SACRAMENTO, Calif. — Six years after he entered office vowing to be California’s “health care governor,” Democrat Gavin Newsom has steered tens of billions in public funding to safety net services for the state’s neediest residents while engineering rules to make health care more accessible and affordable for all Californians.
More than a million California residents living in the U.S. without authorization now qualify for Medi-Cal, the state’s version of Medicaid, making California among the first states to cover low-income people regardless of their immigration status. The state is experimenting with Medicaid money to pay for social services such as housing and food assistance, especially for those living on the streets or with chronic diseases. And the state is forcing the health care industry to rein in soaring costs while imposing new rules on doctors, hospitals, and insurers to provide better-quality, more accessible care.
However, Newsom has so far failed to fully deliver on his most sweeping health care policies — and many changes are not yet visible to the public: Health care costs continue to rise, homelessness is worsening, and many Californians still struggle to get basic medical care.
Now, some of Newsom’s signature health initiatives, which could shape his profile on the national stage, are in peril as Donald Trump returns to the White House. According to national health policy experts, California stands to lose billions of dollars in health care funding should the Trump administration alter Medicaid programs as Republicans have indicated is likely. Such a move could force the state to dramatically slash benefits or eligibility.
And although allowing immigrants without legal status to enroll in free health care has been funded almost entirely with state money, it makes California a political target.
“That is fuel to feed the Republican MAGA argument that we are taking tax dollars from good Americans and providing health care to immigrants,” said Mark Peterson, a health care expert at UCLA, referring to the “Make America Great Again” movement.
Newsom declined an interview with KFF Health News. In a statement, he acknowledged that man …