Medi-Cal changes four times in the next 12 months: your parents get asked about assets, you get asked about work hours — who in your household is affected, and what to do at renewal

What's happening

Medi-Cal is California's Medicaid program: public health insurance for people with low incomes. In Orange County it runs through CalOptima Health, which says about 1 in 4 county residents are insured through it — more than 819,000 people as of July 2026, according to LAist. Many Vietnamese American families in Westminster, Garden Grove and Santa Ana are among them, often with three generations on different kinds of Medi-Cal in one house.

In July 2025, Congress passed H.R. 1, a law that rewrote many Medicaid rules nationwide. California has to follow it, and the state Department of Health Care Services (DHCS), which runs Medi-Cal, has posted the schedule. Its tracking page was last updated September 21, 2026. In an implementation plan released in January 2026, DHCS estimated that the changes combined could push up to 1.8 million people off Medi-Cal by mid-2028.

Separately, California's own 2025 budget brought back the asset limit on January 1, 2026.

Picture a household in Garden Grove — a hypothetical. Grandma, 72, has Medi-Cal alongside Medicare. Her son, 45, lost his job last year and is on Medi-Cal. His daughter, 10, has children's Medi-Cal. Over the next 12 months, Grandma will be asked about her bank balance. The son will be asked about his hours — but because he has a child 13 or younger, he is exempt. The 10-year-old's coverage doesn't change. Here is each change, in order.

Already in effect: the asset limit for people 65 and older

According to DHCS, Medi-Cal started counting assets again on January 1, 2026. An asset limit is the most you can own in countable property and still qualify. It applies to people 65 and older, people with disabilities, people in nursing homes, and some families whose income is above the federal threshold. Income rules did not change.

The limit through June 30, 2027, per DHCS:

• $130,000 for one person.
• Plus $65,000 for each additional person in the household, up to 10 people.

Starting July 1, 2027, the limit drops to $21,000 for one person and $31,000 for two, plus $1,550 per additional person. Both the DHCS asset-limit FAQ and its Medi-Cal Changes page list these figures. They were set in the 2026–27 state budget signed June 29, 2026; according to CPEHN, a health advocacy group, an earlier proposal to cut the limit to $2,000 for an individual was rejected. The 2027–28 budget could revise the figure again.

One detail matters in multigenerational homes. According to DHCS, adult children living with you are not counted toward household size for this limit. A widowed grandmother living with her son and granddaughter is generally treated as a household of one: $130,000.

Counted: bank accounts, cash, a second vehicle, a second home, and other financial resources "no matter where they are," per DHCS.
Not counted: the home you live in, one vehicle, household items, and retirement funds if you are receiving regular payments.

Current members are not asked right away. DHCS's own words: "Right now, you don't need to do anything." Assets are reported at the next renewal, and each case has its own renewal month.

What if your parent is over the limit? DHCS lists two paths: spend some of the money on things you need (medical bills, rent or mortgage, paying off a car loan) or move assets out of their name. Transfers to a spouse, to a blind or disabled child, or sales at full value do not cost you Medi-Cal. But DHCS adds a warning: if your parent later enters a nursing home, Medi-Cal looks back 30 months at anything given away, and gifts below fair value can delay long-term care coverage. DHCS says to ask the county Medi-Cal office about safe ways to transfer assets. Which path fits your family is a question for an enrollment counselor or an attorney.

The four changes ahead

In the order DHCS lists them:

Change 1 — October 1, 2026: immigration status. Federal law narrows who can get full-scope Medicaid with federal money. Still covered: lawful permanent residents (green card holders) past the five-year waiting period, certain Cuban and Haitian entrants, and citizens of the three COFA nations. Refugees, asylees, people paroled into the U.S. for a year or more, and survivors of trafficking and domestic violence lose federal funding.

What does California do? DHCS's Medi-Cal Changes page says that if you are affected, "you will get state-funded full-scope Medi-Cal until June 30, 2027." The 2026–27 budget keeps that coverage for roughly 200,000 people, according to CPEHN. Starting January 1, 2027, DHCS's immigration-status chart moves this group out of managed care — CalOptima Health in Orange County — into Fee-for-Service Medi-Cal, where you see any provider who accepts it. Coverage continues; how you get care changes. DHCS says it will add a nurse advice line and community navigators for the transition.

After June 30, 2027 is unsettled, and DHCS's own pages differ. The Medi-Cal Changes page says that from July 1, 2027, this group "will only be able to get pregnancy-related care and emergency services." The immigration-status chart says they keep full Medi-Cal, pay a monthly premium, and get emergency-only dental. The 2027–28 budget will decide. Most older Vietnamese Americans around Bolsa are already permanent residents or citizens and are not affected by this change.

One more thing, new as of September 18, 2026, for households with someone waiting on a green card. A new federal "public charge" rule took effect that day. According to USCIS, Medi-Cal received on or after September 18, 2026 may be considered when that person applies for a green card. Medi-Cal received before that date is not, except long-term nursing home care. People who already hold a green card, are applying for citizenship, or are citizens are not subject to the review. Don't drop Medi-Cal out of worry. Talk to an immigration attorney or a Department of Justice-recognized organization first. Bolsa Bridge has a separate story: Public charge: who is affected and who is not.

