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"content": "\n\u003cp class=\"wp-block-paragraph\">\u003cem>This story was originally published by \u003ca href=\"https://calmatters.org/\">CalMatters\u003c/a>. \u003ca href=\"https://calmatters.org/subscribe-to-calmatters/\">Sign up\u003c/a> for their newsletters.\u003c/em>\u003c/p>\n\n\n\n\u003cp class=\"wp-block-paragraph\">Julia Feinberg feels like she’s living in a sinister version of Groundhog Day. For the second year in a row \u003ca href=\"https://www.kqed.org/news/tag/california\">California\u003c/a> lawmakers have made it tougher for seniors and people with disabilities to qualify for state-funded health benefits. \u003c/p>\n\n\n\n\u003cp class=\"wp-block-paragraph\">Feinberg, 37, who has a degenerative neuromuscular disorder, said without Medi-Cal she would be confined to a nursing home rather than living and working as a therapist in Oakland.\u003c/p>\n\n\n\n\u003cp class=\"wp-block-paragraph\">“We keep having to have the same fight over and over and over again,” Feinberg said. She requires a power wheelchair and about 19 hours of caregiving each day, which Medi-Cal covers.\u003c/p>\n\n\n\n\u003cp class=\"wp-block-paragraph\">California is cutting Medi-Cal after a decade of expansion, part of \u003ca href=\"https://calmatters.org/health/2026/08/medi-cal-the-cut-healthcare-threatened/\">sweeping federal and state cuts\u003c/a> that experts estimate will kick more than 2.2 million Californians off coverage in the next four years, doubling the state’s uninsured rate. \u003c/p>\n\n\n\n\u003cfigure class=\"wp-block-image size-full\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"1333\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/11/CaregiverGetty.jpg\" alt=\"\" class=\"wp-image-12063947\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/11/CaregiverGetty.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/11/CaregiverGetty-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/11/CaregiverGetty-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">A senior woman at home receiving health care. (LPETTET via Getty Images)\u003c/figcaption>\u003c/figure>\n\n\n\n\u003cp class=\"wp-block-paragraph\">The latest cut came in June, when state leaders approved a budget that will lower the asset limit for low-income seniors and people with disabilities to $21,000 to qualify for Medi-Cal, starting in July 2027. Feinberg, who has built up emergency savings, will have to spend about $10,000 to get under the cap.\u003c/p>\n\n\n\n\u003cp class=\"wp-block-paragraph\">In 2024, the state eliminated longstanding Medi-Cal asset limits, but since then lawmakers have chipped away at that policy. At the beginning of this year, state leaders reinstated an asset limit of $130,000, and the June budget lowered it further. \u003c/p>\n\n\n\n\u003cp class=\"wp-block-paragraph\">A primary residence and one vehicle are exempt from the new limit, but people 65 and older as well as those with disabilities cannot own a second home or car, and they can’t have more than $21,000 in \u003ca href=\"https://www.dhcs.ca.gov/wp-content/uploads/2025/10/MC007-ENG.pdf\">savings accounts, certain retirement accounts, life insurance policies or even burial plots\u003c/a>. They must still meet \u003ca href=\"https://www.dhcs.ca.gov/medi-cal/qualify/qualify-for-medi-cal-eligibility-chart/\">Medi-Cal income eligibility limits\u003c/a> of about $1,800 a month for a single person.\u003c/p>\n\n\n\n\u003cp class=\"wp-block-paragraph\">Advocates say the rules unfairly target older people and those with disabilities. \u003c/p>\n\n\n\n\u003cfigure class=\"wp-block-image size-full\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"1333\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/10/101926_ASSET-LIMIT_LV_CM_04-a244a4ca.jpg\" alt=\"\" class=\"wp-image-12106309\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/10/101926_ASSET-LIMIT_LV_CM_04-a244a4ca.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/10/101926_ASSET-LIMIT_LV_CM_04-a244a4ca-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/10/101926_ASSET-LIMIT_LV_CM_04-a244a4ca-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">Caretaker Lexi Marsh assists Elizabette Guéçamburu with various day-to-day tasks. (Larry Valenzuela/CalMatters)\u003c/figcaption>\u003c/figure>\n\n\n\n\u003cp class=\"wp-block-paragraph\">“It’s really expensive to be disabled,” said Elizabette Guéçamburu, 44, who like Feinberg has spinal muscular atrophy and requires a power wheelchair as well as daily caregiving.\u003c/p>\n\n\n\n\u003cp class=\"wp-block-paragraph\">Guéçamburu said she’s saving up for a used wheelchair-accessible van, which costs about $75,000. Home modifications such as adding ramps and making bathrooms accessible also cost tens of thousands of dollars, none of which are covered by Medi-Cal. Guéçamburu said those expenses would be impossible to afford if she couldn’t save.\u003c/p>\n\n\n\n\u003cp class=\"wp-block-paragraph\">Guéçamburu lives on her family’s farm in Patterson where they grow walnuts, almonds and alfalfa. She works part time as the farm’s bookkeeper. In 2024, doctors diagnosed Guéçamburu’s father with prostate cancer, and he could no longer act as her caregiver. The same year, California eliminated asset limits for people with disabilities and seniors — Guéçamburu cried, able to qualify for Medi-Cal for the first time. \u003c/p>\n\n\n\n\u003cp class=\"wp-block-paragraph\">“The timing was a godsend,” she said.