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Ex-Biden official running in blue state gubernatorial race must tackle key issue amid skyrocketing costs
California gubernatorial candidate and former Health and Human Services Secretary Xavier Becerra said the state may need to rein in its Medicaid program as it faces concerns about costs partly related to those in the country illegally using the system.
Becerra, a Democrat who previously served as the Golden State’s attorney general, explained his stance in an interview with Fox 11 Los Angeles this week.
“I believe we should eventually get there,” he said about allowing people to enroll in Medi-Cal even if they’re undocumented.
HOUSE REPUBLICANS GRILL HHS SECRETARY BECERRA OVER MIGRANT CHILDREN: ‘WOULD NOT WANT TO BE YOU’
Health Secretary Xavier Becerra testified before the House Judiciary Subcommittee on Immigration Integrity, Security, and Enforcement. (House Judiciary GOP / X)
“Can we afford to do it? That’s where a governor has to decide… if we can’t afford it, we have to be realistic. If we can’t afford it, how do we do it?” he added.
“But when you do the scrub… this is where it’s important, if you don’t have the dollars to do it, how do you do it? You need the money. California needs a balanced budget. You scrub it. If you find a way, you do it and don’t delay. But if you scrub it and you can’t figure out how to do it, then that’s the reality and that’s the choices we have,” the former Biden official continued.
The overall Medi-Cal program was originally expected to cost $6 billion until a California budget official revealed that it’s projected to cost $9.5 billion this fiscal year. The governor’s office then asked for two separate loans, totaling $6.2 billion.
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Illegal immigrants wait to be picked up at the southern border on May 23, 2024. (Bill Melugin/Fox News)
When asked by KCRA, Gov. Gavin Newsom, who is term-limited and will leave office in January 2027, said that while illegal immigrants in the program are not the whole issue, it’s a contributing factor.
“That’s partial,” Newsom said last month.
CLICK HERE FOR MORE IMMIGRATION COVERAGE
“With tough fiscal choices ahead, Governor Newsom, jointly with Pro Tem McGuire and Speaker Rivas, will evaluate proposals to rein in long-term spending – including in Medi-Cal – while working to protect the core health and social services Californians rely on,” Newsom spokesperson Izzy Gardon said in a statement to Fox News Digital. The governor and his office have said rising costs have led to higher than expected Medicaid costs in other states that do not allow illegal immigrants to enroll.
“Immigration status doesn’t matter,” according to the California Department of Health Care services website, but Republicans have staunchly criticized allowing illegal immigrants in the program.
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Newsom and Trump face off. (Pool)
“Even Jerry Brown refused to expand Medi-Cal to all illegal immigrants because he knew it was fiscally irresponsible and unsustainable,” California Senate Minority Leader Brian Jones tweeted last month. “Now under Newsom, legal residents are paying the price both financially and in reduced access to healthcare. The public deserves answers: Why are the costs so much higher than what Newsom promised? What is Newsom’s plan to fix the financial disaster he created?”
The 2026 California governor’s race is expected to be contentious, as Becerra, former Rep. Katie Porter, former Los Angeles Mayor Antonio Villaraigosa, and Lt. Gov. Eleni Kounalakis are already in the race on the Democratic side. Reports swirl that former Vice President Kamala Harris could make her comeback into politics after losing the 2024 election by running for governor. On the Republican side, Riverside Sheriff Chad Bianco is currently in the race, and many others are expected to join him.
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HELENA — You probably have goals and plans for 2026—the Montana Department of Agriculture does too.
“We’re really focusing on innovative agricultural practices,” Montana Department of Agriculture director Jillien Streit said.
It’s no secret that agriculture—farming and ranching—is not easy. There are long days, planning, monitoring crops and livestock, and other challenges beyond farmers’ and ranchers’ control.
(WATCH: Montana Department of Agriculture focusing on innovation in 2026)
Montana Department of Agriculture focusing on innovation in 2026
“We have very low commodity prices across the board,” Streit said. “We still have very high input prices across the board, and we have really high prices when it comes to our equipment, and so, it’s a really tough year.”
But innovation, including new practices, partnerships and technology use, can help navigate some of those challenges.
“We can’t make more time and we can’t make more land, so we need to start putting together innovative practices that help us maximize what our time and land can do,” Streit said.
Practices range from using technology like autonomous tractors and virtual fencing—allowing rangers to contain and move cattle right from their phones—to regenerative farming and ranching.
“It is bringing cattle back into farming operations to be able to work with cover cropping practices to invigorate the soil for new soil health benefits,” Streit said.
The Montana Department of Agriculture is working to help producers learn, share, and collaborate on new ideas to work in their operations.
The department will share stories of practices that work from farms and ranches across the state. Also, within the next year or so, Streit said the department is hoping to roll out technology to help producers collaborate.
“(It’s) providing a communication platform where people can get together and really help each other out by utilizing each other’s assets,” she said.
While not easy, agriculture is still one of Montana’s largest industries, and Streit said innovating and sharing ideas across the state can keep it going long into the future.
More than 10,000 people have enrolled in Nevada’s new public option health plans, which debuted last fall with the expectation that they would bring lower prices to the health insurance market.
Those preliminary numbers from the open enrollment period that ended in January are less than a third of what state officials had projected. Nevada is the third state so far to launch a public option plan, along with Colorado and Washington state. The idea is to offer lower-cost plans to consumers to expand health care access.
But researchers said plans like these are unlikely to fill the gaps left by sweeping federal changes, including the expiration of enhanced subsidies for plans bought on Affordable Care Act marketplaces.
