It is the grounds crew. The people who keep the grass low never get mentioned, and without them the field goes bad.
This is the coverage Gavin Newsom expanded until the state was paying for it out of the General Fund. The Legislative Analyst's Office put General Fund spending on the undocumented expansion, including in-home care, at about $10.8 billion in 2025–26, up nearly 50% from the governor's own earlier estimate. Full coverage for people federal Medicaid will not pay for. Doctor visits, prescriptions, hospital stays. Enrollment peaked around 1.48 million, then fell 15% by March 2026. They were about 1 in 9 enrollees and about a third of everyone who left.
That drop is not one switch Trump flipped. ICE raids and Medicaid data sharing made people stop renewing. On January 1, California froze new full-scope sign-ups for undocumented adults. Anyone already on can stay. Anyone who rolls off cannot come back. A premium for those who remain starts in 2027. On October 1, the Big Beautiful Bill ended federal matching funds for some lawfully present immigrants. California is still covering about 148,000 of them with state money through June 2027.
Fraud is the part people skip. A program that overran its estimate by billions, then had to be frozen because the state could not afford the growth, is a drag. Trump treats that drag as the job. Weeding the rolls does not balance the debt by itself. It is how repayment even gets a start. The work nobody clips is the work that keeps the field playable.