\u003c/p>\n\n\n\n\u003cfigure class=\"wp-block-gallery has-nested-images columns-default is-cropped wp-block-gallery-1 is-layout-flex wp-block-gallery-is-layout-flex\">\n\u003cfigure class=\"wp-block-image size-large\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"1333\" data-id=\"12106310\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/10/101926-ASSET-LIMIT-LV_CM_24-4689659e.jpg\" alt=\"\" class=\"wp-image-12106310\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/10/101926-ASSET-LIMIT-LV_CM_24-4689659e.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/10/101926-ASSET-LIMIT-LV_CM_24-4689659e-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/10/101926-ASSET-LIMIT-LV_CM_24-4689659e-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">Caretaker Lexi Marsh helps Elizabette Guecamburu get inside her van in the garage of her home outside Patterson on Oct. 16, 2026. Guecamburu is afraid that recently passed state Medi-Cal cuts will disqualify her from benefits. (Larry Valenzuela/CalMatters)\u003c/figcaption>\u003c/figure>\n\n\n\n\u003cfigure class=\"wp-block-image size-large\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"1333\" data-id=\"12106311\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/10/101926_ASSET-LIMIT_LV_CM_20-967a950c.jpg\" alt=\"\" class=\"wp-image-12106311\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/10/101926_ASSET-LIMIT_LV_CM_20-967a950c.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/10/101926_ASSET-LIMIT_LV_CM_20-967a950c-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/10/101926_ASSET-LIMIT_LV_CM_20-967a950c-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">Caretaker Lexi Marsh feeds Elizabette Guéçamburu her food. (Larry Valenzuela/CalMatters)\u003c/figcaption>\u003c/figure>\n\u003c/figure>\n\n\n\n\u003cp class=\"wp-block-paragraph\">Now, her aging father is unable to take care of her should she lose Medi-Cal, and Guéçamburu is struggling to figure out what to do with money left to her by her grandmother. She’ll likely have to put it into a special needs trust controlled by a family member and give up financial independence. She also had her family strike her from inheriting any portion of their 100-year-old farm. \u003ca href=\"https://www.aarp.org/caregiving/financial-legal/long-term-care-affordability-report/\">Private home care costs thousands of dollars a month\u003c/a>, making it hard for lower- and middle-income people to pay for it out-of-pocket.\u003c/p>\n\n\n\n\u003cp class=\"wp-block-paragraph\">“I have to surrender our legacy just to have medical security and have the ability to live my life,” Guéçamburu said. \u003c/p>\n\n\n\n\u003ch2 class=\"wp-block-heading\">Asset limit flip-flop\u003c/h2>\n\n\n\n\u003cp class=\"wp-block-paragraph\">Gov. Gavin Newsom eliminated Medi-Cal asset requirements in 2024 after a yearslong campaign by senior and disability rights advocates. In a \u003ca href=\"https://www.gov.ca.gov/2023/05/01/governor-newsom-proclaims-older-californians-month-2023/\">statement before the elimination\u003c/a>, Newsom said he was proud of the “bold investments” his administration was making to “protect life savings and homes.”\u003c/p>\n\n\n\n\u003cp class=\"wp-block-paragraph\">But two years later, faced with a $12 billion budget shortfall, Newsom proposed reinstating the former $2,000 limit, arguing that more than twice as many people enrolled as previously estimated. The Legislature opposed that proposal and compromised at the current higher limit of $130,000, lowering it again to $21,000 starting next July. \u003c/p>\n\n\n\n\u003cfigure class=\"wp-block-image size-full\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"1333\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/10/261023-PROP50VICTORYLAP-33-BL-KQED-7273678d.jpg\" alt=\"\" class=\"wp-image-12106175\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/10/261023-PROP50VICTORYLAP-33-BL-KQED-7273678d.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/10/261023-PROP50VICTORYLAP-33-BL-KQED-7273678d-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/10/261023-PROP50VICTORYLAP-33-BL-KQED-7273678d-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">Gov. Gavin Newsom speaks at a rally alongside California Democratic Party members, labor leaders and advocates in San Francisco on Oct. 23, 2026. (Beth LaBerge/KQED)\u003c/figcaption>\u003c/figure>\n\n\n\n\u003cp class=\"wp-block-paragraph\">Lindsay Imai Hong, California director for Hand In Hand, an advocacy group supporting families that need caregiving, said organizers are looking to the next governor for change.\u003c/p>\n\n\n\n\u003cp class=\"wp-block-paragraph\">“We would love to see the asset test permanently taken off of the chopping block,” Imai Hong said.\u003c/p>\n\n\n\n\u003cp class=\"wp-block-paragraph\">Republican gubernatorial candidate Steve Hilton said in a statement to CalMatters that he opposes asset limits. He criticized the state for extending other Medi-Cal benefits beyond what it could afford, including coverage for immigrants without legal status.\u003c/p>\n\n\n\n\u003cp class=\"wp-block-paragraph\">“Seniors and people with disabilities shouldn’t lose their coverage because they’ve managed to save some money. They’ve done the responsible thing. Why punish them for it?” he said.\u003c/p>\n\n\n\n\u003cp class=\"wp-block-paragraph\">Democratic gubernatorial candidate and front-runner Xavier Becerra did not answer specific questions about the asset limit policy, but a campaign spokesperson blamed the Trump administration’s federal cuts for “squeezing” California’s Medi-Cal program.\u003c/p>\n\n\n\n\u003cfigure class=\"wp-block-image size-full\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"1333\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/10/101926_ASSET-LIMIT_LV_CM_07-2a2066eb.jpg\" alt=\"\" class=\"wp-image-12106312\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/10/101926_ASSET-LIMIT_LV_CM_07-2a2066eb.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/10/101926_ASSET-LIMIT_LV_CM_07-2a2066eb-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/10/101926_ASSET-LIMIT_LV_CM_07-2a2066eb-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">Elizabette Guecamburu does her circulation exercises in the living room of her home outside of Patterson on Oct. 16, 2026. Guecamburu is afraid that recently passed state Medi-Cal cuts will disqualify her from benefits. (Larry Valenzuela/CalMatters)\u003c/figcaption>\u003c/figure>\n\n\n\n\u003cp class=\"wp-block-paragraph\">Becerra will be “focused on protecting access to care and demand savings that are real, measurable and sustainable,” spokesperson Johnathan Underland said. On the campaign trail, Becerra has called himself California’s next “healthcare governor” and has \u003ca href=\"https://www.politico.com/news/2025/08/27/xavier-becerra-wants-to-be-the-health-care-governor-00532691\">previously floated raising taxes\u003c/a> to reverse Medi-Cal cuts, but \u003ca href=\"https://calmatters.org/health/2026/09/california-governor-healthcare-plans-2026/\">has not released detailed health policy plans\u003c/a>.\u003c/p>\n\n\n\n\u003cp class=\"wp-block-paragraph\">Camille Nguyen, an attorney with the Legal Aid Society of San Mateo County, said most people who struggle to stay under the limit have little financial security.\u003c/p>\n\n\n\n\u003cp class=\"wp-block-paragraph\">“They have all of their life savings in cash savings instead of a house. That’s their retirement. That is the amount they are expecting to live off of for the rest of their life,” Nguyen said.\u003c/p>\n\n\n\n\u003cp class=\"wp-block-paragraph\">State data shows about 600 people lost Medi-Cal when California reinstated the $130,000 limit. Advocates expect many more to lose Medi-Cal at the lower limit, but the state never released budget estimates before lawmakers approved the $21,000 limit. If the state reinstated the much lower $2,000 limit, the Department of Finance estimated 62,000 seniors and people with disabilities would lose Medi-Cal over two years. \u003c/p>\n\n\n\n\u003ch2 class=\"wp-block-heading\">Limit fuels anxiety, anger among people with disabilities\u003c/h2>\n\n\n\n\u003cp class=\"wp-block-paragraph\">Feinberg said the prospect of losing Medi-Cal is especially scary because she would also lose access to a special disability program that pays for extra caregiving hours and has a multiyear waitlist. Caregivers help Feinberg get in and out of bed, dress and prepare her meals.\u003c/p>\n\n\n\n\u003cp class=\"wp-block-paragraph\">Before the limit was erased in 2024, Feinberg said she checked her bank account every day to make sure the balance was low. At the time, Feinberg was a graduate student and did not earn very much money. Now, as a licensed therapist Feinberg has been able to squirrel away some money.\u003c/p>\n\n\n\n\n\n\u003cp class=\"wp-block-paragraph\">“I don’t want to spend down that money. I want to save that for retirement, maybe buying a house in the future,” Feinberg said. “The prospect of not being able to have a nest egg is very unsettling.”\u003c/p>\n\n\n\n\u003cp class=\"wp-block-paragraph\">Guéçamburu said she’s angry and frustrated that the state views services for people with disabilities as expendable.\u003c/p>\n\n\n\n\u003cp class=\"wp-block-paragraph\">“It’s exhausting to have to justify your existence every legislative cycle,” she said.\u003c/p>\n\n\n\n\u003cp class=\"wp-block-paragraph\">\u003cem>Supported by the California Health Care Foundation (CHCF), which works to ensure that people have access to the care they need, when they need it, at a price they can afford. Visit www.chcf.org to learn more.\u003c/em>\u003c/p>\n\n\n\n\u003cp class=\"wp-block-paragraph\">\u003cem>This article was \u003ca href=\"https://calmatters.org/health/2026/10/california-medi-cal-asset-limit-cut/\">originally published on CalMatters\u003c/a> and was republished under the \u003ca href=\"https://creativecommons.org/licenses/by-nc-nd/4.0/\">Creative Commons Attribution-NonCommercial-NoDerivatives\u003c/a> license.\u003c/em>\u003c/p>\n",
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"innerHTML": "\n\u003cp>\u003cem>This story was originally published by \u003ca href=\"https://calmatters.org/\">CalMatters\u003c/a>. \u003ca href=\"https://calmatters.org/subscribe-to-calmatters/\">Sign up\u003c/a> for their newsletters.\u003c/em>\u003c/p>\n",
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"\n\u003cp>\u003cem>This story was originally published by \u003ca href=\"https://calmatters.org/\">CalMatters\u003c/a>. \u003ca href=\"https://calmatters.org/subscribe-to-calmatters/\">Sign up\u003c/a> for their newsletters.\u003c/em>\u003c/p>\n"
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"innerHTML": "\n\u003cp>Julia Feinberg feels like she’s living in a sinister version of Groundhog Day. For the second year in a row \u003ca href=\"https://www.kqed.org/news/tag/california\">California\u003c/a> lawmakers have made it tougher for seniors and people with disabilities to qualify for state-funded health benefits. \u003c/p>\n",
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"\n\u003cp>Julia Feinberg feels like she’s living in a sinister version of Groundhog Day. For the second year in a row \u003ca href=\"https://www.kqed.org/news/tag/california\">California\u003c/a> lawmakers have made it tougher for seniors and people with disabilities to qualify for state-funded health benefits. \u003c/p>\n"
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"innerHTML": "\n\u003cp>Feinberg, 37, who has a degenerative neuromuscular disorder, said without Medi-Cal she would be confined to a nursing home rather than living and working as a therapist in Oakland.\u003c/p>\n",
"innerContent": [
