Who Are the 1.3 Million Californians Losing Medi-Cal Benefits?

The Affected Population

The 1.3 million individuals projected to lose Medi-Cal benefits are adults classified as having “unsatisfactory immigration status,” a formal Medi-Cal eligibility category. This group consists primarily of undocumented immigrants, along with certain humanitarian immigrants such as asylum applicants and individuals with pending immigration cases. These adults currently receive full-scope Medi-Cal through state-funded coverage expansions that California implemented independently of federal Medicaid rules.

Under recent federal changes and California’s budget adjustments, these individuals will no longer receive comprehensive Medi-Cal services. Instead, they will be shifted to emergency-only Medi-Cal, which provides coverage solely for life-threatening emergencies, childbirth, and a narrow set of urgent medical needs.

Why Coverage Is Being Lost

The loss of benefits results from the combined effects of the federal H.R. 1 legislation enacted in 2025 and California’s 2025–26 and 2026–27 budgets. H.R. 1 imposes new restrictions on Medicaid eligibility, particularly affecting immigrants who do not meet federal documentation requirements. In response to the resulting reduction in federal funding, California scaled back its state-funded Medi-Cal expansions, leading to the removal of full-scope coverage for adults with unsatisfactory immigration status.

The Legislative Analyst’s Office identifies this group as the primary source of the projected increase in uninsured Californians, noting that the shift to emergency-only Medi-Cal effectively eliminates access to routine medical care, chronic disease management, mental health services, and preventive care.

Demographic Characteristics

The affected population is overwhelmingly low-income and concentrated in regions with large immigrant communities, including Los Angeles County, the Central Valley, and the Bay Area. Many work in sectors such as agriculture, food service, construction, caregiving, and other essential but low-wage industries. These individuals already face significant barriers to healthcare access, and the loss of full-scope Medi-Cal further increases their vulnerability.

Nature of the Benefit Loss

Although these individuals retain emergency Medi-Cal, the transition represents a substantial reduction in healthcare access. Full-scope Medi-Cal covers primary care, specialist visits, prescription medications, cancer treatment, diabetes management, mental health services, and preventive care. Emergency-only Medi-Cal does not provide coverage for these services, leaving individuals without insurance for most medical needs.

This change is considered one of the largest reductions in comprehensive healthcare coverage in California’s history and has significant implications for public health, healthcare systems, and community stability.