CalOptima Health, Orange County’s health insurance program for the poor, is committing nearly $19.8 million to help members maintain Medi-Cal coverage ahead of major eligibility changes starting Jan. 1, 2026.
Much of the funding will be used to implement a “multifaceted outreach and education campaign” to ensure the nearly 1 million Orange County residents served by the health plan are aware of the new rules, which include more frequent renewals, new work requirements, and benefit cuts tied to immigration status.
The campaign will engage local media outlets, social media, newsletters and community organizations to guide Medi-Cal recipients through the labyrinth of changes, said CalOptima CEO Michael Hunn.
“When you take the magnitude of all these different sources of messaging, and you don’t speak English, and may or may not have access to an iPhone or even the internet, and you’re trying to figure out, ‘What am I going to do, and what does this mean to me?” Hunn said, referencing the economic and language hurdles faced by many CalOptima clients.
“This is us and our board wanting to be incredibly proactive to help our members.”
President Donald Trump’s massive spending and tax plan that passed in July enacted historic cuts to Medi-Cal, California’s Medicaid program that covers more than 15 million lower-income residents. And California’s $321 billion budget establishes other limits for residents without permanent legal status.
On Jan. 1, 2026, Medi-Cal will freeze new enrollment of undocumented Californian adults aged 19 and older. The 1.6 million undocumented residents currently enrolled in the program will not be ejected, but they cannot re-enroll if they lose coverage. After Jul. 1, 2027, they’ll be required to pay $30 a month to maintain full coverage.
Children under 18, and pregnant people, can continue to enroll in the program regardless of their immigration status.
Starting Jan. 1, 2027, some Medi-Cal enrollees will need to prove they are eligible for the program every six month instead of once a year. Also, working-age able-bodied adults will need to show documentation that they worked at least 80 hours per month.
Coverage renewal is a big focus for CalOptima, Hunn said. Medi-Cal recipients were not required to renew coverage during the Covid-19 pandemic. Since the automatic renewal process resumed in 2023, the renewal rate for CalOptima members has steadily fallen as some struggled to produce the requisite paperwork, Hunn said.
In the last year or so, Hunn said, CalOptima’s automatic renewal rate has dropped from from 54% to 39%, adding: “Our concern is that it’ll continue to decline.”
To keep that from happening, CalOptima will be investing $2 million in a three-year program with the Orange County Social Services Agency, with SSA staff attending CalOptima-sponsored community events to enroll and renew residents in Medi-Cal, CalFresh and other public assistance programs. The Board of Supervisors is expected to vote on the collaboration at its Oct. 28 meeting.
Another $5 million, Hunn said, will be doled out in grants awarded over the next 13 months to community organizations, health care providers and food banks that support residents with Medi-Cal enrollment and renewal. The grant funding can be renewed for an additional two years.
Hunn said losing health care coverage is a frightening prospect for many low-income residents.
“We want to do a really good job at communicating to members to help them overcome confusion, understand what they’re entitled to receive in benefits and, equally important, what they’re going to do to maintain and get access to those benefits,” Hunn said.
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