"\n\u003cp>Feinberg, 37, who has a degenerative neuromuscular disorder, said without Medi-Cal she would be confined to a nursing home rather than living and working as a therapist in Oakland.\u003c/p>\n"
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"innerHTML": "\n\u003cp>“We keep having to have the same fight over and over and over again,” Feinberg said. She requires a power wheelchair and about 19 hours of caregiving each day, which Medi-Cal covers.\u003c/p>\n",
"innerContent": [
"\n\u003cp>“We keep having to have the same fight over and over and over again,” Feinberg said. She requires a power wheelchair and about 19 hours of caregiving each day, which Medi-Cal covers.\u003c/p>\n"
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"innerHTML": "\n\u003cp>California is cutting Medi-Cal after a decade of expansion, part of \u003ca href=\"https://calmatters.org/health/2026/08/medi-cal-the-cut-healthcare-threatened/\">sweeping federal and state cuts\u003c/a> that experts estimate will kick more than 2.2 million Californians off coverage in the next four years, doubling the state’s uninsured rate. \u003c/p>\n",
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"\n\u003cp>California is cutting Medi-Cal after a decade of expansion, part of \u003ca href=\"https://calmatters.org/health/2026/08/medi-cal-the-cut-healthcare-threatened/\">sweeping federal and state cuts\u003c/a> that experts estimate will kick more than 2.2 million Californians off coverage in the next four years, doubling the state’s uninsured rate. \u003c/p>\n"
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"innerHTML": "\n\u003cfigure class=\"wp-block-image size-full\">\u003cimg src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/11/CaregiverGetty.jpg\" alt=\"\" class=\"wp-image-12063947\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/11/CaregiverGetty.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/11/CaregiverGetty-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/11/CaregiverGetty-1536x1024.jpg 1536w\" sizes=\"(min-width: 992px) min(100vw, 1536px), (min-width: 768px) min(100vw, 1280px), min(100vw, 1020px)\"/>\u003cfigcaption class=\"wp-element-caption\">A senior woman at home receiving health care.\u003ccite class=\"wp-inline-image-credit\"> (LPETTET via Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n",
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"innerHTML": "\n\u003cp>The latest cut came in June, when state leaders approved a budget that will lower the asset limit for low-income seniors and people with disabilities to $21,000 to qualify for Medi-Cal, starting in July 2027. Feinberg, who has built up emergency savings, will have to spend about $10,000 to get under the cap.\u003c/p>\n",
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"\n\u003cp>The latest cut came in June, when state leaders approved a budget that will lower the asset limit for low-income seniors and people with disabilities to $21,000 to qualify for Medi-Cal, starting in July 2027. Feinberg, who has built up emergency savings, will have to spend about $10,000 to get under the cap.\u003c/p>\n"
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"innerHTML": "\n\u003cp>In 2024, the state eliminated longstanding Medi-Cal asset limits, but since then lawmakers have chipped away at that policy. At the beginning of this year, state leaders reinstated an asset limit of $130,000, and the June budget lowered it further. \u003c/p>\n",
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"\n\u003cp>In 2024, the state eliminated longstanding Medi-Cal asset limits, but since then lawmakers have chipped away at that policy. At the beginning of this year, state leaders reinstated an asset limit of $130,000, and the June budget lowered it further. \u003c/p>\n"
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"innerHTML": "\n\u003cp>A primary residence and one vehicle are exempt from the new limit, but people 65 and older as well as those with disabilities cannot own a second home or car, and they can’t have more than $21,000 in \u003ca href=\"https://www.dhcs.ca.gov/wp-content/uploads/2025/10/MC007-ENG.pdf\">savings accounts, certain retirement accounts, life insurance policies or even burial plots\u003c/a>. They must still meet \u003ca href=\"https://www.dhcs.ca.gov/medi-cal/qualify/qualify-for-medi-cal-eligibility-chart/\">Medi-Cal income eligibility limits\u003c/a> of about $1,800 a month for a single person.\u003c/p>\n",
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"\n\u003cp>A primary residence and one vehicle are exempt from the new limit, but people 65 and older as well as those with disabilities cannot own a second home or car, and they can’t have more than $21,000 in \u003ca href=\"https://www.dhcs.ca.gov/wp-content/uploads/2025/10/MC007-ENG.pdf\">savings accounts, certain retirement accounts, life insurance policies or even burial plots\u003c/a>. They must still meet \u003ca href=\"https://www.dhcs.ca.gov/medi-cal/qualify/qualify-for-medi-cal-eligibility-chart/\">Medi-Cal income eligibility limits\u003c/a> of about $1,800 a month for a single person.\u003c/p>\n"
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"innerHTML": "\n\u003cp>Advocates say the rules unfairly target older people and those with disabilities. \u003c/p>\n",
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"\n\u003cp>Advocates say the rules unfairly target older people and those with disabilities. \u003c/p>\n"
