California’s Medi-Cal program will impose stricter eligibility rules and reduced benefits beginning in 2026, according to the California Department of Health Care Services (DHCS). The changes will roll out through 2028. According to CalMatters, they follow federal Medicaid budget cuts tied to the OBBBA tax law signed in July 2025 by President Donald Trump, which reduced funding by about $1 trillion over ten years.
Starting January 1, 2026, applicants and renewing members who are 65 or older, disabled, or living in nursing homes will face asset testing. The limit is $130,000 per individual, with an additional $65,000 allowed per household member, up to ten people. Countable assets include bank deposits, cash, and real estate other than a primary residence, as well as vehicles beyond one primary car. Exempt assets include a primary home, one vehicle, household goods, savings accounts, and retirement plans.
From the same date, undocumented immigrants over 19 will no longer be eligible for new Medi-Cal enrollment. Current beneficiaries may keep coverage if they renew on time. If the renewal deadline is missed, they can correct it within 90 days. After that, only limited Medi-Cal—emergency care, maternity and childbirth support, and nursing home treatment—will be available. Children under 19 and pregnant women are exempt.
On July 1, 2026, dental benefits will be scaled back. Adults will still receive treatment for severe pain, infections, and extractions, but non-emergency dental services will be cut. Pregnant women and women within one year postpartum will retain full dental benefits.
Beginning January 1, 2027, applicants and members aged 19 to 64 must meet work-related requirements. They must either earn at least $580 per month, complete 80 hours of job training or volunteer service monthly, or be enrolled for at least half a semester in school. Exemptions include pregnant women, women within one year postpartum, parents of children under 13, disabled and chronically ill individuals, recently released inmates within 90 days, Medicare recipients, Native Americans, and young adults under 26 raised in foster care.
For childless adults ages 19 to 64, eligibility renewal will change from once to twice yearly. Missing deadlines or failing to submit required documents could result in loss of benefits. Coverage of past medical expenses will also shrink: currently up to three months are covered, but from 2027, childless adults will be limited to one month, while others will be capped at two months.
Starting July 1, 2027, Medi-Cal members aged 19 to 59, except pregnant women, must pay a $30 monthly fee. Nonpayment will reduce access to only emergencies, maternity care, and nursing home services.
From October 1, 2028, Medi-Cal members aged 19 to 64, excluding pregnant women and Medicare recipients, with annual incomes above $15,560 will pay copayments for certain services, including specialist visits and some treatments or diagnostic tests. Copayments will not exceed 5% of household income per year. Exempt services include community health center visits, emergency care, preventive checkups, prenatal care, and treatment for mental health and substance abuse.
BY KYEONGJUN KIM [kim.kyeongjun1@koreadaily.com]
