California's decision to expand Medi-Cal, its Medicaid program, to cover undocumented migrants has led to significantly higher costs than expected. The program's price tag has soared to $9.5 billion this year—way over the $6.4 billion estimate from just last year—with $8.4 billion coming from state taxpayers. Meanwhile, in Illinois, Gov. J.B. Pritzker has proposed cutting $330 million from a similar healthcare expansion for the undocumented after a state audit showed costs ballooned to $1.6 billion since 2020, far exceeding the initial $220 million forecast. Both states are grappling with budget shortfalls, and while California's costs are driven by higher enrollment and expenses like pharmacy costs, Illinois faces issues with inaccurate projections and improper enrollment, with services for some groups exceeding initial projections by as much as 280 percent.
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