Health insurance is a hot-button topic affecting millions of Americans as the Trump Administration makes its way through its second term. On Aug. 11, American Community Media held a news briefing titled “What’s Changing in Medi-Cal: Work Rules, Renewals, and Benefits.” Experts from the Department of Healthcare Services (DHCS) discussed federal and state policy changes to Medi-Cal, California’s vision for Medicaid, and how Californians can maintain access to healthcare.
”We have heard that you know Medi-Cal is closing their doors to enrollment, no longer accepting new people into the program. That is obviously not true… the Medi-Cal program is still open for enrollment,” said Deputy Director for Health Care Benefits & Eligibility, DHCS, Yingjia Huang.
The key points of the discussion focused on upcoming federal updates to immigration status categories starting in October 2026, alongside new work and community participation rules launching in January 2027. January 2027 will also mark a significant shift, with roughly 2 million enrollees from managed care plans to traditional Medi-Cal fee-for-service. Also, eligibility reviews will occur twice a year for certain adults beginning on March 1, 2027, followed by new monthly premiums for select enrollees and adjustments to dental coverage beginning July 2027.
”What we are prioritizing at the state level is using all of the information that we have access to in our database and in other databases so that we can automatically determine if people meet the rule or if people are exempt… so that Medi-Cal members don’t have to take any action,” said State Medicaid Director, DCHS Tyler Sadwith.
Starting January 1, 2027, certain adults (ages 19–64 without disabilities or young children) must demonstrate work, volunteering, or school enrollment. These adults must earn at least $580/month, participate in qualifying activities for at least 80 hours/month, or a combination. Those who can be qualified as exempt are pregnant/postpartum individuals, parents/caretakers of children aged 0–13, people with disabilities, Medicare enrollees, American Indians/Alaska Natives, former foster youth, and recently incarcerated individuals.
”Specifically, members can meet this new federal requirement by working and earning at least $580 per month, participating in qualifying activities for at least 80 hours per month—such as volunteering, attending school at least half-time—or using a combination of those activities,” said Sadwith.
He continued, “What we are prioritizing at the state is using all of the information that we have access to in our database and in other databases so that we can automatically determine if people meet the rule or if people are exempt… so that Medi-Cal members don’t have to take any action.”
Certain federal immigration status reclassifications will limit some members (e.g., refugees, asylees, humanitarian parolees) primarily to pregnancy-related and emergency care starting July 1, 2027. Adults aged 19–59 with specific immigration statuses will be required to pay a 30–50 monthly premium to maintain full-scope Medi-Cal. Full-scope dental benefits for certain adults will be scaled back, leaving only emergency dental care covered for children under 19, pregnant individuals, and former foster youth.
”Your renewal packets will still come to you in yellow envelopes… so it’s very important if you do receive that yellow envelope from your county office that you open it quickly and make sure you fill out the packet of information and send it back to the county,” said Huang.
She continued, “If you were in full scope Medi-Cal prior to January 1st of 2026… you are what we call grandfathered into the program. If you don’t provide the additional documentation or the packet that comes to you, you will be moved into what we call emergency and pregnancy-related Medi-Cal, and you can no longer– even if you reapply–get the full scope package.” To watch the full briefing and receive more information, please visit www.americancommunitymedia.org or visit DHCS.ca.gov.