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"innerHTML": "\n\u003cfigure class=\"wp-block-image size-full\">\u003cimg src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/10/101926_ASSET-LIMIT_LV_CM_04-a244a4ca.jpg\" alt=\"\" class=\"wp-image-12106309\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/10/101926_ASSET-LIMIT_LV_CM_04-a244a4ca.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/10/101926_ASSET-LIMIT_LV_CM_04-a244a4ca-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/10/101926_ASSET-LIMIT_LV_CM_04-a244a4ca-1536x1024.jpg 1536w\" sizes=\"(min-width: 992px) min(100vw, 1536px), (min-width: 768px) min(100vw, 1280px), min(100vw, 1020px)\"/>\u003cfigcaption class=\"wp-element-caption\"> Caretaker Lexi Marsh assists Elizabette Guéçamburu with various day-to-day tasks.\u003ccite class=\"wp-inline-image-credit\"> (Larry Valenzuela/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n",
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"\n\u003cfigure class=\"wp-block-image size-full\">\u003cimg src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/10/101926_ASSET-LIMIT_LV_CM_04-a244a4ca.jpg\" alt=\"\" class=\"wp-image-12106309\"/>\u003cfigcaption class=\"wp-element-caption\"> Caretaker Lexi Marsh assists Elizabette Guéçamburu with various day-to-day tasks.\u003ccite class=\"wp-inline-image-credit\"> (Larry Valenzuela/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n"
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"innerHTML": "\n\u003cp>“It’s really expensive to be disabled,” said Elizabette Guéçamburu, 44, who like Feinberg has spinal muscular atrophy and requires a power wheelchair as well as daily caregiving.\u003c/p>\n",
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"\n\u003cp>“It’s really expensive to be disabled,” said Elizabette Guéçamburu, 44, who like Feinberg has spinal muscular atrophy and requires a power wheelchair as well as daily caregiving.\u003c/p>\n"
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"innerHTML": "\n\u003cp>Guéçamburu said she’s saving up for a used wheelchair-accessible van, which costs about $75,000. Home modifications such as adding ramps and making bathrooms accessible also cost tens of thousands of dollars, none of which are covered by Medi-Cal. Guéçamburu said those expenses would be impossible to afford if she couldn’t save.\u003c/p>\n",
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"\n\u003cp>Guéçamburu said she’s saving up for a used wheelchair-accessible van, which costs about $75,000. Home modifications such as adding ramps and making bathrooms accessible also cost tens of thousands of dollars, none of which are covered by Medi-Cal. Guéçamburu said those expenses would be impossible to afford if she couldn’t save.\u003c/p>\n"
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"innerHTML": "\n\u003cp>Guéçamburu lives on her family’s farm in Patterson where they grow walnuts, almonds and alfalfa. She works part time as the farm’s bookkeeper. In 2024, doctors diagnosed Guéçamburu’s father with prostate cancer, and he could no longer act as her caregiver. The same year, California eliminated asset limits for people with disabilities and seniors — Guéçamburu cried, able to qualify for Medi-Cal for the first time. \u003c/p>\n",
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"\n\u003cp>Guéçamburu lives on her family’s farm in Patterson where they grow walnuts, almonds and alfalfa. She works part time as the farm’s bookkeeper. In 2024, doctors diagnosed Guéçamburu’s father with prostate cancer, and he could no longer act as her caregiver. The same year, California eliminated asset limits for people with disabilities and seniors — Guéçamburu cried, able to qualify for Medi-Cal for the first time. \u003c/p>\n"
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"innerHTML": "\n\u003cp>“The timing was a godsend,” she said.\u003c/p>\n",
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"innerHTML": "\n\u003cfigure class=\"wp-block-image size-large\">\u003cimg src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/10/101926-ASSET-LIMIT-LV_CM_24-4689659e.jpg\" alt=\"\" class=\"wp-image-12106310\"/>\u003cfigcaption class=\"wp-element-caption\">Caretaker Lexi Marsh helps Elizabette Guecamburu get inside her van in the garage of her home outside Patterson on Oct. 16, 2026. Guecamburu is afraid that recently passed state Medi-Cal cuts will disqualify her from benefits.\u003c/figcaption>\u003c/figure>\n",
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"\n\u003cfigure class=\"wp-block-image size-large\">\u003cimg src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/10/101926-ASSET-LIMIT-LV_CM_24-4689659e.jpg\" alt=\"\" class=\"wp-image-12106310\"/>\u003cfigcaption class=\"wp-element-caption\">Caretaker Lexi Marsh helps Elizabette Guecamburu get inside her van in the garage of her home outside Patterson on Oct. 16, 2026. Guecamburu is afraid that recently passed state Medi-Cal cuts will disqualify her from benefits.\u003c/figcaption>\u003c/figure>\n"
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"innerHTML": "\n\u003cp>Now, her aging father is unable to take care of her should she lose Medi-Cal, and Guéçamburu is struggling to figure out what to do with money left to her by her grandmother. She’ll likely have to put it into a special needs trust controlled by a family member and give up financial independence. She also had her family strike her from inheriting any portion of their 100-year-old farm. \u003ca href=\"https://www.aarp.org/caregiving/financial-legal/long-term-care-affordability-report/\">Private home care costs thousands of dollars a month\u003c/a>, making it hard for lower- and middle-income people to pay for it out-of-pocket.\u003c/p>\n",
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"\n\u003cp>Now, her aging father is unable to take care of her should she lose Medi-Cal, and Guéçamburu is struggling to figure out what to do with money left to her by her grandmother. She’ll likely have to put it into a special needs trust controlled by a family member and give up financial independence. She also had her family strike her from inheriting any portion of their 100-year-old farm. \u003ca href=\"https://www.aarp.org/caregiving/financial-legal/long-term-care-affordability-report/\">Private home care costs thousands of dollars a month\u003c/a>, making it hard for lower- and middle-income people to pay for it out-of-pocket.\u003c/p>\n"
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"innerHTML": "\n\u003cp>“I have to surrender our legacy just to have medical security and have the ability to live my life,” Guéçamburu said. \u003c/p>\n",
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"\n\u003cp>“I have to surrender our legacy just to have medical security and have the ability to live my life,” Guéçamburu said. \u003c/p>\n"
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"\n\u003ch2 class=\"wp-block-heading\">Asset limit flip-flop\u003c/h2>\n"
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"innerHTML": "\n\u003cp>Gov. Gavin Newsom eliminated Medi-Cal asset requirements in 2024 after a yearslong campaign by senior and disability rights advocates. In a \u003ca href=\"https://www.gov.ca.gov/2023/05/01/governor-newsom-proclaims-older-californians-month-2023/\">statement before the elimination\u003c/a>, Newsom said he was proud of the “bold investments” his administration was making to “protect life savings and homes.”\u003c/p>\n",
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"\n\u003cp>Gov. Gavin Newsom eliminated Medi-Cal asset requirements in 2024 after a yearslong campaign by senior and disability rights advocates. In a \u003ca href=\"https://www.gov.ca.gov/2023/05/01/governor-newsom-proclaims-older-californians-month-2023/\">statement before the elimination\u003c/a>, Newsom said he was proud of the “bold investments” his administration was making to “protect life savings and homes.”\u003c/p>\n"
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"innerHTML": "\n\u003cp>But two years later, faced with a $12 billion budget shortfall, Newsom proposed reinstating the former $2,000 limit, arguing that more than twice as many people enrolled as previously estimated. The Legislature opposed that proposal and compromised at the current higher limit of $130,000, lowering it again to $21,000 starting next July. \u003c/p>\n",
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"\n\u003cp>But two years later, faced with a $12 billion budget shortfall, Newsom proposed reinstating the former $2,000 limit, arguing that more than twice as many people enrolled as previously estimated. The Legislature opposed that proposal and compromised at the current higher limit of $130,000, lowering it again to $21,000 starting next July. \u003c/p>\n"
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"innerHTML": "\n\u003cfigure class=\"wp-block-image size-full\">\u003cimg src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/10/261023-PROP50VICTORYLAP-33-BL-KQED-7273678d.jpg\" alt=\"\" class=\"wp-image-12106175\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/10/261023-PROP50VICTORYLAP-33-BL-KQED-7273678d.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/10/261023-PROP50VICTORYLAP-33-BL-KQED-7273678d-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/10/261023-PROP50VICTORYLAP-33-BL-KQED-7273678d-1536x1024.jpg 1536w\" sizes=\"(min-width: 992px) min(100vw, 1536px), (min-width: 768px) min(100vw, 1280px), min(100vw, 1020px)\"/>\u003cfigcaption class=\"wp-element-caption\">Gov. Gavin Newsom speaks at a rally alongside California Democratic Party members, labor leaders and advocates in San Francisco on Oct. 23, 2026.\u003ccite class=\"wp-inline-image-credit\"> (Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n",
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"\n\u003cfigure class=\"wp-block-image size-full\">\u003cimg src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/10/261023-PROP50VICTORYLAP-33-BL-KQED-7273678d.jpg\" alt=\"\" class=\"wp-image-12106175\"/>\u003cfigcaption class=\"wp-element-caption\">Gov. Gavin Newsom speaks at a rally alongside California Democratic Party members, labor leaders and advocates in San Francisco on Oct. 23, 2026.\u003ccite class=\"wp-inline-image-credit\"> (Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n"
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"innerHTML": "\n\u003cp>Lindsay Imai Hong, California director for Hand In Hand, an advocacy group supporting families that need caregiving, said organizers are looking to the next governor for change.\u003c/p>\n",
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"\n\u003cp>Lindsay Imai Hong, California director for Hand In Hand, an advocacy group supporting families that need caregiving, said organizers are looking to the next governor for change.\u003c/p>\n"
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"innerHTML": "\n\u003cp>“We would love to see the asset test permanently taken off of the chopping block,” Imai Hong said.\u003c/p>\n",
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"innerHTML": "\n\u003cp>Republican gubernatorial candidate Steve Hilton said in a statement to CalMatters that he opposes asset limits. He criticized the state for extending other Medi-Cal benefits beyond what it could afford, including coverage for immigrants without legal status.\u003c/p>\n",
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"\n\u003cp>Republican gubernatorial candidate Steve Hilton said in a statement to CalMatters that he opposes asset limits. He criticized the state for extending other Medi-Cal benefits beyond what it could afford, including coverage for immigrants without legal status.\u003c/p>\n"
