California is set to become the first state to offer all undocumented immigrants, regardless of their age, state-subsidized health insurance starting 2024.

This historic move was part of California Governor Gavin Newsom’s 2022-23 state budget allocation. It includes expanding the state’s Medi-Cal program, which already offers state-subsidized health insurance to those younger than 26 and over the age of 50. Newsom signed a $307.9 billion operating state budget on Thursday (June 30), agreeing to provide coverage for an additional 764,000 people at a cost of about $2.7 billion a year. This is a long awaited victory for healthcare and immigration activists, who have been fighting for this change for more than a decade.

Nationwide, federal and state governments join together to give free healthcare to low-income adults and children through Medicaid. But the federal government won’t cover immigrants who are living in the country illegally. Some states, including California, have used their own tax dollars to cover a portion of healthcare expenses for some of these low-income immigrants.

“This will represent the biggest expansion of coverage in the nation since the start of the Affordable Care Act in 2014,” said Anthony Wright, executive director of Health Access California, a statewide consumer health care advocacy group. “In California we recognize that everybody benefits when everyone is covered.”

Republicans and conservative groups in California have opposed expanding health care to immigrants living in the country illegally. Jon Coupal, president of the Howard Jarvis Taxpayers Association, said offering free healthcare will make California “a magnet for those who are not legally authorized to enter the country.”

He continued, “I think many of us are very sympathetic to the immigrant community, but we really wish we had better control of who enters this nation and this state.”

Previous expansions of California’s Medicaid system have taken six months to a year to implement. But the Newsom administration says it needs more time to complete this expansion because it is larger than the previous ones.