Major changes are coming to Medicaid in California, and they could impact 3.4 million residents who rely on the program for essential health care. Known locally as Medi-Cal, California’s version of Medicaid is facing a potential funding cut that could shake the foundation of health coverage for low-income adults across the state.
This isn’t just a budget shift—it’s a policy transformation that could leave millions at risk of losing access to care. If you live in California and depend on Medi-Cal, here’s what you need to know.
Support
Social support programs like Medicaid are designed to level the playing field. They offer a safety net that ensures access to essential resources—from health care and food to housing and education. By helping vulnerable communities, they aim to break the cycle of poverty and promote long-term economic and social stability.
Medicaid, alongside other programs like SNAP (food stamps), plays a key role in that mission. While SNAP helps with groceries, Medicaid offers a lifeline in the form of health care. Both programs are federally funded, but each state manages them independently, meaning rules, eligibility, and benefits vary across the country.
Equality
Why do these programs matter so much? Because they help remove barriers for people who would otherwise be left behind—families with children, the elderly, people with disabilities, and low-income workers. They’re more than just handouts; they’re tools of empowerment that give people a chance to live with dignity.
In California, Medi-Cal has long been one of the largest and most progressive Medicaid programs in the U.S., covering millions of residents, including undocumented children and pregnant women. But a recent shift in federal policy could change that landscape drastically.
Change
The change comes with the passage of what’s being referred to as the “One, Big, Beautiful Bill”, which could lead to massive cuts in federal funding to California’s Medi-Cal program—up to $30 billion.
Unless the federal government grants an extension, starting January 1, 2027, California will begin enforcing new eligibility requirements. This could result in up to 3 million adults losing their Medi-Cal coverage.
Here’s the critical requirement:
Adults ages 19 to 64 will need to prove they work, are looking for work, or are in job training for at least 80 hours per month to keep their Medi-Cal benefits.
That’s a significant shift from current rules, which focus more on income levels and household size. And it’s a change that could disproportionately affect low-income individuals, single parents, part-time workers, and those in unstable employment situations.
Who
So, who still gets to keep their benefits under the new legislation?
According to Tyler Sadwith, California’s Medicaid director at the Department of Health Care Services (DHCS), certain groups will remain protected regardless of the new work requirements:
- Children
- Pregnant individuals
- People of any immigration status in those two categories
These groups will continue receiving Medi-Cal coverage, even if the new rules go into effect. That’s an important safeguard—but it still leaves millions of adults at risk.
Despite the challenges, Sadwith also emphasized that no one should cancel their Medi-Cal coverage or assume they’re automatically losing it. The state is working on solutions.
Support
California isn’t sitting still. While these federal cuts are looming, the state is launching its own programs to soften the blow.
One key initiative is the Family First Economic Support Pilot (FFESP). This pilot program gives $725 per month for a year to selected residents as part of a guaranteed income experiment. It’s one of several programs aimed at looking into new ways to support vulnerable families beyond traditional assistance.
California also continues to invest heavily in Planned Parenthood and reproductive care, with a $305 million allocation over 12 months starting July 4, 2025.
So while federal funding may shrink, the state appears committed to finding alternative solutions.
Future
What does this all mean if you live in California?
- Don’t panic, but stay informed.
- Review your Medi-Cal eligibility now to prepare for potential changes.
- Track work or training hours if you’re between 19–64 and might need to meet the new requirements.
- Stay enrolled in the program until you’re officially told otherwise.
- Look into local support programs, including county-based services and pilot projects like FFESP.
Medicaid is changing—but not disappearing. If anything, these changes reflect a shift in how safety nets are being managed, both federally and at the state level.
FAQs
Who may lose Medi-Cal in 2027?
Adults aged 19–64 who don’t meet work or training hour rules.
How many could lose coverage?
Up to 3 million Californians may lose Medi-Cal benefits.
Who keeps Medi-Cal coverage?
Children and pregnant people, regardless of immigration status.
What’s FFESP in California?
A pilot giving $725 monthly to test guaranteed income support.
What’s the new Medi-Cal rule?
You must work, train, or job-hunt 80 hours/month to qualify.
