split legislature. So something had to give and they said to keep some other policy provisions they really wanted and fought hard for under Democratic control the last two years. This is what they were willing to sacrifice. And here's what the governor said as they rolled out this agreement.

And I'm not going to sugarcoat how difficult this was. These lawmakers are there, they have their voice heard, we'll vote on this. We didn't expect everybody to be happy in this. I think many of us compromised. The governor noted that, again, he really didn't like this deal. It was hard to make, but he wanted to make sure kids were kept on for their coverage and that's something that they were able to agree to. Laura, how does this compare to what's happening in California?

Yeah, well, Governor Gavin Newsom is also proposing this change amid a pretty bleak budget outlook. The state's facing a $12 billion budget deficit. And so he says in order to save the state some money, you know, Medi-Cal, that's what we call Medicaid out here. It's way over budget and there needs to be cuts to this program. Newsom's proposal, it's a little different though

than what's going on in Minnesota. It's a freeze on new enrollments. So it won't cut anybody off from the program or from coverage. Like in Minnesota, kids could also on on Medi-Cal and California also has some more time to figure this out. State lawmakers have until June 15th to adopt a final budget so there's still about a month or so of negotiations to go before they figure out what's gonna happen with this new

proposal. But there's also the other big difference here between the two states right is the political environment. California is a much more democratic state than Minnesota is. Are Democrats in the legislature going along with this proposal? Yeah. So Democratic lawmakers and the legislature's Latino caucus are pushing back on this proposal pretty fiercely. They fought hard for this expansion in the first place. And now just a year after the full expansion went into effect, it's being paused. I spoke with Senator Lena Gonzalez. She's a Democrat who represents parts of Los Angeles. And this is what she told me. We can look at options for budget cuts elsewhere. We can be a little bit more mindful of how

we do this without always having to look at our most underserved communities. And you know, folks right now are seeing rich people get richer, billionaires, you know, leading, and they're thinking, where am I in this space? Where do I fit in? And I keep working really hard with no end in sight for additional attacks. It's really hard to swallow. So Gonzalez says they're trying to find ways to maintain this coverage during the last month of budget negotiations, maybe look for other places where they can negotiate with the governor's office on different places to cut. And then like you said, Miles, Republicans are a super minority in California, but they're also criticizing Newsom for this proposal because it doesn't actually cut anyone off. It's just a freeze.

So Republicans say that this is basically a budget proposal that's allowing the state to continue spending for health care for people without legal status, which is something they opposed from the get-go. I asked Newsom about how he sees these negotiations going over the next month or so with the legislature. And he said it's pretty much a hard line for him. This is how he summed it up. I don't want to be in this position but we are in this position and instead of rolling back the program, meaning cutting people off for basic care, we have to adjust the comprehensive nature of the care. Healthcare, I feel like, does become a pretty quickly an emotional issue for some lawmakers. Have you seen that, Dana, and how some lawmakers have been talking about it or have been trying to sway Walls one way or the other?

Yeah, they really have. At Governor Walls' press conference last week, we heard members of his own party Democrats pounding on the door and yelling out in opposition to this idea. They said they really don't want to go the opposite direction after making this health insurance accessible to folks who'd never really had it before, had seen serious benefits from it. They shared stories about how adult immigrants who'd never had coverage before were able to get cancer care, care for various medical diagnoses that they'd not had access to previously. And for a number of them, it was really personal.

