California is taking important steps to broaden affordable options for undocumented immigrants, who comprise a substantial share of uninsured state residents. The state will soon extend Medi-Cal coverage to undocumented children and already provides it to some low-income undocumented immigrants. Future options may include comprehensive Medi-Cal and unsubsidized access to Covered California, the state’s health insurance exchange. Without coverage, California's undocumented adults will continue to rely on county indigent programs and safety net services adding pressure to these local entites.