Medi-Cal: What’s New and Why?

By Oluwadara Aina and Smiraa Misra

With the passage of the “One Big Beautiful Bill mid-2025, a key provision was that Medicaid spending would be cut by a whopping 15%. While Medicaid is a joint state and federal program, the federal government has control over general rules that all state Medicaid programs must follow, even though each state runs its own program (US Department of Health and Human Services). In California, the program is Medi-Cal. This loss of federal funding alongside inner-state conflict regarding California's huge budget deficit of $12 billion and the multi-billion overspending of the previous year’s agreed budget has directly led to a massive overhaul of who qualifies for Medi-Cal benefits–one that is far more restrictive.

The changes began on January 1st, 2026, where Medi-Cal now considers assets, or what someone owns, when reviewing eligibility for older adults (65+) and people with disabilities or long-term care needs (California Department of Health Care Services, DHCS). The asset limit per person is $130,000, and each additional household member adds $65,000. Notably, the house you live in, one vehicle, household items, and certain savings (like retirement accounts) are not included in the asset limit (DHCS). 

Also in January, Medi-Cal froze new enrollments for those who don’t have satisfactory immigration status, or SIS, for full scope Medi-Cal–even if they qualified before under other state-funded programs. This includes Californians 19 and older, who are not pregnant, who are undocumented, and who qualified for full scope Medi-Cal because of state-funded Adult Expansions (DHCS). 

Starting later, in July 2026, dental benefits will no longer be provided to adult Medi-Cal members who do not have SIS–which includes people enrolled through trafficking or crime victim assistance programs. Emergency dental care, like treatment for severe pain or tooth extractions, will still be covered for everyone. Full dental benefits will also be provided for pregnant members during their pregnancy and for 1 year after, even if they do not have SIS.

The final major change starting July 2027 is a monthly premium of $30 on full scope Medi-Cal for Californians aged 19 to 59 who don’t have SIS but were previously enrolled in full scope Medi-Cal and still are eligible under past non-state funded Expansions. Full scope Medi-Cal includes preventative care, prescription drugs, mental health care, substance use disorder treatment, vision care, immunizations, and reproductive health services. If their premium is unpaid, their coverage will be reduced to only emergency and pregnancy-related services. 

Fortunately, most individuals who were previously insured are able to retain their status, as long as they keep up with annual renewals and required documentation. However, a key cornerstone of these changes remains a smaller eligibility pool under the new classification of “Satisfactory Immigration Status.”

But what exactly is SIS, and what does it mean for undocumented citizens? According to the California Department of Health Care Services (DHCS), SIS is applied to individuals with US citizenship, Lawful Permanent Residents (Green Card holders who have met the five year waiting period), Refugees, and Asylees. Unsatisfactory Immigration Status (UIS) is defined by any individual without SIS, including undocumented immigrants, DACA users, and US Visa Holders. The term “UIS” casts a wide net, essentially preventing anyone without citizenship, green card, or asylum from accessing low-barrier health care services. Already fraught with provider shortages and complex enrollment processes that make it difficult to utilize, these new changes to Medi-Cal will only worsen healthcare disparities for low-income and undocumented individuals; especially in the case of unhoused, undocumented individuals, who already have limited access to government services and aid. Without proper safety nets like Medi-Cal, health outcomes will only continue to decline, as more unhoused individuals who are undocumented avoid seeking healthcare services due to lack of coverage. In a city like Los Angeles, with large unhoused and undocumented populations, many of the people in these communities will be severely affected by these changes.

Country-wide, many states have seen current rolling back of progressive policy, an alarming trend that has solely targeted underserved and under-resourced communities. Now the wave has reached California, a state that has prided itself on championing progressiveness and protecting marginalized people, now rolling back protections in the name of a deficit. As new policies continue to restrict government resources, we must ensure the safety of our communities by constantly engaging with mutual aid networks focused on building strong networks through solidarity and equity, supporting neighbors in need, and keeping our elected officials accountable through voting. Though harmful policies like these are wide-reaching, citizens can use their collective power to stand up for undocumented populations through intentional community involvement and electoral engagement through voting.