{"id":133443,"date":"2026-01-14T17:14:08","date_gmt":"2026-01-14T17:14:08","guid":{"rendered":"https:\/\/www.newsbeep.com\/us-ca\/133443\/"},"modified":"2026-01-14T17:14:08","modified_gmt":"2026-01-14T17:14:08","slug":"medi-cal-eligibility-changes-and-cuts-impact-caloptima","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/us-ca\/133443\/","title":{"rendered":"Medi-Cal Eligibility Changes and Cuts Impact CalOptima"},"content":{"rendered":"<p>Leaders at CalOptima \u2013 the county-run Medi-Cal program for OC\u2019s neediest residents \u2013 are bracing for drastic cuts and eligibility changes to the public health insurance program that almost a third of Orange County residents rely on to cover doctor visits and hospital stays.\u00a0<\/p>\n<p>Last year, CalOptima and county Social Service Agency leaders warned of the expected impacts of President Donald Trump\u2019s \u201cBig Beautiful Bill\u201d that includes a trillion dollars worth of cuts to Medicaid \u2013 a public health insurance program \u2013 over about a decade\u2019s time.<\/p>\n<p>[Read: <a href=\"https:\/\/voiceofoc.org\/2025\/11\/food-stamp-changes-orange-county\/\" rel=\"nofollow noopener\" target=\"_blank\">OC\u2019s Poorest Brace For Cuts to Food Stamps and Health Insurance This Thanksgiving<\/a>]<\/p>\n<p>CalOptima Chief Operating Officer Yunkyung Kim said the changes will likely mean a decrease in members as they faced a steady decline in the past couple of months.<\/p>\n<p>\u201cIt\u2019s going to be kind of harder for folks to apply for Medi-Cal, and then also to keep their Medi-Cal,\u201d said Kim in a Friday interview.<\/p>\n<p>\u201cWe do expect that there will be individuals in Orange County who have had Medi-Cal who either will no longer receive their Medi-Cal benefits, or at least will not receive the full scope of their medical benefits. That\u2019s the piece that we worry about, of course, the most.\u201d<\/p>\n<p>The bill signed into law last year will also mean eligibility changes for recipients of Medi-Cal \u2013 California\u2019s Medicaid program \u2013 this year and in the coming years including enrollment freeze for undocumented adults, work requirements and more frequent application renewals.<\/p>\n<p>Those changes also include reinstated asset limits for older adults and people with disabilities as well as copayments for certain health care services.<\/p>\n<p><img loading=\"lazy\" data-recalc-dims=\"1\" decoding=\"async\" width=\"771\" height=\"514\" data-attachment-id=\"3219353\" data-permalink=\"https:\/\/voiceofoc.org\/caloptima-2025-leopo-10\/\" data-orig-file=\"https:\/\/i0.wp.com\/voiceofoc.org\/wp-content\/uploads\/2025\/10\/caloptima-2025-leopo-10.jpg?fit=1500%2C1000&amp;quality=89&amp;ssl=1\" data-orig-size=\"1500,1000\" data-comments-opened=\"0\" data-image-meta=\"{&quot;aperture&quot;:&quot;6.3&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;Canon EOS R3&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;1760655727&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;95&quot;,&quot;iso&quot;:&quot;800&quot;,&quot;shutter_speed&quot;:&quot;0.016666666666667&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;0&quot;}\" data-image-title=\"caloptima-2025-leopo-10\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;CalOptima board members conduct business during a special meeting on Oct. 16, 2025. &lt;\/p&gt;&#10;\" data-medium-file=\"https:\/\/i0.wp.com\/voiceofoc.org\/wp-content\/uploads\/2025\/10\/caloptima-2025-leopo-10.jpg?fit=336%2C224&amp;quality=89&amp;ssl=1\" data-large-file=\"https:\/\/i0.wp.com\/voiceofoc.org\/wp-content\/uploads\/2025\/10\/caloptima-2025-leopo-10.jpg?fit=771%2C514&amp;quality=89&amp;ssl=1\" src=\"https:\/\/www.newsbeep.com\/us-ca\/wp-content\/uploads\/2026\/01\/caloptima-2025-leopo-10.jpg\" alt=\"\" class=\"wp-image-3219353\"  \/>CalOptima board members conduct business during a special meeting on Oct. 16, 2025.  Credit: JULIE LEOPO, Voice of OC<\/p>\n<p>Orange County Supervisor Vicente Sarmiento, the new chair of CalOptima, said the changes will hurt people\u2019s access to health coverage as the agency is already experiencing a decrease in members.<\/p>\n<p>\u201cWe are preparing for these changes by prioritizing clear communication and outreach, so residents are aware of what is changing and can plan accordingly, while continuing to support our providers and community partners who will be on the front lines of these impacts,\u201d he said in an emailed statement last week.