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"innerHTML": "\n\u003cp>“Seniors and people with disabilities shouldn’t lose their coverage because they’ve managed to save some money. They’ve done the responsible thing. Why punish them for it?” he said.\u003c/p>\n",
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"\n\u003cp>“Seniors and people with disabilities shouldn’t lose their coverage because they’ve managed to save some money. They’ve done the responsible thing. Why punish them for it?” he said.\u003c/p>\n"
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"innerHTML": "\n\u003cp>Democratic gubernatorial candidate and front-runner Xavier Becerra did not answer specific questions about the asset limit policy, but a campaign spokesperson blamed the Trump administration’s federal cuts for “squeezing” California’s Medi-Cal program.\u003c/p>\n",
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"\n\u003cp>Democratic gubernatorial candidate and front-runner Xavier Becerra did not answer specific questions about the asset limit policy, but a campaign spokesperson blamed the Trump administration’s federal cuts for “squeezing” California’s Medi-Cal program.\u003c/p>\n"
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"innerHTML": "\n\u003cfigure class=\"wp-block-image size-full\">\u003cimg src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/10/101926_ASSET-LIMIT_LV_CM_07-2a2066eb.jpg\" alt=\"\" class=\"wp-image-12106312\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/10/101926_ASSET-LIMIT_LV_CM_07-2a2066eb.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/10/101926_ASSET-LIMIT_LV_CM_07-2a2066eb-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/10/101926_ASSET-LIMIT_LV_CM_07-2a2066eb-1536x1024.jpg 1536w\" sizes=\"(min-width: 992px) min(100vw, 1536px), (min-width: 768px) min(100vw, 1280px), min(100vw, 1020px)\"/>\u003cfigcaption class=\"wp-element-caption\">Elizabette Guecamburu does her circulation exercises in the living room of her home outside of Patterson on Oct. 16, 2026. Guecamburu is afraid that recently passed state Medi-Cal cuts will disqualify her from benefits.\u003ccite class=\"wp-inline-image-credit\"> (Larry Valenzuela/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n",
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"\n\u003cfigure class=\"wp-block-image size-full\">\u003cimg src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/10/101926_ASSET-LIMIT_LV_CM_07-2a2066eb.jpg\" alt=\"\" class=\"wp-image-12106312\"/>\u003cfigcaption class=\"wp-element-caption\">Elizabette Guecamburu does her circulation exercises in the living room of her home outside of Patterson on Oct. 16, 2026. Guecamburu is afraid that recently passed state Medi-Cal cuts will disqualify her from benefits.\u003ccite class=\"wp-inline-image-credit\"> (Larry Valenzuela/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n"
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"innerHTML": "\n\u003cp>Becerra will be “focused on protecting access to care and demand savings that are real, measurable and sustainable,” spokesperson Johnathan Underland said. On the campaign trail, Becerra has called himself California’s next “healthcare governor” and has \u003ca href=\"https://www.politico.com/news/2025/08/27/xavier-becerra-wants-to-be-the-health-care-governor-00532691\">previously floated raising taxes\u003c/a> to reverse Medi-Cal cuts, but \u003ca href=\"https://calmatters.org/health/2026/09/california-governor-healthcare-plans-2026/\">has not released detailed health policy plans\u003c/a>.\u003c/p>\n",
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"\n\u003cp>Becerra will be “focused on protecting access to care and demand savings that are real, measurable and sustainable,” spokesperson Johnathan Underland said. On the campaign trail, Becerra has called himself California’s next “healthcare governor” and has \u003ca href=\"https://www.politico.com/news/2025/08/27/xavier-becerra-wants-to-be-the-health-care-governor-00532691\">previously floated raising taxes\u003c/a> to reverse Medi-Cal cuts, but \u003ca href=\"https://calmatters.org/health/2026/09/california-governor-healthcare-plans-2026/\">has not released detailed health policy plans\u003c/a>.\u003c/p>\n"
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"innerHTML": "\n\u003cp>Camille Nguyen, an attorney with the Legal Aid Society of San Mateo County, said most people who struggle to stay under the limit have little financial security.\u003c/p>\n",
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"\n\u003cp>Camille Nguyen, an attorney with the Legal Aid Society of San Mateo County, said most people who struggle to stay under the limit have little financial security.\u003c/p>\n"
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"innerHTML": "\n\u003cp>“They have all of their life savings in cash savings instead of a house. That’s their retirement. That is the amount they are expecting to live off of for the rest of their life,” Nguyen said.\u003c/p>\n",
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"\n\u003cp>“They have all of their life savings in cash savings instead of a house. That’s their retirement. That is the amount they are expecting to live off of for the rest of their life,” Nguyen said.\u003c/p>\n"
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"innerHTML": "\n\u003cp>State data shows about 600 people lost Medi-Cal when California reinstated the $130,000 limit. Advocates expect many more to lose Medi-Cal at the lower limit, but the state never released budget estimates before lawmakers approved the $21,000 limit. If the state reinstated the much lower $2,000 limit, the Department of Finance estimated 62,000 seniors and people with disabilities would lose Medi-Cal over two years. \u003c/p>\n",
