The Golden State is expanding its massive health care system this year, which means more taxpayer dollars will fund sex change surgeries for state residents, regardless of their citizenship status. 

According to a memo first circulated in May 2022 and reported by the Daily Caller Foundation, California’s Medi-Cal covers costs for hormone therapy and procedures “that bring primary and secondary gender characteristics into conformity with the individual’s identified gender, including ancillary services, such as hair removal, incident to those services.”

Nearly 700,000 illegal immigrants between the ages of 26 and 49 qualify, as of Jan. 1, for these federal health care services, which will cost California taxpayers an estimated $3.1 billion. For those living in California illegally within this age range, it translates to approximately $4,058 per year in medical coverage subsidies funded by the state’s general fund.

“Gender affirming care is a covered Medi-Cal benefit when medically necessary,” the memo states. “Requests for gender affirming care should be from specialists experienced in providing culturally competent care to transgender and gender diverse individuals and should use nationally recognized guidelines.”

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The memo adds that “medical necessity” is determined “and services shall be recommended by treating licensed mental health professionals and physicians and surgeons experienced in treating patients with incongruence between their gender identity and gender assigned at birth.”

From Dec. 1 to Dec. 31, over 302,000 migrants were documented attempting to cross the U.S. southern border, the highest total for a single month ever recorded. It also marked the first time monthly migrant encounters surpassed 300,000.

A recent report from Immigration and Customs Enforcement (ICE) shows a significant rise in the number of undocumented immigrants not held in detention. It went up from 3.7 million in 2021 to almost 4.8 million in 2022 and nearly 6.2 million in 2023. These are illegal migrants with final orders to leave or who are in the process of being removed but aren’t held in ICE custody.

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“In California, we believe everyone deserves access to quality, affordable health care coverage — regardless of income or immigration status,” Gov. Newsom’s office reportedly said in a statement. “Through this expansion, we’re making sure families and communities across California are healthier, stronger and able to get the care they need when they need it.”

Newsom announced California would begin providing health care coverage to additional illegal immigrants on top of the 1.1 million already in the Medi-Cal system. More than one-third of California’s shrinking population of 39 million is enrolled in the Medi-Cal program.  

California has been incrementally adding illegal immigrants to the Medi-Cal program since 2015. That was the year it made undocumented children eligible. Four years later, it added adults 50 and older.  

Fox News Digital reached out to Newsom’s office for comment. 

Fox News’ Chuck DeVore contributed to this report.