<\/p>\n<p>\u201cThe anticipated federal Medicaid reductions and policy changes have already caused a drastic decline in our membership \u2013 now below 800,000 (from nearly a million in 2024) \u2013 undoing years of progress made in expanding access to care for our most vulnerable residents.\u201d<\/p>\n<p>As of Nov. 30, CalOptima had 877,271 members\u2013 about 28% of the county\u2019s population, according to <a href=\"https:\/\/cop-p-001.sitecorecontenthub.cloud\/api\/public\/content\/80e8f09c9195430fbfe6a0be0d2cc5a3?v=3b7beb21\" rel=\"nofollow noopener\" target=\"_blank\">CalOptima<\/a> and <a href=\"https:\/\/data.census.gov\/profile\/Orange_County,_California?g=050XX00US06059\" rel=\"nofollow noopener\" target=\"_blank\">U.S. census data<\/a>.<\/p>\n<p>In <a href=\"https:\/\/voiceofoc.org\/2023\/03\/end-of-covid-emergency-means-loss-of-healthcare-for-up-to-146000-poor-oc-residents\/\" rel=\"nofollow noopener\" target=\"_blank\">2023<\/a>, nearly a million OC residents were CalOptima members.<\/p>\n<p>Kim said enrollment numbers dropped less than they expected when the redetermination process started after the COVID-19 pandemic and that numbers have been on a study decline since last August.<\/p>\n<p>The changes are coming as CalOptima sits on over $1.8 billion in reserves they\u2019ve been stockpiling partly in case of cuts to Medicaid despite state auditors raising concerns in 2023 that the agency should be spending more on service improvements and expanding access.<\/p>\n<p>[Read: <a href=\"https:\/\/voiceofoc.org\/2025\/07\/orange-countys-medi-cal-program-stockpiles-1-8-billion-despite-ca-auditor-concerns\/\" rel=\"nofollow noopener\" target=\"_blank\">Orange County\u2019s Medi-Cal Program Stockpiles $1.8 Billion Despite CA Auditor Concerns<\/a>]<\/p>\n<p><img loading=\"lazy\" data-recalc-dims=\"1\" decoding=\"async\" width=\"771\" height=\"514\" data-attachment-id=\"3219357\" data-permalink=\"https:\/\/voiceofoc.org\/caloptima-2025-leopo-14\/\" data-orig-file=\"https:\/\/i0.wp.com\/voiceofoc.org\/wp-content\/uploads\/2025\/10\/caloptima-2025-leopo-14.jpg?fit=1500%2C1000&amp;quality=89&amp;ssl=1\" data-orig-size=\"1500,1000\" data-comments-opened=\"0\" data-image-meta=\"{&quot;aperture&quot;:&quot;2.8&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;Canon EOS R3&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;1760655870&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;155&quot;,&quot;iso&quot;:&quot;800&quot;,&quot;shutter_speed&quot;:&quot;0.005&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;0&quot;}\" data-image-title=\"caloptima-2025-leopo-14\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;CalOptima CEO, Michael Hunn, on Oct. 16, 2025. &lt;\/p&gt;&#10;\" data-medium-file=\"https:\/\/i0.wp.com\/voiceofoc.org\/wp-content\/uploads\/2025\/10\/caloptima-2025-leopo-14.jpg?fit=336%2C224&amp;quality=89&amp;ssl=1\" data-large-file=\"https:\/\/i0.wp.com\/voiceofoc.org\/wp-content\/uploads\/2025\/10\/caloptima-2025-leopo-14.jpg?fit=771%2C514&amp;quality=89&amp;ssl=1\" src=\"https:\/\/www.newsbeep.com\/us-ca\/wp-content\/uploads\/2026\/01\/caloptima-2025-leopo-14.jpg\" alt=\"\" class=\"wp-image-3219357\"  \/>CalOptima CEO, Michael Hunn, on Oct. 16, 2025. <\/p>\n<p>In November, CalOptima CEO Michael Hunn defended the reserves at a virtual convening about the \u201cbig beautiful act\u2019s\u201d impacts.<\/p>\n<p>\u201cWe have to be very prudent in having sufficient reserves that if there is a real hiccup in the funding or the financial flow for whatever reason, we\u2019ve got enough reserves to pay medical claims and make sure our members have access to all levels of care,\u201d he said.<\/p>\n<p>Kim said CalOptima\u2019s board will soon discuss using the reserves in response to the changes and cuts and how sustainable that will be.<\/p>\n<p>\u201cIt\u2019s going to be a discussion with our board, with management, as well as with our stakeholders in terms of how we use those reserves to support these programs,\u201d she said.\u00a0<\/p>\n<p>\u201cOur members are going to be impacted. Our providers are going to be impacted so again, how do we do this so that we can support the entire delivery system?