By Anthony White, Vice President, Government & Community Affairs; and Moira Tan, Advocacy & Government Affairs Manager, TrueCare
Ongoing changes to Medicaid, Medicare, and the Affordable Care Act (ACA) at the federal level can affect up to 21.5 million Californians who rely on one or more of these programs for their health care coverage. That’s almost one in every two people in the state. You or someone you know is likely to face changes to their health care coverage starting now.
Below, we break down what’s new in Medi-Cal, Medicare, and Covered California, what’s ahead in 2026 and 2027, and how TrueCare can help you stay covered and cared for.
What to Do Now
Before diving into the details, take these immediate steps to protect your coverage:
- Check your mail, texts, and email regularly for messages from your health plan or county office.
- Update your address, phone number, and email with both your county Medi-Cal office and your health care provider to ensure you receive renewal and outreach notices on time.
- Act quickly if you receive a renewal or termination notice—deadlines are strict and missing them could interrupt your coverage.
Medi-Cal = Medicaid
- When you hear “Medicaid” on the news, think Medi-Cal, California’s version of the federal program providing coverage for low-income individuals and families.
- You might have Medi-Cal if you have one of the following plans: Blue Shield of California Promise Health Plan, Community Health Group, Kaiser Permanente Medi-Cal Managed Care Plan, Molina Healthcare of California, and Inland Empire Health Plan (IEHP).
Changes and dates to know
Medi-Cal requirements are tightening in 2026 due budget cuts and new federal laws, mainly H.R.1., or the “One Big Beautiful Bill Act.”
January 1, 2026:
- Adults aged 19+ who are undocumented or have Unsatisfactory Immigration Status (UIS) and are not pregnant will no longer be able to newly enroll in full-scope Medi-Cal.
- Current members must renew on time to stay covered.
- Seniors and people with disabilities will once again face asset limits for eligibility. TrueCare can help calculate your limits.
July 1, 2026:
- Full adult dental benefits will end for adults who are undocumented or have Unsatisfactory Immigration Status (UIS), except for emergency dental services.
- Pregnant individuals keep full dental coverage during pregnancy and for one year after.
January 1, 2027:
- Renewals for adults ages 19–64 will now occur twice per year instead of annually.
Exemptions:
- Adults with incomes up to 100% of the Federal Poverty Level ($15,650 for single person)
- Adults with children aged 19 or under in the same household
- Work requirements begin for Medicaid expansion adults which means 80 hours per month of work, school, volunteer service, or community engagement will be required to maintain coverage.
Exemptions:
- Parents or caregivers with children under 14
- People who are medically frail, pregnant, postpartum, or have disabilities
- Certain hardship or short-term exceptions
- Retroactive Medicaid and CHIP coverage will be shortened from three months to one month before application.
July 1, 2027:
- Adults who are undocumented or have Unsatisfactory Immigration Status (UIS) aged 19–59 must begin paying a $30 monthly premium to keep full-scope coverage. Nonpayment will reduce benefits to emergency and pregnancy services.
Medicare
Medicare is the federal health insurance program that provides affordable medical coverage for people aged 65 and older and for younger individuals with certain disabilities.
If you have Medicare, you might have one of the following plans: Kaiser Permanente Senior Advantage, SCAN Health Plan, Blue Shield 65 Plus, UnitedHealthcare AARP, and Humana Gold Plus.
Changes and dates to know
October 15–December 7, 2025
- Medicare Open Enrollment period for 2026 coverage. Review your Annual Notice of Change, confirm prescription coverage, and renew or change your plan by December 7.
January 4, 2027
- Coverage for certain immigrant Medicare beneficiaries will terminate.
| Non-US Citizens Eligible to Keep Medicare Coverage | Non-US Citizens Losing Eligibility for Medicare Coverage |
| Lawful Permanent Residents (green card holders) Cuban/Haitian entrants Individuals lawfully residing under the Compacts of Free Association (COFA) | Refugees Asylees People with Temporary Protected Status (TPS) Survivors of human trafficking or domestic violence People with work visas and humanitarian parole |
TrueCare can help you compare plan options, understand cost changes, and determine eligibility for additional programs and savings.
Covered California
The Affordable Care Act created Covered California, where you can pay for a private health insurance plan if you do not qualify for Medi-Cal or job-based coverage.
Plan Examples: Blue Shield, Kaiser, Health Net, Molina, and Sharp Health Plan.
Changes and dates to know:
November 1, 2025 – January 31, 2026:
- Open Enrollment for 2026 coverage. You must take action to renew—reenrollment is not automatic.
Potential Premium Changes (2026)
- If the federal government doesn’t renew ACA premium tax credits, premiums may rise in 2026, increasing costs of coverage and reducing affordable options for many families.
Stay informed and proactive with TrueCare today to ensure that health care remains in reach for you and your loved ones.
If you have questions or need help understanding what these changes mean for you, TrueCare can help. TrueCare is a community health center serving nearly 70,000 patients across San Diego County.
Visit: https://truecare.org/programs-resources/health-insurance-assistance/
Call or text TrueCare: (760) 736-6734
