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Vanessa G. Sánchez was a correspondent for KFF Health News until July 2025.
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A statewide initiative to formalize the role of community health workers and expand their ranks was meant to improve the health of underserved communities, particularly Hispanic populations, who often experience higher rates of chronic illnesses. But years in, California has abandoned a certification program and rescinded public support.
Recent federal reductions in funding for language assistance and President Donald Trump’s executive order designating English as the official language of the United States have some health advocates worried that millions of people with limited English proficiency will be left without adequate support and more likely to experience medical errors.
Federal cuts are hurting community organizations in California that provide language assistance services to people who speak limited English. Despite President Trump’s executive order declaring English the national language, millions in the U.S. need help navigating the health system.
Gov. Gavin Newsom said that he’s proud his state expanded health care to all low-income residents regardless of immigration status but that tough budget times call for some adjustments. The Democrat’s new budget proposes scaling back benefits to adults living in the country illegally, as well as charging them a $100 monthly premium.
The state has in recent years embraced several initiatives recommended in an influential health care workforce report, including alternative payment arrangements for primary care doctors to earn more. Despite increasing residency programs, student debt forgiveness, and tuition-free medical school, California is unlikely to meet patient demand, observers say.
Families, nursing facilities, and home health agencies rely on foreign-born workers to fill health care jobs that are demanding and do not attract enough American citizens. The Trump administration’s anti-immigration policies threaten to cut a key source of labor for the industry, which was already predicting a surge in demand.
Democratic state lawmakers in California have proposed bills to protect women, transgender people, and immigrants in response to concerns that their health data could be used against them. If the measures reach his desk, Gov. Gavin Newsom could lay such legislation aside to focus on securing federal funds.
Different states are offering starkly different guidelines to hospitals, community clinics, and other health facilities for interacting with immigrant patients as President Donald Trump issues a flurry of executive orders on immigration.
California and Massachusetts are teaching immigrants their rights while Florida and Texas are collecting patients’ immigration status. As states offer differing guidelines for interacting with immigrant patients, hospitals around the U.S. say they won’t turn people away for care because of their immigration status.
Donald Trump’s second term is reigniting mistrust in health services among California immigrants, making it harder for community health workers to get people enrolled in Medi-Cal. Yet the president-elect is also seen as someone who could improve their lives with a better economy, even if that means forgoing health care.
A private immigration detention center contractor has sued to block a California law allowing local public health officials to inspect facilities in response to allegations of medical neglect or unsanitary conditions.
The state Office of Health Care Affordability has set a goal for insurers to direct 15% of their spending to primary care by 2034, part of a push to expand preventive care services. Health plans say it’s unclear how the policy will mesh with the state’s overarching goal to slow spending growth.
California this year completed its Medi-Cal expansion to include income-eligible residents regardless of their immigration status. This final installment of the “Faces of Medi-Cal” series profiles three of those newly eligible patients and how coverage has affected their health.
California voters will decide in November whether to approve a $10 billion climate bond that supporters say is needed to jump-start water system repairs for residents without safe drinking water. Opponents say those repairs should be prioritized in the state budget, not put on a credit card.
Health and Human Services Secretary Xavier Becerra has a plan to protect farmworkers from extreme heat and wildfire smoke, but farmworkers who pick California grapes say they need more, as climate change brings more extreme weather.
New HIV diagnoses have decreased among Latinos in San Francisco, potentially marking the first time in five years that the group hasn’t accounted for the largest number of new cases. Public health experts express cautious optimism, but outreach workers warn that many Latinos still struggle to find testing and treatment.
Immigration is regulated by the federal government, but California lawmakers may give local public health inspectors the authority to inspect privately operated immigration detention facilities, citing complaints and lawsuits from detainees alleging inadequate medical care and unsanitary conditions.
Since being diagnosed with HIV in 2022, Fernando Hermida has had to move three times to access treatment. A KFF Health News-Associated Press analysis found gay and bisexual Latino men account for a fast-growing proportion of new diagnoses and infections, showing they are falling behind in the fight against HIV.
Lawmakers passed a budget that rejected Gov. Gavin Newsom’s proposal to save nearly $95 million by eliminating in-home support services for qualifying older, blind, and disabled immigrants lacking legal residency. Advocates say Newsom’s plan would have cost more in the long run. Newsom has not indicated whether he’ll veto.
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