\u201d<\/p>\n<p>Eligibility Changes to Medi-Cal<\/p>\n<p><img loading=\"lazy\" data-recalc-dims=\"1\" decoding=\"async\" width=\"771\" height=\"434\" data-attachment-id=\"3219343\" data-permalink=\"https:\/\/voiceofoc.org\/caloptima-2025-leopo-1\/\" data-orig-file=\"https:\/\/i0.wp.com\/voiceofoc.org\/wp-content\/uploads\/2025\/10\/caloptima-2025-leopo-1.jpg?fit=1500%2C844&amp;quality=89&amp;ssl=1\" data-orig-size=\"1500,844\" data-comments-opened=\"0\" data-image-meta=\"{&quot;aperture&quot;:&quot;11&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;Canon EOS R3&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;1760607563&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;70&quot;,&quot;iso&quot;:&quot;800&quot;,&quot;shutter_speed&quot;:&quot;0.0002&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;0&quot;}\" data-image-title=\"caloptima-2025-leopo-1\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;CalOptima building Oct. 16, 2025. &lt;\/p&gt;&#10;\" data-medium-file=\"https:\/\/i0.wp.com\/voiceofoc.org\/wp-content\/uploads\/2025\/10\/caloptima-2025-leopo-1.jpg?fit=336%2C189&amp;quality=89&amp;ssl=1\" data-large-file=\"https:\/\/i0.wp.com\/voiceofoc.org\/wp-content\/uploads\/2025\/10\/caloptima-2025-leopo-1.jpg?fit=771%2C434&amp;quality=89&amp;ssl=1\" src=\"https:\/\/www.newsbeep.com\/us-ca\/wp-content\/uploads\/2026\/01\/caloptima-2025-leopo-1.jpg\" alt=\"\" class=\"wp-image-3219343\"  \/>CalOptima building Oct. 16, 2025.  Credit: JULIE LEOPO, Voice of OC<\/p>\n<p>This month\u2019s changes include reinstated asset limits for adults age 65 and older and individuals with disabilities as well as enrollment freezes on undocumented adults.<\/p>\n<p>Later this year, dental coverage will stop for undocumented adults.<\/p>\n<p>In 2027, able bodied recipients will have to meet work requirements to be eligible for Medi-Cal and recipients 19-64 will have to renew their Medi-Cal application every six months.<\/p>\n<p>By 2028, Medi-Cal recipients will have co-payments for certain health care services.<\/p>\n<p>Kim said those enrolled in Medi-Cal today won\u2019t be subject to some of those changes as long they maintain their enrollment.<\/p>\n<p>\u201cIf you are enrolled today, then you can maintain that, as long as you maintain your enrollment, go through the process, do not let that eligibility lapse,\u201d she said.<\/p>\n<p>CalOptima\u2019s Response<\/p>\n<p>In response to the expected changes, Hunn announced last fall that the agency would be launching a nearly $20 million outreach and education campaign to warn residents of the eligibility shifts and help them keep their coverage.<\/p>\n<p>\u201cWe will be launching a $19.8 million multiyear effort to educate our members on how to keep their health care benefits and navigate the new rules ahead, including work requirements and more frequent eligibility renewals,\u201d he later wrote in a <a href=\"https:\/\/voiceofoc.org\/2025\/12\/hunn-caloptima-health-more-committed-than-ever-to-quality-care-for-orange-countys-most-vulnerable\/\" rel=\"nofollow noopener\" target=\"_blank\">December Op-Ed published in the Voice of OC<\/a>.<\/p>\n<p>\u201cWe will do all we can to support eligible members in receiving their benefits.\u201d<\/p>\n<p>Kim said about $5 million from the outreach campaign will go towards navigation grants with community partners to help keep members enrolled in their health benefits.<\/p>\n<p>Beyond that, she said they\u2019re focusing on advocacy at the state and federal levels so policy makers understand the impacts on the ground and keeping members informed about the changes.<\/p>\n<p>Public Food Assistance Program Simultaneously Faces Drastic Cuts &amp; Changes<\/p>\n<p><img loading=\"lazy\" data-recalc-dims=\"1\" decoding=\"async\" width=\"771\" height=\"434\" data-attachment-id=\"3222572\" data-permalink=\"https:\/\/voiceofoc.org\/taylor_fooddistributionvolunteers-37\/\" data-orig-file=\"https:\/\/i0.wp.com\/voiceofoc.org\/wp-content\/uploads\/2025\/11\/Taylor_fooddistributionvolunteers-37.jpg?fit=1500%2C844&amp;quality=89&amp;ssl=1\" data-orig-size=\"1500,844\" data-comments-opened=\"0\" data-image-meta=\"{&quot;aperture&quot;:&quot;2.8&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;Canon EOS R6m2&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;1763838880&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;70&quot;,&quot;iso&quot;:&quot;200&quot;,&quot;shutter_speed&quot;:&quot;0.0005&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;0&quot;}\" data-image-title=\"Taylor_fooddistributionvolunteers-37\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;Volunteers