By: California Black Media
Medi-Cal is undergoing major changes. For Black Californians, these shifts bring both opportunities and challenges. As California continues to reshape its health care system through initiatives like California Advancing and Innovating Medi-Cal (CalAIM), the state is working to close long-standing racial disparities in care, especially in areas like maternal health, mental health, and preventive services.
With new rules around eligibility, asset limits, and coverage for immigrant communities taking effect in 2026 and beyond, it’s more important than ever for Black families to stay informed and empowered.
We’ll break down what’s changing, what’s staying the same, and how Black Californians can protect their Medi-Cal coverage, access culturally responsive care, and advocate for their health in an evolving system.
Medi-Cal provides low-cost or no-cost health coverage to more than 14 million Californians, including more than 1 million African Americans. Medi-Cal helps children, pregnant people, older adults, people with disabilities, and caregivers get the care they need, including doctor visits and hospital stays, dental, vision, mental health, substance abuse disorder treatment, and ongoing care for chronic conditions.
A federal law -House Resolution 1 (HR 1, also known as the “One Big Beautiful Bill”) – was signed by the President. It includes Medicaid funding cuts that could reduce support for Medi-Cal. It also changes Medi-Cal rules, affecting some low-income families, immigrants, rural residents, and seniors.
Despite these challenges, California is working to strengthen Medi-Cal and protect access to care. For now, eligibility and benefits remain unchanged for seniors, students, caregivers, and people returning home from incarceration.
Michelle Baass, Director of the Department of Health Care Services (DHCS), puts it this way: “Medi-Cal is more than just health care. It’s a lifeline for the Californians it serves, providing access to vital medical and dental services, preventive care, mental health support, substance use disorder treatment, and care for chronic conditions.”
Why This Matters for Black Californians
Black Californians are more likely to face health issues like hypertension, diabetes, and maternal health risks, and often experience barriers to housing and mental health care.
To help address these disparities, CalAIM is transforming Medi-Cal to better meet people’s needs. Two key programs include:
• Enhanced Care Management (ECM): Connects high-need members with a lead care manager, often at a community clinic or nonprofit, who coordinates medical, behavioral, dental, and social services. ECM focuses on people who are unhoused, living with serious mental illness or a substance use disorder, frequent emergency room users, or transitioning from incarceration, foster care, or institutions.
• Community Supports: Non-medical services that promote health and stability, such as housing support, medically supportive meals, in-home asthma help, recuperative care, and caregiver respite.
Together, ECM and Community Supports help Medi-Cal members stay healthy and stable beyond the doctor’s office.
What’s Staying the Same—for Now
Medi-Cal eligibility and basic benefits remain unchanged. Members still have access to:
• Doctor and hospital care
• Prescriptions and vaccines
• Mental health services
• Dental and vision care
• Transportation to appointments
• ECM and Community Supports
To stay covered, keep your contact information up to date with your county and respond promptly to your Medi-Cal eligibility renewal mail.
New Supports in 2025 and 2026
Medi-Medi Plan Expansion (2026): For people with both Medicare and Medi-Cal, integrated Medi-Medi Plans combine both programs under one card and helpline. These plans offer coordinated care and wraparound services, like rides to appointments or the pharmacy. In 2026, Medi-Medi Plans will expand to 49 counties across California.
• Asset Test Returns: Beginning on January 1, 2026, older adults, people with disabilities, and people with long-term care needs will face an asset limit of $130,000 for one person, plus $65,000 for each additional household member (up to 10 in the home). A home, one vehicle, household items, and some retirement accounts do not count toward this limit. Income rules will not change. Assets will be checked during the annual Medi-Cal renewal and when applying.
• Enrollment Freeze for Certain Adults: Adults ages 19 and older who are undocumented or have an immigration status that does not qualify for the federal Medicaid program will no longer be able to newly enroll in full-scope Medi-Cal beginning on January 1, 2026. This group will still be eligible for emergency Medi-Cal.
Undocumented members who are already enrolled in Medi-Cal as of January 1, 2026, will stay covered if they renew on time. If their coverage lapses due to paperwork, they have a 90-day grace period to address it. Children and pregnant people can keep or apply for full-scope Medi-Cal, regardless of immigration status.
• Dental Coverage Change: For adults ages 19 or older who are undocumented or have an immigration status that does not qualify for the federal Medicaid program, full dental benefits will end on July 1, 2026. They will still have access to emergency dental care (for situations like severe infections or needing to get a tooth pulled). Pregnant people in this group keep full dental coverage during their pregnancy and for one year postpartum.
• Work Requirements: Starting January 1, 2027, adults ages 19–64 must show proof that they are working 80 hours each month or doing a similar activity (like volunteering, going to school, or participating in a job training program) to keep their Medi-Cal coverage. There will be exceptions for children (0-18); older adults (65+); pregnant people, including one year postpartum, regardless of birth outcome; parents with children ages 13 or younger; people with disabilities; and others.
• Monthly Premiums: Beginning July 1, 2027, adults ages 19–59 who are undocumented or do not have an immigration status that qualifies for federal Medicaid must pay a small fee to keep full-scope Medi-Cal. Without payment, coverage will be limited to emergency and pregnancy-related care.
• Biannual Eligibility Checks: Starting in 2027, Medi-Cal will check eligibility twice a year instead of once. That makes it even more important to keep your contact information updated and to submit renewal paperwork on time.
What You Can Do Now
Medi-Cal is more than a safety net. It’s your family’s gateway to lifelong health. Keep your contact information up to date, respond to renewal mail promptly, and talk to your Medi-Cal health plan about all the benefits available to you, from doctor visits and prescriptions to ECM and Community Supports.
To maintain coverage or apply for services:
• Visit BenefitsCal.com,
• Call Covered California at (800) 300-1506.
• Call the Medi-Cal Member Help Line at (800) 541-5555.
• Or visit or call your county Medi-Cal office. In Alameda County call (510) 272-3663 or the toll-free number 1-800-698-1118. In San Francisco call (855) 355-5757.
Stay tuned in 2026 for more updates so you can take advantage of new services and prepare for changes in eligibility and benefits.
