Up to two million Californians could lose Medi-Cal coverage as new federal requirements take effect — including work mandates, more frequent eligibility checks, and restrictions on immigrant coverage.
The state has options, but none are simple. Each involves trade-offs between cost, access, and the scope of benefits.
Two Care Alternatives
This analysis examines two illustrative state options for people losing Medi-Cal, with estimated annual costs ranging from $3.1 billion to $4.6 billion — compared to $6.7 billion for a full Medi-Cal equivalent. The options differ on benefits, cost sharing, provider payment rates, and how long bridge coverage lasts after someone loses eligibility.
Why It Matters Now
California reduced its uninsured rate significantly over the past decade, driven largely by the Medi-Cal expansion. Federal and state policy changes now threaten to reverse that progress.
Without a state response, the cost of caring for those who lose coverage will not disappear. It will shift to emergency departments, safety-net providers, and county programs — often with unequal access and at greater expense. This analysis outlines options for state policymakers weighing how to provide Californians with health care.
