tax cut

New restrictions have stripped Medicaid coverage from certain legal immigrants, including refugees and victims of human trafficking, as part of broader federal changes to the health insurance program that are expected to force millions off their coverage.

The change effective Oct. 1 cut from Medicaid what is estimated to be hundreds of thousands of people who legally immigrated to the United States, many of whom work and pay taxes, in the latest Trump administration policy to target foreigners.

The move is part of sweeping changes to Medicaid under President Donald Trump’s 2025 tax cut and policy law, with many set to take effect early next year. The Medicaid changes are projected to result in 7.5 million fewer people with health insurance, according to the Congressional Budget Office’s 2025 estimate.

Advocates say that without Medicaid, people will not be able to afford private insurance and will either delay care or end up in emergency rooms, adding pressure to a strained health system. For immigrants, the cuts could be felt more acutely, compounding the effects of other administration efforts to restrict their access to public assistance as part of a broader immigration crackdown.

“This is about telling every immigrant in the United States that they are not welcome here and that they should leave,” said Ben D’Avanzo, a senior strategist at the National Immigration Law Center, which has pursued litigation against the Republican administration over its immigration agenda.

Refugees, asylum seekers, victims of human trafficking and domestic violence are among those who have lost coverage. Green-card holders were not impacted.

Lauren Bis, a White House spokesperson, said in a statement that “immigrants must be able to support themselves without taking from overburdened benefits programs paid for by hard-working American taxpayers.”

D’Avanzo said many people who have lost coverage will likely only realize when they need medical care. But for some, the change has been felt immediately.

Dwindling supplies of lifesaving medication

In Tucson, Arizona, María Chacon has been caring for her son Jesus for almost five years since a car accident at 17 left him unable to breathe on his own. He requires a ventilator, a feeding tube and daily medication, and must be turned once every two hours to stop sores from forming. Chacon said he sometimes opens his eyes.

The family is originally from Mexico and entered the U.S. on a T visa, offered to victims of human trafficking, in 2018.

Chacon said Medicaid has helped cover almost $25,000 per month of care for her son, which includes a small stipend for her and her husband as compensation for being long-term caregivers. She said doctors have explained that even if they both worked 24 hours a day, they would not be able to cover the cost of his care.

“Since that day I haven’t been able to sleep. We haven’t been able to eat or anything. We’re wondering what we’re going to do?” Chacon said.

Jesus takes medication that Chacon estimates costs $7,000 a month. The supply runs out in mid-October. Without coverage, she does not know how her son is going to survive.

Chacon found out just days before the cuts that she was losing care. She called the state’s Medicaid offices to appeal. Although she is in the process of obtaining a green card, Medicaid coverage would only kick in five years after she is approved.

Steven Camarota, research director for the Center for Immigration Studies, a right-leaning think tank that seeks less immigration, said the administration “is trying to nibble around the edges” with the Oct. 1 cuts, finding piecemeal ways to curb immigration into the U.S.

Camarota believes the government should screen legal immigrants for income potential and education, reducing the number who might rely on public benefits once they cross the border.

“You need immigrants who are unlikely to need welfare,” he said, or those with high educational attainment.

The administration recently revived a federal rule that could deny green cards to immigrants who use public benefits that could include food stamps, Medicaid, housing vouchers and others.

Chacon believes the cuts to Medicaid coverage are part of the administration’s clampdown on immigrants. She said her son is in no condition to travel.

“I know that’s what he’s doing, but, as my son is, I couldn’t go to Mexico,” Chacon said.

Millions more will be dropped from Medicaid

Medicaid, jointly funded by states and the federal government, has become a political focal point during Trump’s second term. The president has pushed to root out what he describes as fraud in the program. In July, the administration deferred over $1 billion in Medicaid payments to California and Minnesota, claiming there was suspected fraud; critics argued the move targeted Democratic-led states.

As more people are cut from Medicaid, the federal government is predicted to reduce program spending by $911 billion, according to healthcare research nonprofit KFF.

In Arizona, officials said 29,000 legal immigrants were cut from Medicaid rolls on Oct. 1. In Florida, estimates are closer to 177,000. Overall, more than 281,000 immigrants from nine states and the District of Columbia are estimated to lose Medicaid coverage, according to KFF.

