Connecticut's program offering health insurance to undocumented residents could face financial pressures in light of provisions in the federal budget proposal currently under debate in the U.S. Congress.

On June11, the CT Mirror reported that a federal budget measure would penalize states providing health coverage to residents regardless of immigration status, despite such programs being fully state-funded and not reliant on federal dollars. Under current law, Connecticut covers certain populations—including undocumented children and postpartum women—with no federal match, spending roughly $30 million on children and $11 million on postpartum women in fiscal year 2025. The Children's Health Insurance Program (CHIP) also supports pregnant women, costing about $16.6 million last year, with the federal government covering 65 percent.

Governor Ned Lamont has pledged vigilance. “Governor Lamont supports providing medical coverage for children, regardless of immigration status… and will work with the legislature when the final bill passes,” said spokesperson Rob Blanchard.

Advocates praise the role HUSKY for Immigrants has played in reducing the uninsured population, supporting community health, and easing uncompensated care burdens on hospitals. Kati Villeda of the HUSKY 4 Immigrants coalition noted Connecticut's budget surplus can absorb program costs, and she urged legal action if federal penalties proceed.

Still, lawmakers remain cautious. State Rep. Jillian Gilchrest (D–West Hartford), co-chair of the legislative committee, emphasized the priority to safeguard existing coverage before considering expansion.

Washington State Weighing Cuts to Immigrant Health Expansion

While Washington's Apple Health Expansion program has been lauded for providing critical coverage to low-income undocumented residents, the state is now considering significant changes amid rising costs and budget pressures.

According to the Washington State Standard, the program—launched July 1, 2024—was initially funded at around $76.8 million per year, offering state-funded Medicaid-like care to approximately 13,000 undocumented individuals, with a waitlist of 17,000 appearing in just days. The current biennium’s budget, set at roughly $150 million, awaits Governor Bob Ferguson’s signature, though the state Senate proposed lower funding levels tied to potential cost-saving measures.

Advocates warn that withdrawing coverage would be a step backward for public health and equity. Health Network policy director Sasha Wasserstrom noted that Medicare-like access has allowed patients to receive treatments like cancer care and dialysis, which "sounds extreme … people will die as a result of not receiving health-care access." Furthermore, the Georgetown Center highlights how federal penalties could force Washington—as in other states—to terminate immigrant health programs to avoid steep budget impacts.

California’s Bold Expansion Under Review

California stands out as the first state to offer comprehensive Medi-Cal coverage to undocumented adults aged 26–49, following earlier expansions that included children, young adults, and seniors. The program, passed in July2022 and implemented on January1,2024, now covers about 700,000 previously uninsured undocumented adults.

Advocates describe the expansion as transformative. A San Francisco Chronicle columnist shared that farmworkers reported significant health improvements, including surgeries and reduced chronic pain thanks to the policy.

However, actual costs climbed sharply—Medi-Cal's immigrant coverage exceeded projections by $2.7billion last year and contributed to a $6.2billion budget shortfall. In response, Governor Gavin Newsom has proposed freezing new enrollments for undocumented adults starting in 2026 and charging premiums for existing enrollees. Legislative analysts conservatively estimate this plan could save the state more than $5billion over four years.

Newsom’s efforts signal a strategic recalibration amid widespread budget pressures. Though he stresses that no current beneficiaries will be removed, the policy shift reflects tensions between ambitious health equity goals and fiscal constraints. Opposition voices warn that cutting access undermines both human rights and long-term cost-savings from preventive care.

A National Challenge at the Crossroads

Connecticut’s HUSKY for Immigrants is not isolated. As Washington and California demonstrate, expanding sanctuary-state coverage can produce significant public health and economic benefits—but can also draw the ire of federal policymakers and spark state budget crises.

An analysis by KFF Health News shows 14 states and the District of Columbia cover undocumented children, and eight states—including CT, WA, and CA—cover unspecified immigrant adults. The proposed federal budget would penalize these states by reducing federal Medicaid matching funds, amplifying fiscal exposure.

Connecticut, safeguarded by its surplus, may hold off on short-term changes. But precedent from Washington and California suggests lawmakers may soon confront trade-offs between equity commitments and balanced budgets. According to Villeda, “We have the money,” though others may advocate prioritizing citizens or argue that the federal incentives are too steep.

Sources:
CT Mirror, Washington State Standard, KFF Health News, San Francisco Chronicle, CalMatters, Associated Press, Washington Post, Bloomberg Law, Georgetown University Center for Children and Families