What the Data Tell Us About the 730,000 Californians Who Have Left Medi-Cal

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Medi-Cal enrollment declined by approximately 5%, or 730,000 people, between June 2025 and March 2026. Enrollment fell from 14.78 million to 14.05 million, according to recent data from the California Department of Health Care Services and published in CHCF’s Medi-Cal Enrollment Tracking Tool. The pace of decline accelerated in the first quarter of 2026.

Here’s what the data tell us at this point — and what they don’t.

Enrollment Trends Resemble COVID Unwinding

Overall Medi-Cal enrollment has been in decline since May 2023, when the state began “unwinding” COVID-era policies that prohibited states from disenrolling anyone. After the initial 12 months of the unwinding, enrollment falloff slowed.

Starting in the summer of 2025, disenrollments started to pick up again at an accelerating rate. Of the 730,00 disenrollments between June 2025 and March 2026, over half (378,000) occurred in the first quarter of calendar 2026. The kind of drops we saw by March 2026 are approaching the enrollment losses at the height of the COVID unwinding. If annualized, the pace of first quarter change would translate to a decline of 1.5 million enrollees, about 10% of the Medi-Cal population.

Steep Disenrollments for Undocumented Young People

In recent years, undocumented Californians with low incomes have been eligible for full-scope Medi-Cal. However, last summer California froze new enrollment among undocumented adults effective in 2026. Undocumented adults enrolled prior to 2026 were allowed to stay in the program, although they will have to pay a monthly premium starting in 2027.  

Between June 2025 and March 2026, the number of undocumented Medi-Cal enrollees declined 15%, or 244,000. The largest decline in absolute terms was among undocumented adults ages 26 to 49, or128,000 enrollees. On a percentage basis, undocumented children and young adults were hardest hit. Enrollment dropped 20%, or 44,000, among undocumented kids and 22%, or 33,500, among young adults.

State and federal policy changes adopted last year, combined with ongoing fear of immigration raids and Medicaid data sharing for federal immigration enforcement may be driving some undocumented Californians out of Medi-Cal, including many who may still technically be eligible. These fears are likely to increase with the September implementation of the new federal public charge rule.

Other Factors Driving Overall Medi-Cal Declines

While the declines among undocumented enrollees are substantial, they account for one-third of the overall Medi-Cal decline between June 2025 and March 2026. Medi-Cal shed about 500,000 other enrollees.

Some possible reasons for that include the following, although they are only hypotheses:

COVID-19 era flexibilities expired in July 2025. The move away from pandemic policies that made Medi-Cal verification and renewals easier and more efficient may mean fewer people are successfully enrolling or renewing coverage.

Fear within mixed-status households. More non-citizen parents may be disenrolling their citizen children for fear of immigration enforcement.

Job market and overall economic conditions. Some enrollees leave the program as they earn more money and no longer qualify.

Looking Ahead

Declines in Medi-Cal enrollment aren’t inherently a problem if people transition to other types of coverage. Tracking the uninsured rate, especially among Californians with lower incomes, will help us determine if that’s happening. The California Health Interview Survey will publish 2025 data on the uninsured this fall.

The size of recent enrollment declines and the over-representation of undocumented people and children is worrisome. Unfortunately, declines will intensify as H.R. 1’s main Medicaid provisions take effect in 2027.

We’ll continue tracking the numbers: The next update to our Medi-Cal Enrollment Tracking Tool is scheduled for early fall this year and will include data through July 2026.