San Francisco, CA – October 23, 2025 – A resurfaced video is reigniting fierce debates over California’s spending priorities as Governor Gavin Newsom defends his longstanding commitment to providing subsidized healthcare for undocumented immigrants, even as the state grapples with a staggering $20 billion budget shortfall for the 2025–26 fiscal year.
The clip, originally from 2007, shows then–San Francisco Mayor Newsom proudly announcing the launch of Healthy San Francisco, a groundbreaking program designed to offer low-cost or free healthcare to uninsured adults in the city — explicitly including undocumented residents. “This is about making sure everyone in our city has access to basic care,” Newsom said in the video, crediting the initiative’s funding to a mix of local business taxes, city general funds, and partnerships with local hospitals.
The program, which now serves tens of thousands annually, was hailed at the time as a model for universal coverage and later inspired similar efforts nationwide.
Fast forward to today, and California’s embrace of such policies has only deepened. Under Newsom’s governorship, the state expanded its Medi-Cal program — the nation’s largest Medicaid system — to cover roughly 700,000 undocumented adults by the end of 2024. This expansion, phased in over several years, comes with a hefty price tag: an estimated $3.1 billion annually from state coffers alone, according to the California Department of Health Care Services.
Proponents, including public health experts and immigrant rights advocates, argue that the investment pays long-term dividends. “By providing preventive care, we’re slashing costly emergency room visits and curbing the spread of communicable diseases,” said Dr. Elena Ramirez, policy director at the California Health Care Foundation. Studies from the early years of Healthy San Francisco support this claim, showing a 20% drop in ER overcrowding and improved chronic disease management among participants.
Yet, as the video circulates anew on platforms such as X and TikTok, it’s fueling a wave of criticism from fiscal conservatives and frustrated taxpayers. “Why are we footing the bill for non-citizens while our schools crumble and roads fall apart?” one user tweeted, echoing a sentiment shared by thousands in recent days.
The timing couldn’t be worse: California’s Legislative Analyst’s Office projected a $20 billion deficit earlier this month, driven by sluggish economic growth, overestimated tech revenues, and ballooning costs for housing and homelessness programs. Critics, including Republican lawmakers, cite the Medi-Cal expansion as emblematic of misplaced priorities. “This is Sacramento’s elite virtue-signaling at its finest — $3 billion for illegals when Californians are fleeing the state in droves,” said Assemblyman Vince Fong, a Bakersfield Republican eyeing a 2026 gubernatorial run.
Newsom’s office pushed back swiftly, framing the policy as both a moral and economic imperative. In a statement released Thursday, the governor’s spokesperson emphasized that undocumented immigrants contribute billions in taxes while lacking access to many federal benefits — and that healthcare investments yield broader societal gains. “Governor Newsom has always believed health is a right, not a privilege — and data proves these programs save money in the long run,” the statement read.
Supporters rallied online under hashtags such as #HealthForAllCA, sharing testimonials from families who credit Medi-Cal with preventing medical bankruptcies.
The controversy comes at a pivotal moment for Newsom, who has been positioning himself as a national Democratic leader amid President Kamala Harris’s second term. With midterm elections looming and whispers of a potential 2028 presidential bid, the governor faces pressure to balance progressive ideals with fiscal restraint. Last week’s state budget revision already slashed funding for wildfire prevention and education — moves that drew bipartisan ire.
As one Democratic strategist put it anonymously, “Gavin’s heart is in the right place, but optics matter — especially when every dollar feels like a battle.”
Whether this flare-up will force a policy rethink remains unclear. For now, Healthy San Francisco continues to serve patients from all walks of life across the Bay Area. As Newsom reflected in the old video, “We’re not just patching wounds — we’re building a healthier future.”
In deficit-plagued California, that future feels more precarious than ever.
