States and health plans are mobilizing emergency outreach efforts to help low-income residents maintain healthcare coverage as federal budget cuts to Medicaid and food assistance programs take effect. California’s Medi-Cal system faces particularly severe impacts, with up to 3.4 million recipients potentially losing benefits and new work requirements and eligibility restrictions coming in 2027.
Federal Cuts and Their Scale
The One Big Beautiful Bill Act cuts more than $900 billion in federal Medicaid funding and slashes around $187 billion from the Supplemental Nutrition Assistance Program—approximately 20 percent of the program’s budget over the next 10 years. As a result, up to 3.4 million Medi-Cal recipients and almost 400,000 CalFresh beneficiaries could lose benefits, with most CalFresh beneficiaries also receiving Medi-Cal. Republican representatives argue the changes will prevent waste, fraud, and abuse through expanded eligibility checks and work requirements.
State and Health Plan Response
CalOptima, one of about two dozen Medi-Cal managed-care plans paid monthly based on enrollee numbers, allocated up to $2 million through the end of 2028 to fund county eligibility workers at events like food distributions. The organization launched a $20 million campaign to help low-income residents get and maintain health coverage and food benefits. At a November event in Orange County, more than 3,000 people attended a CalOptima gathering offering free groceries and on-site assistance with benefit applications. Similar efforts are underway nationally: L.A. Care Health Plan launched community information sessions in Los Angeles County, Hawaii’s AlohaCare mobilized a COVID-era coalition, and Community Behavioral Health in Philadelphia plans hosting summits.
Orange County, which serves around 850,000 Medi-Cal members and over 300,000 CalFresh recipients, employs about 1,500 eligibility workers to handle reenrollments and verification checks. An Tran, Orange County’s Social Services Agency head, noted that CalOptima’s funding supports “critical outreach the county otherwise wouldn’t be able to afford,” particularly crucial given high food costs and inflation.
Immigration Status and Additional Barriers
California is simultaneously rolling back benefits for immigrant enrollees. Starting July, the state will eliminate full-scope dental benefits for some enrollees who have had a green card less than five years, with monthly premiums beginning a year later. Beginning in January, California froze enrollment for people 19 or older without legal status and some lawfully present immigrants. The state also reinstated an asset limit for all older enrollees.
Federal work rules and twice-yearly eligibility checks are slated to take effect by the start of 2027, applying to enrollees under the Affordable Care Act coverage expansion. People considered physically or mentally unable to work can be exempted. Carmen Basu, a Medi-Cal recipient and sole family breadwinner after her husband suffered a stroke, expressed concern about eligibility changes for her immigrant mother-in-law: “Before having a green card, we were paying cash for cardiology, for labs, everything. It was very pricey. I’m thinking I will have to pay out-of-pocket again. It’s a burden.”
This article is an AI-assisted summary. All facts and figures are drawn from the original report: https://www.postandcourier.com/health/medicaid-federal-cuts-california-health-coverage/article_7ede5329-b3c3-4d7d-ac1d-04161616682c.html