What is Changing for Public Programs?

Written By Fedieson Landicho

What’s in this post:

Medi-Cal (Medicaid)

Medi-Cal provides free or low-cost health coverage to Californians with low income. Between 2026 and 2027, federal and state policy changes will introduce new requirements for adults, older adults, and certain immigrant groups.

New Rules for Adults (19–64)

Effective January 1, 2027, new federal law (H.R. 1) requires adults who receive Medi-Cal through the “Expansion” group (based on income) to meet a work requirement to keep their health insurance.

Your county Medi-Cal office will send you a letter to let you know if you must comply with work requirements, or if other information is needed from you to demonstrate that you meet one of these exemptions.



Who is NOT required to meet work rules?

The following groups are automatically excused from the 2027 Medi-Cal work requirements:

  • Children (0–18).

  • Older Adults (65 and older).

  • Pregnant people, including one year postpartum, regardless of birth outcome.

  • Parents with children age 0-13.

  • People with disabilities.

  • People with serious health or mental health conditions or substance use problems.

  • People who were released from jail or prison within the last 90 days.

  • People on Medicare Part A or Part B.

  • American Indians or Alaska Natives.

  • Former foster youth under age 26, who were in foster care on their 18th birthday.

80 Hour Requirement

  • Members must do one or more of the following:

    • Work at a job and get paid.

      • Earn at least $580 a month from working.

      • Be a seasonal worker (someone who only works during certain times of the year) and make an average of $580 a month over the last six months.

    • Be in a job training program (that helps you learn skills to get a job) for at least 80 hours per month.

    • Volunteer or do community service for at least 80 hours per month. This should be organized and something you can prove you did with a letter or form.

    • Go to school at least half-time. This usually means taking two or three classes or about six to eight credits each semester.

    • Do a mix of the things listed above for a total of at least 80 hours per month, or at least $580 per month.

  • If you are required to work or volunteer under these new rules and do not meet the rules, you could lose your Medi-Cal.

  • When you get a letter from Medi-Cal, open it right away and respond quickly to show how you are meeting the work rules.

  • Medi-Cal will send more information before this rule starts, including ways to help you meet the rules.

Six-Month Eligibility Checks

Starting January 1, 2027, Medi-Cal members who are Adults (age 19-64) who receive Expanded Medi-Cal, which uses Modified Adjusted Gross Income (MAGI), will have their eligibility checked twice a year instead of once.



WHO WILL CONTINUE WITH ONCE A YEAR RENEWALS:

  • Members in a Non-MAGI Medi-Cal program (e.g. aged 65+, blind, disabled, etc.)

  • Pregnant or postpartum individuals

  • Alaska Native or American Indian members

  • Former foster youth under age 26, who were in foster care on their 18th birthday



Reduced Retroactive Coverage

Medi-Cal will only pay for 1 month of past medical bills (previously 3 months) for new applicants who are Adults (age 19-64) without children (0-18). If this applies to you, Medi-Cal will send you a letter. For all others, Medi-Cal will pay for two months of past bills

Copayments

Starting October 1, 2028, some adults on Medi-Cal may have to pay a small fee (called a copayment) for certain services.



THIS APPLIES TO Medi-Cal Members who:

  • Are adults (age 19-64), and

  • Are not pregnant, (Pregnancy coverage lasts through your whole pregnancy and up to one year after it ends.) and

  • Are not on Medicare, and

  • Make more than $15,560 a year.



Changes for Older Adults & People with Disabilities

Starting January 1, 2026, when you apply for or renew your Medi-Cal, the government will look at what you own. This is called an asset check. Assets are things you own that have value.

You may be affected if you:

  • Are age 65 and older and meet the household income limit for Medi-Cal.

  • Have a disability (physical, mental, or developmental).

  • Live in a nursing home.

  • Are in a family that makes too much money to qualify under federal tax rules.

Asset Limit Test

  • The most you can own (asset limit) is $130,000 for one person.

  • You can add $65,000 for every extra person in your family. The maximum is 10 people.

  • Assets that count include:

    • Bank accounts

    • Cash

    • More than one house or vehicle

  • Assets that don’t count include:

    • The home you live in

    • One Vehicle

    • Household items

    • Some savings, like retirement accounts

  • If you have Medi-Cal that requires an asset test, we look at what you own every year when you renew.

  • The income rules for Medi-Cal have not changed.




Adult Immigrant Coverage Updates

Federal and state policy shifts have introduced new restrictions and costs for non-citizens ages 19 and older.