The public option gained attention in the late 2000s when Congress considered but ultimately rejected creating a health plan funded and run by the government that would compete with private carriers in the market. The programs in Washington state, Colorado, and Nevada don’t go that far — they aren’t government-run but are private-public partnerships that compete with private insurance.
In recent years, states have considered creating public option plans to make health coverage more affordable and to reduce the number of uninsured people. Washington was the first state to launch a program, in 2021, and Colorado followed in 2023.
Washington and Colorado’s programs have run into challenges, including a lack of participation from clinicians, hospitals, and other care providers, as well as insurers’ inability to meet rate reduction benchmarks or lower premiums compared with other plans offered on the market.
Nevada law requires that the carriers of the public option plans — Battle Born State Plans, named after a state motto — lower premium costs compared with a benchmark “silver” plan in the marketplace by 15% over the next four years.
But that amount might not make much difference to consumers with rising premium payments from the loss of the ACA’s enhanced tax credits, said Keith Mueller, director of the Rural Policy Research Institute.
“That’s not a lot of money,” Mueller said.
Three of the eight insurers on the state’s exchange, Nevada Health Link, offered the state plans during the open enrollment period.
Insurance companies plan to meet the lower premium cost requirement in Nevada by cutting broker fees and commissions, which prompted opposition from insurance brokers in the state. In response, Nevada marketplace officials told state lawmakers in January that they will give a flat-fee reimbursement to brokers.
The public option has faced opposition among state leaders. In 2024, a state judge dismissed a lawsuit, brought by a Nevada state senator and a group that advocates for lower taxes, that challenged the public option law as unconstitutional. They have appealed to the state Supreme Court.
Federal Policy Impacts
Recent federal changes create more obstacles.
Nevada is consistently among the states with the largest populations of people who do not have health insurance coverage. Last year, nearly 95,000 people in the state received the enhanced ACA tax credits, averaging $465 in savings per month, according to KFF, a health information nonprofit that includes KFF Health News.
But the enhanced tax credits expired at the end of the year, and it appears unlikely that lawmakers will bring them back. Nationwide ACA enrollment has decreased by more than 1 million people so far this year, down from record-high enrollment of 24 million last year.
About 4 million people are expected to lose health coverage from the expiration of the tax credits, according to the Congressional Budget Office. An additional 3 million are projected to lose coverage because of other policy changes affecting the marketplace.
Justin Giovannelli, an associate research professor at the Center on Health Insurance Reforms at Georgetown University, said the changes to the ACA in the Republicans’ One Big Beautiful Bill Act, which President Donald Trump signed into law last summer, will make it more difficult for people to keep their coverage. These changes include more frequent enrollment paperwork to verify income and other personal information, a shortened enrollment window, and an end to automatic reenrollment.
In Nevada, the changes would amount to an estimated 100,000 people losing coverage, according to KFF.
“All of that makes getting coverage on Nevada Health Link harder and more expensive than it would be otherwise,” Giovannelli said.
State officials projected ahead of open enrollment that about 35,000 people would purchase the public option plans. Of the 104,000 people who had purchased a plan on the state marketplace as of mid-January, 10,762 had enrolled in one of the public option plans, according to Nevada Health Link.
Katie Charleson, communications officer for the state health exchange, said the original enrollment estimate was based on market conditions before the recent increases in customers’ premium costs. She said that the public option plans gave people facing higher costs more choices.
“We expect enrollment in Battle Born State Plans to grow over time as awareness increases and as Nevadans continue seeking quality coverage options that help reduce costs,” Charleson said.
According to KFF, nationally the enhanced subsidies saved enrollees an average of $705 annually in 2024, and enrollees would save an estimated $1,016 in premium payments on average in 2026 if the subsidies were still in place. Without the subsidies, people enrolled in the ACA marketplace could be seeing their premium costs more than double.
Insights From Washington and Colorado
Washington and Colorado are not planning to alter their programs due to the expiration of the tax credits, according to government officials in those states.
Other states that had recently considered creating public options have backtracked. Minnesota officials put off approving a public option in 2024, citing funding concerns. Proposals to create public options in Maine and New Mexico also sputtered.
Washington initially saw meager enrollment in its Cascade Select public option plans; only 1% of state marketplace enrollees chose a public option plan in 2021. But that changed after lawmakers required hospitals to contract with at least one public option plan by 2023. Last year the state reported that 94,000 customers enrolled, accounting for 30% of all customers on the state marketplace. The public option plans were the lowest-premium silver plans in 31 of Washington’s 39 counties in 2024.
A 2025 study found that since Colorado implemented its public option, called the Colorado Option, coverage through the ACA marketplace has become more affordable for enrollees who received subsidies but more expensive for enrollees who did not.
Colorado requires all insurers offering coverage through its marketplace to include a public option that follows state guidelines. The state set premium reduction targets of 5% a year for three years beginning in 2023. Starting this year, premium costs are not allowed to outpace medical inflation.
Though the insurers offering the public option did not meet the premium reduction targets, enrollment in the Colorado Option has increased every year it has been available. Last year, the state saw record enrollment in its marketplace, with 47% of customers purchasing a public option plan.
Giovannelli said states are continuing to try to make health insurance more affordable and accessible, even if federal changes reduce the impact of those efforts.
“States are reacting and trying to continue to do right by their residents,” Giovannelli said, “but you can’t plug all those gaps.”
Are you struggling to afford your health insurance? Have you decided to forgo coverage? Click here to contact KFF Health News and share your story.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF — an independent source of health policy research, polling, and journalism. Learn more about KFF.
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