SACRAMENTO, Calif. — Isabel Coronel, 76, walked into a hospital for the first time in almost 30 years last month.
Coronel, an undocumented immigrant, had spent decades laboring in the fields of Southern California's Inland Empire, picking watermelon, cilantro and radishes. She didn’t have health insurance and feared deportation if she tried to access medical care.
She endured high cholesterol and blood pressure, severe knee pain, vision loss and the long-term effects of her January bout with COVID-19 rather than risk a hospital visit.
That changed on May 1, when Coronel became eligible for Medi-Cal, California's Medicaid health care program. She was among 235,000 undocumented adults who gained access to the state’s income-based health insurance network through a new expansion of the program signed by Gov. Gavin Newsom last year.
“I give thanks to God that I now have my Medi-Cal because I didn’t go to the doctor before,” Coronel said in Spanish. “Many of us need to go to the doctors and we don’t because we don’t have the ways to do so and we have fear of everything.”
Her access to health care follows a decadelong campaign in California’s Capitol to build a social safety net for the state’s roughly 2.3 million undocumented immigrants, an effort that culminated last month when Newsom signed a budget bill extending Medi-Cal access to all remaining uncovered adults.
The milestones include driver’s licenses, protections from deportation, tax breaks, COVID-19 pandemic relief and now health care. It’s the strongest social safety net for undocumented immigrants in the country, advocates say.
Undocumented immigrants “don’t get out of the system, what they put into the system so I hope this serves as an example to the rest of the country,” said state Sen. Maria Elena Durazo, a Los Angeles Democrat. “We’re in the forefront of policies to treat the undocumented as real Americans, real Californians because they contribute so much.”
The immigrant-friendly policies come at a time when other states are trying to push away undocumented residents.
In Texas, leaders are empowering state authorities to return migrants to the border. And last month, Florida Gov. Ron DeSantis signed legislation that requires law enforcement agencies in the state to work with Immigration and Customs Enforcement to crack down on immigration.
California’s expansion of social programs resulted from multiple factors, such as organizing by pro-immigrant advocacy groups who played a long game in advancing policies during former Gov. Jerry Brown’s administration that Newsom later signed into law and the power a generation of Latino leaders accumulated in the Capitol just two decades after the state’s Republican leaders tried to prohibit any government spending on undocumented immigrants.
Now, with undocumented immigrants accounting for as many as 1 in 10 California workers, advocates want to keep their momentum.
“It leaves us surprised to see so many differences,” said Coronel, the former farm worker. “But it needs to keep going. And not leave us behind.”
The legacy of Proposition 187
California was not always so welcoming to its undocumented residents. In 1994, voters overwhelmingly approved Proposition 187, which sought to ban immigrants from receiving social services, health care and education. Legal challenges prevented the law from taking effect, but it nonetheless inspired young Democrats to get involved in politics.
Assemblywoman Cristina Garcia, a Bell Gardens Democrat, protested against the proposition as a high school student. She remembers it as a “long-fought battle” that led to creating support and solutions for the state’s undocumented population.
“For a lot of us, those experiences color our decision-making here and as the Latino caucus has grown so has our ability to influence policy and tell a more balanced story,” said Garcia. “A Legislature that looks a little bit closer to society is paying dividends and things are moving faster.”
The first big breakthrough for undocumented Californians came in 2013, when former Gov. Jerry Brown signed a law allowing residents to apply for driver’s licenses regardless of immigration status.
Cynthia Buiza, executive director for the California Immigrant Policy Center, said the law reduced transportation hardships and allowed immigrant parents to lawfully drive their children.
Two years later, Brown signed a law allowing low-income undocumented children to receive health insurance through Medi-Cal. At the time, only Washington, Illinois, New York, Massachusetts and Washington, D.C., offered similar coverage to undocumented kids.
