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Adults in California with what the state calls “unsatisfactory immigration status” face a major change to their health coverage in the new year.

Health centers in Sonoma County are urging eligible immigrants to sign up for Medi‑Cal before the Dec. 31 deadline.

California immigrants can still apply for full‑scope Medi‑Cal coverage, but after Dec. 31 enrollment will close.

The change could affect tens of thousands of Sonoma County residents. It applies not only to undocumented immigrants, but also to DACA recipients, people on temporary visas and green card holders who have not yet met the five‑year wait.

Pedro Toledo, chief executive officer of Petaluma Health Center, said local health centers are bracing for a rise in emergency room visits. He worries that could lead to life‑or‑death delays in an already crowded system.

“Every moment counts when you’re having a heart attack or a stroke, and having a busy emergency room with these avoidable conditions can lead to delays in care,” Toledo said.

He urged families with teens turning 17 or 18 who lack qualifying immigration status to apply before the deadline.

Income‑eligible children under 18 and pregnant people can still enroll after Jan. 1 regardless of immigration status.