They were sons and daughters of immigrants. They were friends and community members who had fought for this coverage. And they really told the governor, Governor Walz, that he shouldn't go in this direction as part of a compromise. Okay, well we're gonna take a quick break and when we get back we'll talk more about how some of these policies could actually impact people. I'm Tonya Mosley, co-host of Fresh Air. At a time of sound bites and short attention spans, our show is all about the deep dive. We do long form interviews with people behind the best in film, books, TV,

music and journalism. Here our guests open up about their process and their lives in ways you've never heard before. Listen to the Fresh Air podcast from NPR and WHYY. And we're back. So Dana, let's talk about how these proposals would actually impact people. Do you have any sense of what that would look like in Minnesota? Yeah, we know that about 20,000 people have enrolled since this program was expanded to include immigrants without legal status. Again, 20,000 new people, about 3,000 of those are kids. So the kids that are on the program would still be eligible, could continue into 2026. But those adults would no longer be eligible and would be removed if they're currently accessing coverage. The

governor has said that that was really important to him. That was a big point of the compromise and something he wanted to keep. And what about California, Laura? How many people have used this program since it's been expanded? So since the program's been fully expanded, 1.6 million immigrants without legal status are currently enrolled in Medi-Cal. And throughout the end of this year, people without legal status can still sign up. But under Newsom's budget proposal, enrollment would

freeze for adult immigrants in January of next year if it's adopted. And experts, lawmakers, and even Newsom acknowledged that people without insurance coverage will end up seeking care in the state's emergency rooms. So in some ways taxpayers pay for this care either way on the front end or the back end. Wow. Yeah, I can imagine advocates are probably running around California then trying to get as many people signed up this year as absolutely possible. Are we seeing that at all? Yeah, absolutely. And I think, you know, because this isn't set in stone yet, there's still a lot of, you know, I think a lot of the work's being done in the legislature right now to see if there's a way to avoid this enrollment freeze. So I think

that's really where the focus is right now. But certainly, I mean, there could be really big changes to people's access to care if this proposal is adopted. Do we have any sense on how the public feels about this idea about providing health care for people who are in this country without legal status? Californians support Medi-Cal coverage for children without legal status but the public's a little more divided when it comes to the 18 to 49 age group and that's the age group that would really be impacted by this enrollment freeze. Like we said earlier children would still be allowed to enroll in the Medi-Cal program. Yeah and to Laura's

point I don't know that we have the same level of recent polling in Minnesota, but what we've heard at the Capitol is there is public blowback to this effort to roll back coverage. Religious groups, immigrant advocates, and hospitals have been here in the last week or so saying, please don't do this because number one, folks care about individuals in their communities who might not be able to access healthcare anymore. And also there is that financial impact to hospitals if folks are uninsured and are coming to the emergency room for care, rather than getting treatment earlier and detecting things that could be serious.

I do feel like the other elephant in the room politically is that two of the main characters that we're talking about here, Governor Tim Walz and Governor Gavin Newsom, are in the conversation to run for president potentially in 2028. Do you guys see that playing a role at all in this story? Yeah, it's hard not to look at a former

vice presidential candidate in Governor Walls and think that he might not be thinking about the future. He's not committed to running for reelection for governor yet, but says he'll do that potentially soon, make an announcement. He's still circulating in other states doing town halls and political functions. And I think in the past, he's presented himself as someone who can work across the political aisle and said that's a positive for him as a candidate. So I imagine if he's got his sights set on 2028 or another office some other time, he

is going to look at this decision and be able to come back to it and say, maybe I didn't love this, but it's something that I was able to do as an act of compromise. Yeah. And out in California, I mean, Newsom is widely seen as somebody who's evaluating a move for a presidential bid in 2028. You know, and when he's asked about this, he doesn't say one way or the other You know, he he's really when it comes to this policy in this proposal He's really framed it in the sense that Medi-Cal is way over budget in California and that we just need to Make up for a 12 billion dollar budget deficit

But I think the thing that you can't ignore here is that Newsome has been changing his tune on lots of different policies, you know, in the past few years. Homelessness spending and he issued an executive order last summer on encampment removals, things like that. And so I think that that is really important context in this backdrop of, you know, a potential reason why he's making this policy shift to the middle. I think a lot of people see it that way out here in California.

Okay, Cap Radio's Laura Fitzgerald and Minnesota Public Radio's Dana Ferguson. Thank you both for walking me through this. You're welcome, Miles. Thanks so much, Miles. And I'm Miles Parks. I cover voting. Thank you for listening to the MPR Politics Podcast.