pass out food during a distribution event by Seva Collective on Nov. 22, 2025. Credit: ERIKA TAYLOR, Voice of OC&lt;\/p&gt;&#10;\" data-medium-file=\"https:\/\/i0.wp.com\/voiceofoc.org\/wp-content\/uploads\/2025\/11\/Taylor_fooddistributionvolunteers-37.jpg?fit=336%2C189&amp;quality=89&amp;ssl=1\" data-large-file=\"https:\/\/i0.wp.com\/voiceofoc.org\/wp-content\/uploads\/2025\/11\/Taylor_fooddistributionvolunteers-37.jpg?fit=771%2C434&amp;quality=89&amp;ssl=1\" src=\"https:\/\/www.newsbeep.com\/us-ca\/wp-content\/uploads\/2026\/01\/Taylor_fooddistributionvolunteers-37.jpg\" alt=\"\" class=\"wp-image-3222572\"  \/>Volunteers pass out food during a distribution event by Seva Collective on Nov. 22, 2025. Credit: ERIKA TAYLOR, Voice of OC<\/p>\n<p>The public health insurance program isn\u2019t the only welfare program that many families rely on that is facing cuts and eligibility changes.<\/p>\n<p>Last year, Social Service Agency and food bank leaders also warned of impacts of the \u201cBig Beautiful Bill\u201d on CalFresh food stamps, including $4.5 billion worth of cuts annually to the food assistance program.<\/p>\n<p>[Read: <a href=\"https:\/\/voiceofoc.org\/2025\/12\/orange-county-food-hunger-crisis\/\" rel=\"nofollow noopener\" target=\"_blank\">Orange County Families Confront Hunger &amp; Financial Woes This Holiday Season<\/a>]<\/p>\n<p>About 200,000 CalOptima members are also enrolled in the CalFresh program, according to OC Hunger Alliance.<\/p>\n<p>The warning came on the heels of a <a href=\"https:\/\/voiceofoc.org\/2025\/11\/government-shutdown-impact-orange-county\/\" rel=\"nofollow noopener\" target=\"_blank\">prolonged federal government shutdown that temporarily disrupted the CalFresh program<\/a>.<\/p>\n<p>In response to the disruption, CalOptima board members allocated $5 million to provide $25 flex cards to their members also enrolled in CalFresh ahead of Thanksgiving.<\/p>\n<p>They also provided $1.5 million to <a href=\"https:\/\/feedoc.org\/\" rel=\"nofollow noopener\" target=\"_blank\">Second Harvest Food Bank<\/a> and $1.5 million to <a href=\"https:\/\/www.capoc.org\/oc-food-bank\/\" rel=\"nofollow noopener\" target=\"_blank\">Community Action Partnership of Orange County<\/a> \u2013 which runs the OC Food Bank.<\/p>\n<p>Kim said the agency is concerned about its members who will navigate the changes to both CalFresh and Medi-Cal and they will continue to communicate with food bank leaders on how they can support.<\/p>\n<p>\u201cWe are continuing to talk to them about whether there are other ways that CalOptima Health can support those programs. We have been big supporters of nutrition programs over the past several years,\u201d<\/p>\n<p>\u201cFood is health, and we intend to continue to be supportive of those programs.\u201d<\/p>\n<p>Hosam Elattar is a Voice of OC reporter and corps member with Report for America, a GroundTruth initiative. Contact him at helattar@voiceofoc.org or on Twitter @ElattarHosam.<\/p>\n<p>\n\tRelated<\/p>\n","protected":false},"excerpt":{"rendered":"Leaders at CalOptima \u2013 the county-run Medi-Cal program for OC\u2019s neediest residents \u2013 are bracing for drastic cuts&hellip;\n","protected":false},"author":2,"featured_media":133444,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[36],"tags":[163,165,164,8590,1755,8591,26358,4767,2267,68277],"class_list":["post-133443","post","type-post","status-publish","format-standard","has-post-thumbnail","category-anaheim","tag-anaheim","tag-anaheim-headlines","tag-anaheim-news","tag-caloptima","tag-medi-cal","tag-michael-hunn","tag-orange-county-food-insecurity","tag-vicente-sarmiento","tag-voice-of-oc","tag-yunkyung-kim"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/posts\/133443","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/comments?post=133443"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/posts\/133443\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/media\/133444"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/media?parent=133443"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/categories?post=133443"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ca\/wp-json\/wp\/v2\/tags?post=133443"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}