Latino Californians awash in medical debt amid sweeping cuts to health care

The Weekly Dispatch

Community-powered immigration news from the Bay Area.

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Welcome to El Tímpano’s Weekly Dispatch. I’m Erica Hellerstein, senior immigration, labor, and economics reporter.

Much has been written about California’s affordability challenges. Sky-high housing costs, record-breaking food inflation, soaring gas prices, and spiking energy bills are routinely invoked as the primary sources of the Golden State’s cost of living crisis. 

But there’s another expense that’s quietly imposing severe financial hardship on households across California, even though it rarely gets the same level of attention as groceries, gas, or rent. That’s the rising cost of health care. While increasing health care costs are a source of economic and psychological distress for Californians of all stripes, they appear to be causing uniquely severe financial hardship for Latinos. 

That’s according to a recent report by the California Health Care Foundation, which polled more than 2,500 adults across the state about the affordability of health services and how they are coping with rising costs of medical care. [Disclosure: The California Health Care Foundation is one of El Tímpano’s funders. This does not influence our reporting or analysis.] Researchers polled respondents in English, Spanish, and Chinese, and asked their racial identity. Anyone who identified as Latino, whether surveyed in English or Spanish, was placed in that demographic grouping. However, some of the data shows small percentage differences between Latino and Spanish-speaking interviewees, likely because not all people who took the survey in Spanish identified as Latino.

The findings were stark. On numerous metrics, California’s Latino and Spanish-speaking populations are faring worse than other demographic groups. They’re struggling to keep up with the cost of care, cutting back on essentials like groceries to pay their health bills, and buckling under the weight of medical debt.

As Kristof Stremikis, California Health Care Foundation’s director of market analysis and insight, put it:  “We’re in crisis territory.”

The organization has polled California residents about their experiences affording health care on a semi-annual basis since 2019, and “this is as bad as we’ve ever seen it,” Stremikis said. “These affordability challenges are serious and pronounced across the state for everyone, and they’re particularly bad for folks that are Latino or took this survey in Spanish.”

Skyrocketing costs lead to delayed care and debt

The 60-plus page report paints a bleak picture for all Californians, but especially Latinos and Spanish-speaking respondents, who are disproportionately struggling to meet their health care expenses compared to other racial and ethnic groups in the state. 

These populations are more likely to report that it is difficult for themselves or their family members to pay for health care than Californians of other races or ethnicities or interviewees polled in English and Chinese. Nearly half of Latinos polled have medical debt, and are more likely to report having trouble affording dental care, primary care, mental health care, and treatment for substance use than other racial or ethnic groups. 

67% of Latino Californians, and 71% of those polled in Spanish, said they delayed or skipped medical care over the past year due to cost, compared to 57% of Asian, 43% of Black, and 54% of White respondents. 40% of Latinos said they delayed buying groceries or household necessities to pay for their health care bills, nearly double the percentage of White, Asian, and Black Californians who were polled. 

Almost 50% of Latino Californians said they are carrying some sort of medical debt, significantly higher than White, Asian, and Black Californians. Nearly 60% of Latinos polled with medical debt said it came from dental care, which has been a significant barrier for this population compared to other demographic groups. Half reported difficulty affording  dental care, compared to 39% of Californians overall.

The report only included statewide figures by race, ethnicity, and language, and was unable to provide a regional breakdown of how Latinos are experiencing affordability challenges. However, the cost of health care has been a persistent challenge for members of El Tímpano’s SMS community. Subscribers have shared questions, concerns, and stories about their difficulties accessing and paying for medical care, as well as their increased anxiety due to unexpected medical costs.

One audience member, based in Oakland, shared: “I’ve never had health insurance. I am currently paying off a $6,000 bill. I tried to get coverage, but I was told I don’t qualify, and I am struggling to make the payments.”

Affordability worsens as both state and federal government roll back access to health care

The report did not provide an explanation for why Latinos appear to be faring worse on health care-related payment and access than other races or ethnicities and non-Spanish speakers. However, it’s possible that these outcomes are worsening due to recently enacted policy changes that have exacerbated health care access and affordability challenges. 

Chief among these policy changes is the federal government’s One Big Beautiful Bill Act (H.R. 1), which became law in July 2025. The legislation enacted sweeping cuts to Medicaid, the joint federal and state program that provides health coverage to tens of millions of low-income Americans. The California Budget & Policy Center has estimated that the bill will cut roughly $30 billion a year in federal funding from Medi-Cal, California’s Medicaid program, and strip health coverage from up to 2 million Californians.

That’s on top of recent cuts on the state level that have significantly reduced access to health care for immigrants living in California. In last year’s budget, California lawmakers enacted a number of changes that scaled back the state’s landmark health coverage program for undocumented immigrants, including an enrollment freeze that went into effect in January. Gov. Gavin Newsom’s proposed 2026–27 budget would build on those cuts, imposing federal work requirements on undocumented adults who receive state-funded Medi-Cal. The proposal would also effectively end full health coverage for an estimated 200,000 refugees, asylees, and survivors of domestic violence and trafficking who lost access to federally funded Medi-Cal under H.R.1.

These cuts may be making it harder for Latino Californians who have lost coverage to pay for care. As Stremikis explained, “access to insurance is the number one predictor of someone being able to go and get care that they need and be able to afford it.” Indeed, a study from the health policy nonprofit KFF has found that adults who are uninsured are more likely to delay or skip medical care because of cost and often face extremely high medical bills when they seek health services. This causes people without coverage to have higher rates of medical debt than those who are insured. 

As my colleague Vanessa Sánchez recently reported, Bay Area lawmakers introduced legislation in Sacramento in March to reopen Medi-Cal enrollment for undocumented immigrants. While the bill is still in the early stages, it shows that there is an appetite among California lawmakers to push back on cuts to immigrant health care at both the state and federal levels. Whether or not that will be reflected in the state’s final budget, as Newsom likely pursues a bid for the presidency, remains to be seen.

We’ll continue to keep track of these changes, especially the ways in which rising medical debt is affecting the Bay Area’s Latino and Mayan immigrant communities. As always, feel free to reach out to me at ehellerstein@eltimpano.org with any questions, tips, or reflections.

Thank you, see you next week.

Ear to the Ground

Hi, I’m Vanessa Flores, El Tímpano’s community reporter. El Tímpano’s text messaging (SMS) service reaches more than 6,500 Spanish-speaking immigrants across the Bay Area. Over the years, community members have shared concerns about the challenges they face with medical costs and accumulating medical debt. “I have a debt of $8,000. I went to the emergency room, but I don’t have medical insurance,” a subscriber in Oakland texted in December. “What can I do to reduce the debt?” he asked.

Our SMS subscribers have consistently asked for resources to help them navigate high-cost medical care, and they’ve shared how medical costs have directly affected their families’ financial stability, with some reporting that medical bills strain their budgets or leave them with no way to pay them. 

In December, the same Oakland subscriber told us that he had visited the emergency department at San Leandro Hospital because he was having trouble breathing. “I’m still afraid to go back to the hospital because of that debt,” he said. 

From the El Tímpano Newsroom

El Tímpano’s Vanessa G. Sánchez brings you the story of how a provision in the GOP’s One Big Beautiful Bill Act will make an estimated 100,000 lawfully present immigrant seniors ineligible for Medicare. The was story produced in collaboration with KFF Health News and NPR

Immigrant seniors lose Medicare coverage despite paying for it

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