California gubernatorial candidate Xavier Becerra defended extending healthcare coverage to immigrants without legal status during the 2026 campaign. His opponent, Republican Steve Hilton, has pledged to eliminate such coverage.

During a debate in May, Becerra said, "Immigrants, whether documented or not, work hard." He added, "They pay taxes, and sometimes they get injured on the job or their children get sick." Becerra stated it would be "foolish" to exclude the poorest immigrants from routine care, which could push them into expensive emergency rooms. He has vowed to pursue new revenue streams to fund basic services, proposing to raise taxes on corporations and the wealthiest Californians.

Hilton announced he would end state-funded health coverage for immigrants without legal status. In a Facebook video on the morning of June 2, Hilton said, "Stop taking money from California taxpayers who can barely afford their healthcare to give free healthcare to citizens of other countries who shouldn't even be here." He also promised in campaign speeches to use savings from eliminating coverage to lower healthcare costs for other Californians.

Medi-Cal coverage for immigrants without legal status costs the state approximately $10 billion annually, according to the California Legislative Analyst's Office. This figure is more than double initial estimates. A Public Policy Institute of California poll indicated that a majority of likely voters in California opposed providing health insurance to immigrants without legal status. Mark Baldassare, PPIC survey director, said, "The state faces major challenges, and healthcare is one of the major expenditures." Baldassare added, "People have become more selective about how they want to see those limited healthcare dollars spent."

California lawmakers previously expanded Medi-Cal over the past decade to offer comprehensive coverage to all low-income residents, regardless of immigration status. Becerra objected last year when Governor Gavin Newsom and legislative leaders froze Medi-Cal enrollment for adults without legal status, cut benefits, and imposed monthly premiums. Democratic lawmakers and Governor Newsom agreed to delay several Medi-Cal cuts until July 2027.

In 2023, California was home to about 2.3 million people without legal status, representing roughly 8% of the state's labor force, according to the Pew Research Center. One in five California children live in a family that includes at least one member without legal status, according to the California Department of Education.