Big changes are coming to Medi-Cal over the next few years because of a new federal law called H.R. 1. These updates may affect many Californians, and the state is working to make sure people understand what’s happening and how to keep their coverage. DHCS says the new rules “are expected to affect up to two million Medi-Cal members,” and they are focused on helping people stay enrolled.

Here’s an overview of what’s changing:

  • Immigrant Coverage Rules (2026): Some immigrants will move from full Medi-Cal to restricted (emergency-only) coverage.
  • Work/Activity Requirements (2027): Some adults ages 19–64 may need to work, study, or volunteer 80 hours a month unless they qualify for an exemption.
  • Six‑Month Renewals (2027): Certain adults will need to renew Medi-Cal twice a year. Children, pregnant individuals, older adults, people with disabilities, and tribal members are not included.
  • Address & Data Checks (2027–2029): The state will use new tools to keep member information updated and reduce accidental disenrollments.
  • Shorter Retroactive Coverage (2027): Coverage for past medical bills will be reduced for some groups.
  • New Copays (2028): Some adults will have small copays for certain services, but emergency, prenatal, and behavioral health care will remain free.

How the State Will Support Members

DHCS plans to:

  • Use more automation to make renewals easier
  • Provide training and tools to counties and health plans
  • Improve online systems
  • Share reminders and materials in multiple languages

For more details and summary pleaes refer to DHCS H.R. 1 Implementation Plan Summary PDF: