The state immigrant-coverage rollback is now a national wave: Minnesota and Illinois ended programs, Washington froze, DC is phasing out, Colorado capped — and California's freeze fits the pattern

What looked like isolated state decisions is now a coherent national retreat from state-funded immigrant health coverage, driven by H.R. 1 fiscal pressure and the threat of FMAP penalties for states covering barred populations.

The inventory: Minnesota ended MinnesotaCare for undocumented adults January 1, 2026 (~57,000 people); Illinois ended HBIA (ages 42-64, ~30,000) in July 2025 and capped its seniors program; Washington's Apple Health Expansion hit its 13,000 cap and froze in December 2025; DC blocks Healthcare Alliance re-enrollment for adults 26+ and eliminates eligibility for 21+ by FY2028 (~26,000 covered, ~$12.4M/yr FQHC revenue); Colorado capped Cover All Coloradans at 25,000 children and slashed OmniSalud from ~12,000 to ~6,700 subsidized adults; and California froze new Medi-Cal enrollment for undocumented adults in January 2026 with the dental benefit ending July 1.

Oregon's Healthier Oregon (100,000+ covered) survives but faces a ~$400M/yr federal penalty risk. Only a handful of states — MA, CT, RI, NM — are holding. For health centers the pattern is the point: these patients don't disappear, they reappear as self-pay sliding-fee visits, and the centers with the largest immigrant panels take the revenue hit in proportion to their mission.