Enrollment Freeze

Starting January 1, 2026, some adults will no longer be able to sign up for full-scope Medi-Cal coverage based on their immigration status.

  • If you already have full-scope Medi-Cal, you can stay covered no matter your immigration status.

  • To keep your Medi-Cal, you must:

    • Fill out your renewal form as required

    • Meet Medi-Cal eligibility rules (like income and living in California)

  • Renew your benefits on time.

  • If your Medi-Cal ends, you will have a three-month grace period from the last date of eligibility provided on your Notice of Action, to reenroll into full scope Medi-Cal.

If you do not re-enroll by the end of the three-month grace period, you must reapply for Medi-Cal. You will be eligible only for restricted scope Medi-Cal, which covers:

  • Emergency care

  • Pregnancy-related care

  • Nursing home care

Who can still get full-scope Medi-Cal, regardless of immigration status:

  • Children (age 0-18)

  • Pregnant people through the whole pregnancy and up to one year after it ends

  • Former foster youth under age 26, who were in foster care on their 18th birthday





Dental Coverage

Starting July 1, 2026, some Medi-Cal members will stop getting full-scope dental services as part of their Medi-Cal coverage. Please see these Frequently Asked Questions for more information. See Immigration Status Categories chart to see if you are subject to changes to Dental Coverage.

  • You can still get care for emergency dental needs, including:

    • Serious tooth pain

    • Infections

    • Tooth extractions

  • You will also get full-scope dental if:

    • You are a former foster youth under age 26 who was in foster care on your 18th birthday, or

    • You are pregnant (and you will get it for one year after your pregnancy ends)





Immigration Status Changes

Starting October 1, 2026, the federal government will change how it classifies some immigration statuses (your legal standing in the U.S. based on how and why you came here). Details on how this policy will be implemented in California will be available soon.

You may be affected if you get Medi-Cal and are:

  • A refugee or asylee – someone who left their home country for safety and don’t yet have a Green Card

  • A humanitarian parolee – someone allowed into the U.S. for urgent reasons for at least one year

  • A survivor of domestic violence or human trafficking, and you have a pending status

Monthly Premiums

Starting July 1, 2027, Medi-Cal Members without satisfactory immigration status (SIS) receiving full-scope Medi-Cal will need to pay a small monthly fee (called a premium) to keep their full-scope Medi-Cal. See Immigration Status Categories chart to see if you must pay Monthly Premiums.

  • If this change applies to you, you will need to pay a small fee each month to keep your full Medi-Cal.

  • If you don’t pay, your Medi-Cal will be changed to restricted scope Medi-Cal.

  • You will only get restricted Medi-Cal, which covers:

    • Emergency care

    • Pregnancy-related care

    • Nursing home care

You will not have to pay a premium if you are:

  • A former foster youth under age 26 and were in foster care on your 18th birthday, or

  • Pregnant, and for one year after your pregnancy ends.





How to Prepare

6-Month Renewal Requirement

Starting in 2027, many adults will need to renew their Medi-Cal twice a year. Missing a renewal letter is the #1 reason people lose coverage.

Update your contact info at BenefitsCal.com today.

Keep Your Information Current:

Affected members will get letters by mail, text, or email. Make sure to keep yourMedi-Cal information updated so you don’t miss important notices.

Check Your Mail:

Be sure to read any notifications you receive from the County. Watch your mail and respond quickly to Medi-Cal renewal packets or letters from your health plan or local county Medi-Cal office. With 6-month renewals, missing one letter could end your health and food benefits.

Know Your Renewal Date:

Know your renewal date so you can renew your Medi-Cal online or work with your local county Medi-Cal office if you do not receive notifications.

Report Changes Quickly:

If you become pregnant, get a new job, or experience a health change, tell the County immediately because this may exempt you from work requirements.

Apply Early:

Because “Retroactive Coverage” is being cut from 3 months to 1, waiting to apply after an injury could leave you with thousands in unpaid bills.

Continue to Seek Care:

Keep going to the doctor and other medical appointments, and ask about available telehealth services.

Ask Questions!

Ask questions if you’re unsure.

Follow Updates

Visit the DHCS website and follow DHCS, the County, and 211 San Diego on social media.





Information Resources

California Department of Healthcare Services (DHCS) Medi-Cal Changes Overview

DHCS Facebook, DHCS LinkedIn, DHCS Instagram

County of San Diego (COSD) X,COSD Facebook

County of San Diego Health & Human Services Agency (HHSA) X, COSD HHSA Facebook,COSD HHSA Instagram





Fedieson Landicho
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