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 LA 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\u2019re 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
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 prepare<\/p>\n
Keep your address and phone number current with your county Medi-Cal office.
\nWatch your mail, and respond promptly to Medi-Cal notices in yellow or white envelopes.
\nIf you\u2019re unsure what a notice means, community health centers and trained volunteers can help in person and in multiple languages, county officials said.<\/p>\n
How we got here<\/p>\n
Nearly 4 million LA 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
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\u00a0statement<\/a>.<\/p>\n Later that month, states including California\u00a0sued<\/a>\u00a0to challenge the changes. In July, a federal judge denied their request to pause the rules while the lawsuit continues.<\/p>\n Last week, LA Care Health Plan, which administers Medi-Cal benefits for many county residents and other partners, launched \u201cKeep LA 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\u00a0www.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 \u201cOne missed notice, one missed deadline, one moment of confusion can mean them losing their coverage, and it\u2019s not because they\u2019re no longer eligible,\u201d Martha Santana-Chin, CEO of L.A. Care, said at a campaign launch last week. \u201cIt\u2019s simply because they haven\u2019t been able to navigate the paperwork that\u2019s 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\u2019t 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\u00a0more than 73,000 people<\/a> were experiencing homelessness in LA 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>\u00a0Federal guidance doesn\u2019t 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\u00a0projects<\/a>\u00a0the 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\u2019t 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