As more states implement various restrictions to coverage, 7.5 million people are expected to lose coverage by 2034, according to analysis by the Congressional Budget Office.

Without coverage, people will turn to emergency rooms for care. When people delay seeing a doctor, conditions can worsen and become even more expensive to treat.

“At the end of the day, it does raise the cost for the states because once you get these people in for something that could have been prevented, they could not go to the doctor because they were uninsured; they most likely will end up at a hospital in an emergency room,” said Carmen Feliciano, the vice president of policy and advocacy at UnidosUS, a Latino civil rights organization.

UnidosUS partners with community organizations to help provide medical care, but Feliciano said they already are overwhelmed and would not be able to support the number of people who are going to lose medical coverage in the coming months.

“We are not going to have the capacity to serve all the people who need it,” Feliciano said.

Schuettler and Hussein write for the Associated Press.

California Republican gubernatorial candidate Steve Hilton dove deep into his housing platform and lobbed a few attacks at his Democratic opponent, Xavier Becerra, during a town hall with Los Angeles news outlets Tuesday.

Hilton also pointed to some disagreements with President Trump, providing daylight between himself and a president who remains deeply unpopular in California, during the event hosted and livestreamed by the Los Angeles Times and LAist.

Democratic Gov. Gavin Newsom’s final term ends in early January, providing California voters the opportunity to select a new governor at a time of conflict between the state and the Trump administration over environmental policies, immigration, healthcare and other pressing issues.

Ballots already have started to arrive in California voters’ mailboxes ahead of the Nov. 3 election.

Here are the top takeaways from the discussion with Hilton:

Walking the tightrope on Trump

Republicans running for statewide office already have an uphill battle because of California’s heavily Democratic electorate. It’s an acute challenge this year, campaign experts say, because many Democratic voters are itching to help their party regain control of Congress and neutralize Trump’s agenda.

Trump endorsed Hilton in April, which helped the former Fox News host pull ahead of his GOP rival, Riverside Sheriff Chad Bianco, and secure the second-place spot in the primary election, behind Becerra.

On the campaign trail, Hilton has remained supportive of Trump and said Democratic policies, not the war in Iran, are to blame for high prices.

Pressed to name an instance where he disagrees with the president, Hilton named federal funding cuts for the University of California, threats to withdraw Customs and Border Protection agents from airports in states with sanctuary policies, and the federal government buying stakes in California-based companies.

The Republican said those differences are rooted in his strong support for states’ rights.

“The broader point I want to make, and you can track this back to the commentary and what I’ve written over the years, is I’m a strong believer in decentralizing power,” he said. “I think there’s far too much involvement of the federal government in our affairs in California, and I’m going to be a very strong advocate for bringing those powers back in all sorts of ways.”

Gas prices, taxes and housing permits

Hilton described California’s cost of living as “a nightmare” and a major contributor to residents and businesses moving out of the state.

He laid out an affordability plan, which he refers to as “Califordable,” that he would prioritize if elected governor. His plan includes:

• Ending income taxes for Californians who earn $150,000 or less.
• Slashing oil industry regulations and clean energy mandates for utility companies to achieve $3 gas and lower electric bills.
• Ushering in a new construction boom of single-family homes, including by developing 10 new cities around the state, and capping government fees on newly constructed houses.

He blames the state’s affordability woes on Democrats, who have controlled the state legislative seats and held every elected statewide office since 2009.

“It’s not just that it’s time for some change in California, it’s time for balance. It’s time to try something different after 16 years of doing it the same way,” he said.

Republican gubernatorial candidate Steve Hilton said he does have some policy differences with President Trump during a town hall at the Los Angeles Times Building on Tuesday in El Segundo.

(Ronaldo Bolanos/Los Angeles Times)

Hilton said he would stop enforcing laws requiring communities to meet housing production goals and instead focus on building in undeveloped areas of the state that want new homes.

“We’ve got this attitude that the only place you can build is inside what’s currently developed, and that’s motivated by a desire to stop traffic and sprawl and all these things. But the consequence of that is that you end up finding [it] almost impossible to build anything” because of permitting battles and lawsuits, he said. “My plan is to open that up so that we build outwards, not just upwards, increasing the amount of space we use for housing.”