California Democrats in Trump era
California Democrats went further after former President Donald Trump took office with his pledge to build a wall along the entire U.S. Mexico border. In 2017, California Democrats passed the so-called sanctuary state law, which restricts when local law enforcement can cooperate with federal immigration agents.
Brown, who took office for his second run as governor during the Great Recession, at times indicated he was reluctant to expand health care services to undocumented households because of the ongoing costs they presented to the state budget.
“I will just say generally that there are a lot of ideas that often are memorialized into bills that, when you price them out, they exceed the available money,” Brown said in 2015 in response to a question about health care for undocumented Californians.
The financial dynamics changed with a succession of staggering budget windfalls during the Newsom administration. He projected a $21 billion surplus in in 2019. That swelled to a $75 billion surplus for the 2021-22 budget year.
The spending plan he signed last month included what he called a $97.5 billion surplus.
With that kind of money, Democrats felt comfortable locking in spending for social services.
Newsom signed a law in September 2020 making low-income undocumented immigrants for the California Earned Income Tax Credit, a step Brown’s administration had blocked. That expansion put hundreds of dollars into the pockets of low-income Californians.
More changes came in 2021 with the state extending Medi-Cal eligibility to undocumented seniors age 50 and over.
And last month, California announced it would become the first state to remove all age barriers to health care and begin providing food assistance to the undocumented 55 and older.
“We wish it had happened before but we will take what we can get,” Buiza said. ‘These are the most basic things that we’re asking for. To let our communities, who have the least, the fighting chance to survive.”
From February 2020 to July 2020, Hispanic immigrants in California were 11 times more likely to die from COVID-19 than non-Hispanics, according to a University of Southern California 2021 study. That disparity underscored for advocates that working-class, undocumented immigrants lacked a safety net in California.
Jacqueline Garcel, executive director of the Latino Foundation, said these early statistics told a “story of inaction.”
Undocumented workers in essential industries were especially at risk because of no opportunities for remote work or sources of wage replacement. They were also excluded from collecting benefits in federal stimulus packages.
“It just forced us as a state to reckon with the fact that in a public health crisis the most vulnerable people are undocumented immigrants,” Garcel said.
Garcel said advocates pushed Newsom and lawmakers to address those disparities. Garcel believes Newsom, in particular, responded to these appeals, calling him one of the most “pro-immigrant leaders in American history.”
California in May 2020, became the first state to give pandemic relief directly to undocumented households. Workers became eligible for up to $1,700 in state funds: a $500 relief pre-paid card and $1,200 from the Golden State Stimulus Fund.
“California proudly leads the nation when it comes to supporting undocumented families through universal and targeted investments,” said Daniel Villasenor, deputy press secretary for Gov. Newsom. “The California way means supporting all Californians — no matter where they come from or their immigration status.”
California is bucking a trend in Republican-led states where leaders are trying to make communities less hospitable to undocumented immigrants.
In Texas, Gov. Gregg Abbott recently announced his desire for the federal government to pay for the public education of undocumented students in schools. He also argued that President Joe Biden’s policies will bring an influx of immigrants that is “unsustainable and unavoidable.”
David Jaroslav, a state and local legislative manager for the Federation of American Immigration, a D.C.-based nonprofit seeking to reduce immigration to a “more normal level,” disagreed with California extending benefits to undocumented households. He said the benefits conflict with federal law and are a “burden” on taxpayers who prefer the money to be spent elsewhere.
“These kinds of benefits act as magnets for further illegal immigration,” said Jaroslav.
California Democrats push back on the idea that tax dollars are being stretched to help immigrants. Instead, they say workers are accessing resources they’ve already helped finance through paying taxes on wages, consumption and daily economic activities.
Californians without lawful immigration status contribute an estimated $3 billion in local and state taxes, according to the nonprofit Institute on Taxation and Economic Policy. The economy depends on its undocumented population, said Luz Gallegos, executive director of Training Occupational Development Educating Communities Legal Center.
“We are the Golden State because of the contributions of immigrants,” Gallegos said.