Change 2 — January 1, 2027: 80 hours a month. Adults 19–64 who get Medi-Cal through the Affordable Care Act expansion and have no child 13 or younger must log 80 hours a month of work, school, job training or volunteering — in any combination. Per DHCS, earning at least $580 a month from a job also satisfies the rule. This is what Washington calls a "work requirement" or "community engagement requirement." According to CHCF, compliance is checked at the first renewal after January 1, 2027, unless the state can confirm it from data it already has. DHCS says it will mail letters to people who fall under the rule before it starts. DHCS estimates about 1.1 million Californians will lose Medi-Cal by 2029–30 because of it, per CHCF, and the department expects the rule to increase the number of people cut off for paperwork reasons.

The rule is being challenged in court. According to DHCS, California is a lead plaintiff in a multistate lawsuit, filed in June 2026, against the rule CMS issued to carry out the requirement. The states argue that the rule narrows the "medically frail" exemption, according to Georgetown University's Center for Children and Families. In late July, a federal judge in Massachusetts declined to pause the rule, STAT News reported, writing that the timeline was "set by Congress in H.R. 1, not by CMS." A hearing on the merits is scheduled for October 20, 2026. For now, the January 1, 2027 start date stands.

Also January 1, 2027: shorter retroactive coverage. Medi-Cal can pay old medical bills from before your application date. Per DHCS, that window shrinks to one month for adults 19–64 without children under 19 and two months for everyone else. It used to be three months.

Change 3 — March 1, 2027: renewals every six months. According to DHCS, adults 19–64 in the expansion group will renew every six months instead of once a year. Children, pregnant women, people 65 and older, and people with disabilities stay on annual renewals. Current members switch at their first renewal after this date. Federal law and Orange County's Social Services Agency give a January 1, 2027 date; DHCS set March 1, 2027 as the operational start.

Change 4 — October 1, 2028: copays. Per DHCS, some adults earning more than $15,560 a year will pay copays of $1 to $35 for certain services, capped at 5 percent of household income. No copays for emergency care, checkups, pregnancy care, pediatric care, mental health care or community clinics. Far off, but it is in the law.

Two more changes this year sit outside the four. According to Orange County's Social Services Agency, CalFresh (food stamps) began requiring 20 hours a week of work for adults 18–64 on June 1, 2026, and narrowed immigrant eligibility on April 1, 2026. And per DHCS, adults 19–59 without satisfactory immigration status who are on full-scope Medi-Cal will pay a $30 monthly premium starting July 1, 2027; people 60 and older will not. The same day, that group drops to emergency-only dental.

Who is not subject to the 80-hour rule

According to DHCS, the rule does not apply to:

• People on Medicare Part A or Part B, and anyone 65 or older — they are outside the 19–64 group.
• Parents, guardians or caregivers of a child 13 or younger.
• People caring for a disabled family member.
• Veterans with a total disability rating.
• Pregnant women, through one year after birth.
• People with serious physical or mental health conditions, the medically frail, and people in addiction treatment.
• People released from jail or prison in the past 90 days; former foster youth under 26; American Indians and Alaska Natives.
• People already meeting CalFresh or CalWORKs work rules.
• People facing a short-term hardship: a natural disaster, a hospital stay, living in a high-unemployment area.

CHCF estimates about 4.8 million Californians are in the 19–64 expansion group and 2.2 million of them qualify for an exemption. The tricky phrase is "medically frail." Someone with a serious chronic illness may qualify, and DHCS says the county will tell you if it needs more documentation to confirm an exemption.

What to do at renewal — for each person in the house

Step 1 — Update the address and phone number on file with the county at BenefitsCal.com or through the Medi-Cal Helpline. Why first? In the 2023–2024 renewal cycle, according to DHCS data compiled by CHCF, 66 percent of people who lost Medi-Cal lost it for procedural reasons — paperwork that did not reach the county on time or was missing proof. Among people 65 and older and people with disabilities, the share was 83 percent. DHCS expects six-month renewals and the 80-hour rule to push those numbers up.

Step 2 — Grandparents 65+: gather asset documents before the packet arrives. Recent bank statements, the car title, and papers for any second property. The home they live in does not count, per DHCS.

Step 3 — Adults 19–64 without a child 13 or younger: keep proof of hours. Pay stubs, class enrollment, a letter confirming volunteer hours. From January 1, 2027, the total has to reach 80 hours a month, or $580 in earnings.

Step 4 — Answer the packet on time, even if nothing has changed. DHCS puts it plainly: "If you miss deadlines, you could lose your Medi-Cal coverage."

Step 5 — If coverage is cut, act fast. According to DHCS, turning in the missing paperwork within 90 days of losing coverage gets the case reviewed without a new application. You can also ask for the decision to be reviewed. The lines below help for free.

Free help

Medi-Cal Helpline (DHCS), Vietnamese interpreters available:
1-800-541-⁠5555

Orange County Social Services Agency (applications, renewals, address changes), Monday–Friday, 7:30 a.m.–5 p.m.:
1-800-281-⁠9799
TTY 714-834-⁠8500
Online: BenefitsCal.com. The county's timeline page has a Vietnamese version: ssa.ocgov.com/Changes-Medi-cal-Calfresh

CalOptima Health (members): the number on your card.

Free legal help with Medi-Cal — Health Consumer Alliance, listed by DHCS:
(888) 804-⁠3536

Bigger than one case file

None of the four changes cuts off a 72-year-old in Garden Grove because of her age. What cuts people off is the unopened envelope, the old address, the late paperwork. DHCS says so itself: the new rules are expected to increase procedural terminations. Over the next 12 months, the job for every household is knowing who renews in which month — and what each person needs to have ready.

Translation assisted by AI and reviewed by an editor.