How he would pay for it all

Hilton said that Newsom and Democratic lawmakers have gotten accustomed to spending big and that he wants to return California’s state budget to its pre-pandemic size.

Earlier this year Newsom signed a budget just shy of $352 billion. His first budget as governor, in 2019, clocked in at nearly $215 billion.

The growth occurred during a time “when around 2 million people on net have moved out of the state,” Hilton said. “So we’re spending twice as much for a big reduction in population and worse results.”

He said he could offset the tax cuts by ending funding for high-speed rail, trimming state agencies by 5% and cracking down on Medicaid fraud. Together, he estimates those cuts would save about $25 billion annually. He has also promised to end state-funded healthcare for undocumented immigrants and to hollow out agencies that regulate the state’s air quality and coastlines.

Another round of attacks on Becerra

While he largely stayed focused on policy, Hilton criticized Becerra’s record as U.S. Health and Human Services secretary and dinged him for skipping the town hall.

“Looking forward to perhaps one day having another chance to sit down with my competitor in this race, Xavier Becerra. We’ve had one debate. He promised that there would be debates, plural. Not to be today. But hopefully we can have that conversation because Californians deserve a conversation about the future of our state,” he said during his opening remarks.

On Monday, Hilton attacked Becerra for having “pulled out” of the debate, though the Democratic candidate never agreed to attend a debate proposed by The Times and LAist. Becerra’s spokesperson said the campaign declined the invitation because of a full campaign schedule.

In the weeks following the June primary election, Becerra made himself scarce on the campaign trail and attended few public events. In August, he told reporters there would be multiple debates. He and Hilton faced off last week in an hourlong debate on CNN but no other debates have been announced.

Offshore wind projects “grotesque,” Hilton says

At a time when the Trump administration has systematically dismantled climate and environmental policies, Hilton took care to cast himself as an environmentalist who is concerned about climate change.

He criticized many of the policies favored by Democrats, however, as a “very one-dimensional way of thinking” and offered a more business-friendly approach to addressing climate change:

• Planting 3 billion trees and restoring wetlands.
• Expanding the use of climate-friendly geothermal energy near places such as the Salton Sea and Sonoma and Modoc counties.
• Expanding oil production in California, which he said reduces the need to import foreign oil on tanker ships that spew carbon emissions.

“So that’s a way of reducing carbon emissions that doesn’t burden working people and small businesses with the highest energy costs in the country. We’ve got to get the balance right,” Hilton said.

Hilton aligns with Trump’s vehement opposition to offshore wind projects, a potential source of abundant renewable energy. This year, the Trump administration announced deals to pay wind project developers billions to abandon U.S. wind leases off the coasts of California, North Carolina, New York and New Jersey.

“I think offshore wind is an absolute abomination. I mean, you look at beautiful Morro Bay or Humboldt up in the northern part of our state,” Hilton said. “The industrialization of our coastline that offshore wind would create, I think, is just grotesque, and I’m dead against it.”

Working across the aisle

When asked how he would work with a Democratic majority in the state Legislature, Hilton said he has experience doing it — as an advisor to former United Kingdom Prime Minister David Cameron, he shared an office with a member of the opposite party.

“We worked together very well. Didn’t agree on everything,” he said. “That would be my attitude. I’m very open. I’m not tribal. I’m not particularly partisan. I’m a pragmatic, problem-solving kind of person, and I’m looking forward to working with the Legislature.”

He said he would press the Legislature to cut spending and “the endless number of bills that they pass every year. … But I want to work together to reduce costs for Californians.”

Hilton also found alignment with Democrats who ran in the gubernatorial primary, including former Orange County Rep. Katie Porter, San José Mayor Matt Mahan and former Los Angeles Mayor Antonio Villaraigosa.

“Katie Porter in the primary … actually endorsed my tax plan. Matt Mahan and I agree on a lot of things to help” cut costs and speed up housing constriction, he said. “Antonio Villaraigosa, we agreed on a lot of things to do with energy policy. So I think there are Democrats who we’ll be able to work with to get consensus on some of the things that we need to get done.”