Immigrant Fear Drives Major Exodus from Medi-Cal Thousands of immigrants without legal status are leaving California's Medi-Cal program amid fears of stricter public charge rules, reversing years of enrollment growth. Community health workers report widespread apprehension, with families hesitant to access essential healthcare due to potential immigration consequences. This trend, amplified by federal policy shifts, raises concerns for the health of immigrant families and U.S. citizen children. A KFF Health News analysis has revealed a significant outflow of immigrants without legal status from California's Medi-Cal program, with nearly 100,000 individuals disenrolling in the latter half of 2025. This trend, impacting communities like San Bernardino where a quarter of residents are foreign-born, is creating a climate of fear and discouraging program participation. María González, a community health worker in San Bernardino, observes that many of her clients, including U.S. citizen children who qualify for Medi-Cal, are now reluctant to enroll or renew their coverage. This apprehension stems from the potential for expanded public charge rules, which could penalize immigrants seeking permanent legal residency if they or their family members have utilized public benefits, including Medicaid. The KFF Health News analysis highlights that between June and December 2025, nearly 100,000 immigrants without legal status left Medi-Cal. This group constitutes about a quarter of all disenrollments during this period, despite representing only roughly 11% of the program's enrollees. This marks a stark reversal from the consistent growth in enrollment among this demographic observed since California opened Medi-Cal to all low-income residents regardless of immigration status in January 2024. While a spokesperson for the California Department of Health Care Services cited the resumption of eligibility checks, suspended during the COVID-19 pandemic, as a primary driver for overall Medi-Cal enrollment declines, researchers Leonardo Cuello and Susan Babey point to federal policy changes. Specifically, they emphasize the impact of the One Big Beautiful Bill Act and subsequent executive orders that are accelerating disenrollments. Researchers have noted a nationwide trend of immigrant adults, particularly parents, avoiding government assistance programs for food, housing, and healthcare to prevent scrutiny of their or a family member's immigration status. This avoidance extends to lawfully present residents and naturalized citizens. Cuello expresses particular concern over parental abstention, given that approximately one in four children in the U.S. have an immigrant parent, even if the children themselves are U.S.-born. This phenomenon may contribute to a national Medicaid and Children’s Health Insurance Program enrollment drop of almost 3% in the first ten months of last year, with California experiencing a 5.6% decline among children. Historically, the Trump administration broadened public charge criteria to include Medicaid usage and other assistance, leading to significant confusion and deterring participation among citizen children and other household members. Louise McCarthy of the Community Clinic Association of Los Angeles County noted that health center staff are still working to counteract the effects of those earlier rules. Currently, only reliance on cash assistance or long-term institutionalized care poses a public charge risk for immigration applications. However, the proposed Trump-era rule would have allowed the use of Medicaid and other noncash programs in determining public charge status, granting immigration officers greater discretion. The Department of Homeland Security's proposal justifies these changes by asserting that current rules hinder its ability to assess an immigrant's risk of becoming reliant on government resources. Public comments on this proposal concluded in December, with DHS yet to announce a final decision. The agency projects that such a change could yield annual savings of nearly $9 billion for federal and state governments by discouraging program participation