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<\/p>\nWhy Medi-Cal enrollees need to keep an eye on their mailboxes<\/p>\n
Beginning Jan. 1, 2027, many Medi-Cal enrollees will face new work requirements and eligibility checks \u2014 the result of sweeping federal changes that could affect more than 1 million L.A. County residents, according to organizers of a new countywide outreach campaign. <\/p>\n
If you are a Medi-Cal enrollee between ages 19 and 64, you may soon need to show you’re working, volunteering, going to school or in a job training program for at least 80 hours a month or otherwise earning income to keep your public health insurance coverage. <\/p>\n
Some enrollees will also have to prove they\u2019re eligible every six months instead of once a year. <\/p>\n
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Parents of children 13 and younger, pregnant women, older adults and people with disabilities are largely exempt from the requirements. <\/p>\n
What to do to prepareKeep your address and phone number current with your county Medi-Cal office.
Watch your mail, and respond promptly to Medi-Cal notices in yellow or white envelopes.
If you’re unsure what a notice means, community health centers and trained volunteers can help in person and in multiple languages, county officials said.
\nHow we got here <\/p>\n
Nearly 4 million L.A. County residents, or 41% of the population, rely on Medi-Cal \u2014 California\u2019s version of Medicaid, a joint federal and state insurance program providing free or low-cost coverage to low-income people. <\/p>\n
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President Donald Trump, joined by Republican lawmakers, signs the “One, Big Beautiful Bill Act,” a massive spending and tax bill, at the South Lawn of the White House in Washington, D.C. on July 4, 2025.<\/p>\n
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Samuel Corum<\/p>\n
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Getty Images North America<\/p>\n
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President Donald Trump signed the \u201cOne Big Beautiful Bill\u201d \u2014 formally H.R. 1 \u2014 in July 2025, and it reduced federal Medicaid funding while adding a requirement that people who receive benefits work or show they are going to school, volunteering or seeking job training. <\/p>\n
The new requirements and six-month renewal rules apply to adults 19-64 covered through Medi-Cal\u2019s Affordable Care Act expansion, according to county officials. <\/p>\n
In June, the federal Centers for Medicare & Medicaid Services issued the rule that implements the work requirement. CMS said in a news release that the framework is meant to promote economic stability and self-sufficiency. <\/p>\n
\u201cThis rule helps Americans build skills and independence through work, education, job training, or community service, creating new opportunities for themselves and their families,\u201d CMS Administrator Mehmet Oz said in a statement<\/a>. <\/p>\n Later that month, states including California sued<\/a> to challenge the changes. In July, a federal judge denied their request to pause the rules while the lawsuit continues.<\/p>\n Last week, L.A. Care Health Plan, which administers Medi-Cal benefits for many county residents and other partners, launched \u201cKeep L.A. Covered,\u201d a public campaign to train community leaders, including pastors, teachers and health workers, to warn Medi-Cal recipients about renewal notices. The first training is Oct. 27, hosted by Maternal Child Health Access.<\/p>\n County officials say people and organizations that want to get involved can sign up at www.keeplacovered.org<\/a>.<\/p>\n Paperwork hurdles <\/p>\n Campaign leaders say people are more likely to lose coverage because a notice went to an old address or went unanswered than because they stopped qualifying for Medi-Cal.<\/p>\n “One missed notice, one missed deadline, one moment of confusion can mean them losing their coverage, and it’s not because they’re no longer eligible,” Martha Santana-Chin, CEO of L.A. Care, said at a campaign launch last week. “It’s simply because they haven’t been able to navigate the paperwork that’s ahead of them.\u201d<\/p>\n The state of California is already mailing letters about the changes, Santana-Chin said. <\/p>\n If the state can’t verify compliance, it must send a noncompliance notice and give the enrollee 30 days to prove compliance or an exemption. Otherwise, the application may be denied, or the person disenrolled. <\/p>\n Advocates say the risk is greatest for people without a stable mailing address. Statewide, most people experiencing homelessness are eligible for or already enrolled in Medi-Cal, according to the California Health Care Foundation.<\/p>\n The 2026 Los Angeles Homeless Services Authority homeless count estimated more than 73,000 people<\/a> were experiencing homelessness in L.A. County. Many would qualify for medical exemptions that would allow them to receive Medi-Cal benefits without proof of work or other requirements, but claiming an exemption requires clinical documentation and regular contact with the healthcare system, the foundation said.<\/a> Federal guidance doesn’t let states exempt people from the requirements solely for being unhoused. <\/p>\n Some details of the 80-hour monthly work requirement remain unsettled. The federal government is still writing the details on what counts as qualifying work, volunteering or education, Santana-Chin said.<\/p>\n The Centers for Medicare and Medicaid Services projects<\/a> the requirement will reduce Medicaid enrollment nationwide by more than 3 million people. The federal agency assumes about 15% of enrollees will lose coverage, about 9% because they don’t meet the requirement and about 6% because of paperwork or other administrative barriers. The actual effect depends on how states carry out the rules, according to a recent report from the federal agency.<\/p>\n