Orange County Supervisor and Chair of CalOptima\u2019s Board of Directors Vicente Sarmiento said the changes will only add to the financial hardships many OC residents already face and strain hospitals after officials decreased the number of people without health insurance.\u00a0<\/p>\n
\u201cMy biggest fear is that we\u2019re going to just have higher costs. The costs are going to shift to hospitals that taxpayers are going to have to pay for. There\u2019s going to be delayed care for everybody because now we\u2019re going to have hospitals that are saturated with people receiving preventive care,\u201d he said in an interview.<\/p>\n
\u201cThis just becomes a spiraling problem, making people\u2019s lives much, much more difficult.\u201d<\/p>\n
CalOptima Chief Operating Officer Yunkyung Kim said while enrollment restrictions to public health insurance isn\u2019t anything new, the changes are coming one after the other at a time when the state has its own budget constraints that makes it harder to fill in the gaps.<\/p>\n
\u201cIt\u2019s a double whammy in a way because again we\u2019re getting it from a federal policy, state budget, and they\u2019re all happening right around the same time,\u201d Kim said in an interview last week.<\/p>\n
\u201cWe\u2019ve had times of big enrollment increases, we\u2019ve had times of enrollment decreases. I don\u2019t know that I\u2019ve seen an enrollment decrease of this volume all at once. At least not in my time working in the Medi-Cal program.\u201d<\/p>\n
Trump\u2019s \u201cBig Beautiful Bill\u201d isn\u2019t only cutting and changing the public health insurance program, it is also impacting the CalFresh Food Stamp program as hunger continues to grow in Orange County.<\/p>\n
[Read: Orange County\u2019s Food Insecurity Continues Growing as Food Stamp Cuts Loom<\/a>]<\/p>\n \u201cThis is a major change in which the stated goal of H.R.1 was to reduce individuals on public assistance,\u201d said An Tran, Director of the OC Social Services Agency, in an interview last week.<\/p>\n Tran and Kim said residents who rely on both benefits may lose two vital lifelines, driving them to food pantries and community health clinics.\u00a0<\/p>\n \u201cThe overall change to both programs are worrisome for me because these are safety net programs and many times many of our families that are on these programs are already struggling to get by, with the high costs of living right now, especially in Orange County,\u201d Tran said.<\/p>\n \u201cIndividuals who aren\u2019t able to get their basic needs met are going to have to find other sources in order for them to take care of their families. That is going to put a further strain on community partners, on churches, on food banks.\u201d<\/p>\n Meanwhile, CalOptima has been seeing an enrollment decline since the tail end of 2023 \u2013 going from nearly a million members at its peak to 760,000 members on Medi-Cal in July, according to both Tran and Kim.<\/p>\n They say there was about a 100,000 member decline in the past year and membership was dwindling even before H.R.1.<\/p>\n Sarmiento said officials are projecting to lose 250,000 members by July \u2013 a 29% decline.\u00a0<\/p>\n He said the changes to Medi-Cal were aimed at pushing more people off the public benefit program including seniors and people with language barriers.\u00a0<\/p>\n \u201cWe\u2019re dealing with a demographic that already has difficulty complying with the existing criteria for Medi-Cal,\u201d he said.\u00a0<\/p>\n \u201cThese additional requirements quite frankly, in my opinion, were intended to bump off a lot of really vulnerable people who have challenges with mobility.\u201d\u00a0<\/p>\n OC Supervisor Janet Nguyen, who sits on the CalOptima board, did not respond to a request for comment through her spokeswoman.\u00a0<\/p>\n Changes to Medi-Cal<\/p>\n A host of changes to Medi-Cal will continue to roll out in 2027 and 2028 under H.R.1.<\/p>\n At the start of this year, a full-scope enrollment freeze for Medi-Cal for certain undocumented residents was implemented barring some adults from signing up for the insurance program because of their immigration status.\u00a0<\/p>\n CalOptima leaders say undocumented resident enrollment has dropped from 150,000 when they first informed people of the changes to 120,000 today \u2013 but can\u2019t speak to specifically as to why the decrease occurred.<\/p>\n Starting next January, some undocumented residents in the county won\u2019t get their Medi-Cal through a managed plan with CalOptima that connects them to a doctor but rather one run by the state through a fee for service type program where the patient has to find their own doctor.\u00a0<\/p>\n Kim said about 120,000 undocumented residents will be impacted by the transition to the fee for service system \u2013 a change she said would be hard to work through and ensure residents won\u2019t face interruptions in their health care.<\/p>\n \u201cIn that population are also going to be children with very very severe and special needs who have many specialists that they are seeing right now. Those are the patients that I want to make sure we help them plan for this,\u201d she said.\u00a0<\/p>\n Come next July, some undocumented immigrants will also have to pay a monthly fee to keep their insurance.\u00a0<\/p>\n To see immigration status changes to Medi-Cal eligibility, click here<\/a>.<\/p>\n The changes are not just impacting immigrants.\u00a0<\/p>\n At the start of next year, some adults between the ages of 19-64 will have to work, volunteer or go to school to be able to keep their Medi-Cal health insurance and they will also be checked every six months to see if they are still eligible for the insurance.\u00a0<\/p>\n Kim said these changes will impact about 225,000 people in OC who will have to show they meet income and work requirements every six months.<\/p>\n \u201cSix months comes around pretty quickly,\u201d she said.\u00a0<\/p>\n Kim added they want to make sure people who meet the income and work requirements don\u2019t lose their healthcare just because they failed to get their administrative paperwork together or keep their information up to date.<\/p>\n By October 2028, some adults will also have to pay a copay for certain healthcare services.\u00a0<\/p>\n![\"\"](\"https:\/\/www.newsbeep.com\/us-ca\/wp-content\/uploads\/2026\/09\/AP_3730.jpg\")
The CalFresh and Medi-Cal building in Santa Ana on July 31, 2020. Credit: JULIE LEOPO, Voice of OC<\/p>\n![\"\"](\"https:\/\/www.newsbeep.com\/us-ca\/wp-content\/uploads\/2026\/09\/caloptima-2025-leopo-13.jpg\")
CalOptima CEO Michael Hunn sits by the public speaker podium during the Oct. 16, 2025 CalOptima board meeting. Credit: JULIE LEOPO, Voice of OC<\/p>\n
![\"\"](\"https:\/\/www.newsbeep.com\/us-ca\/wp-content\/uploads\/2026\/09\/CalOptima-2025-Leopo-0604.jpg\")
CalOptima board members conduct business during a special meeting on Oct. 16, 2025.<\/p>\n