California postponed some clinic and dental cuts, while changes to health plans, support services and eligibility arrive on different dates.
California has postponed some Medi-Cal cuts, but patients still face changes to their doctors, support services and eligibility in 2027. For some Los Angeles families, keeping insurance will mean checking whether their doctor can still treat them.
The first major care transition starts January 1, 2027, under new federal requirements. Certain immigrant members will leave Medi-Cal health plans and receive care through providers who bill the state directly. Coverage continues for eligible members, but some services available only through health plans will end.
The Legislative Analyst’s Office’s October 19 budget review helps explain the changes. Its headline figures need context: For 2026–27, its tables put General Fund health spending at $52.2 billion, down $1.6 billion from the revised prior-year estimate, while total Medi-Cal spending rises 13% to $219.7 billion. Those tables exclude August budget amendments. Neither number alone tells patients what happens to their care.
January: Check your doctor and support services
The fee-for-service transition affects undocumented members, some green-card holders still subject to the federal five-year waiting period, and other specified immigration categories. Individual exemptions apply.
“Fee-for-service” describes how providers are paid. It does not mean patients must pay a fee for each visit.
Patients can stay with a doctor who accepts fee-for-service Medi-Cal. If their doctor does not, they will need another provider.
The California Department of Health Care Services (DHCS) says Enhanced Care Management, which coordinates care for people with complex needs, and Community Supports, such as housing navigation and medically tailored meals, will not continue for members moving to fee-for-service.
Other assistance remains available, including services from enrolled community health workers, chronic care management and county behavioral health programs. Medicines remain covered through Medi-Cal Rx. Los Angeles dental managed care continues during the January transition. People enrolled in the Program of All-Inclusive Care for the Elderly, known as PACE, stay in that program.
Separately, the enacted budget changes who qualifies for Enhanced Care Management and selected Community Supports, how referrals work and how providers are paid, starting January 1. These programs are part of California’s CalAIM initiative and will continue for eligible health-plan members.
July: Delayed cuts and new costs
California delayed changes to safety-net clinic payments for state-funded care provided to certain immigrant patients until July 1, 2027. This temporarily preserves the existing payment approach for affected community health centers and rural clinics.
The state also postponed the loss of routine dental benefits for certain immigrant adults until July 1. Emergency dental care remains covered. Children, pregnant and postpartum patients, and qualifying former foster youth have protections. Exact rules depend on age and immigration category.
A separate reduction ends Proposition 56 supplemental dental payments on July 1. That changes what providers receive; it does not itself eliminate every patient’s dental benefits.
Monthly premiums are also scheduled for certain immigrant adults beginning in July. The LAO says the amount will be set between $30 and $50 in the May 2027 budget revision. The budget assumes $50, but that is subject to the later determination.
For some immigrants affected by October’s federal funding restrictions, California is paying for comprehensive coverage through June 30, 2027. The budget schedules narrower coverage for affected patients afterward. Members should confirm their specific category with the county rather than assume one rule covers every immigrant.
For seniors and people with disabilities subject to asset rules, the individual limit remains $130,000 through June. It falls to $21,000 in July, or $31,000 for two people. Parriva’s guide to countable assets explains why a home, car and savings are treated differently.
The budget also protects scheduled maintenance dialysis for affected immigrant patients through state-only coverage beginning in October 2026.
New requirements follow a separate timeline
Under federal law, starting January 1, some adults ages 19–64 covered through Medicaid expansion must meet work, school, training or volunteer requirements, or qualify for an exemption. State legislation extends these rules to certain state-funded immigrant members. Pregnancy, disability, serious health conditions and certain caregiving responsibilities are among the exemptions.
DHCS’s current implementation guidance says twice-yearly eligibility checks begin March 1 for certain adults. These requirements do not apply to every Medi-Cal member. Counties will notify affected patients.
What Los Angeles patients should do now
Before January, ask your doctor or clinic whether it accepts fee-for-service Medi-Cal. If you receive care coordination, meals, housing assistance or ongoing treatment, ask your health plan how each service will be handled.
Health Net advises members with treatment underway, existing approvals or support services to contact Member Services. DHCS warns that equipment, supplies or transportation may require new authorizations.
Keep your address current with Los Angeles County’s Department of Public Social Services (DPSS), open notices promptly and renew on time. Certain immigrant adults already face enrollment restrictions. DHCS says affected members who lose coverage have three months to re-enroll before those restrictions apply.
Keep your Medi-Cal Benefits Identification Card. For help finding fee-for-service care, call 800-541-5555.
The immediate task is to confirm three things before the transition: who will provide your care, which services will continue and whether any approval needs to be renewed.