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"\n\u003cp>State data shows about 600 people lost Medi-Cal when California reinstated the $130,000 limit. Advocates expect many more to lose Medi-Cal at the lower limit, but the state never released budget estimates before lawmakers approved the $21,000 limit. If the state reinstated the much lower $2,000 limit, the Department of Finance estimated 62,000 seniors and people with disabilities would lose Medi-Cal over two years. \u003c/p>\n"
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"text": "Limit fuels anxiety, anger among people with disabilities",
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"innerHTML": "\n\u003ch2 class=\"wp-block-heading\">Limit fuels anxiety, anger among people with disabilities\u003c/h2>\n",
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"innerHTML": "\n\u003cp>Feinberg said the prospect of losing Medi-Cal is especially scary because she would also lose access to a special disability program that pays for extra caregiving hours and has a multiyear waitlist. Caregivers help Feinberg get in and out of bed, dress and prepare her meals.\u003c/p>\n",
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"\n\u003cp>Feinberg said the prospect of losing Medi-Cal is especially scary because she would also lose access to a special disability program that pays for extra caregiving hours and has a multiyear waitlist. Caregivers help Feinberg get in and out of bed, dress and prepare her meals.\u003c/p>\n"
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"innerHTML": "\n\u003cp>Before the limit was erased in 2024, Feinberg said she checked her bank account every day to make sure the balance was low. At the time, Feinberg was a graduate student and did not earn very much money. Now, as a licensed therapist Feinberg has been able to squirrel away some money.\u003c/p>\n",
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"\n\u003cp>Before the limit was erased in 2024, Feinberg said she checked her bank account every day to make sure the balance was low. At the time, Feinberg was a graduate student and did not earn very much money. Now, as a licensed therapist Feinberg has been able to squirrel away some money.\u003c/p>\n"
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"innerHTML": "\n\u003cp>“I don’t want to spend down that money. I want to save that for retirement, maybe buying a house in the future,” Feinberg said. “The prospect of not being able to have a nest egg is very unsettling.”\u003c/p>\n",
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"\n\u003cp>“I don’t want to spend down that money. I want to save that for retirement, maybe buying a house in the future,” Feinberg said. “The prospect of not being able to have a nest egg is very unsettling.”\u003c/p>\n"
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"innerHTML": "\n\u003cp>Guéçamburu said she’s angry and frustrated that the state views services for people with disabilities as expendable.\u003c/p>\n",
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"\n\u003cp>Guéçamburu said she’s angry and frustrated that the state views services for people with disabilities as expendable.\u003c/p>\n"
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"innerHTML": "\n\u003cp>“It’s exhausting to have to justify your existence every legislative cycle,” she said.\u003c/p>\n",
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"\n\u003cp>“It’s exhausting to have to justify your existence every legislative cycle,” she said.\u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cem>Supported by the California Health Care Foundation (CHCF), which works to ensure that people have access to the care they need, when they need it, at a price they can afford. Visit www.chcf.org to learn more.\u003c/em>\u003c/p>\n",
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"\n\u003cp>\u003cem>Supported by the California Health Care Foundation (CHCF), which works to ensure that people have access to the care they need, when they need it, at a price they can afford. Visit www.chcf.org to learn more.\u003c/em>\u003c/p>\n"
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"innerHTML": "\n\u003cp>\u003cem>This article was \u003ca href=\"https://calmatters.org/health/2026/10/california-medi-cal-asset-limit-cut/\">originally published on CalMatters\u003c/a> and was republished under the \u003ca href=\"https://creativecommons.org/licenses/by-nc-nd/4.0/\">Creative Commons Attribution-NonCommercial-NoDerivatives\u003c/a> license.\u003c/em>\u003c/p>\n",
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"\n\u003cp>\u003cem>This article was \u003ca href=\"https://calmatters.org/health/2026/10/california-medi-cal-asset-limit-cut/\">originally published on CalMatters\u003c/a> and was republished under the \u003ca href=\"https://creativecommons.org/licenses/by-nc-nd/4.0/\">Creative Commons Attribution-NonCommercial-NoDerivatives\u003c/a> license.\u003c/em>\u003c/p>\n"
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"excerpt": "Next July, new Medi-Cal rules prohibit seniors and people with disabilities from saving more than $21,000. Senior and disability rights advocates say the cuts unfairly target vulnerable groups.",
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"title": "Medi-Cal Cuts Could Push Seniors and People With Disabilities Off of Coverage | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\n\u003cp class=\"wp-block-paragraph\">\u003cem>This story was originally published by \u003ca href=\"https://calmatters.org/\">CalMatters\u003c/a>. \u003ca href=\"https://calmatters.org/subscribe-to-calmatters/\">Sign up\u003c/a> for their newsletters.\u003c/em>\u003c/p>\n\n\n\n\u003cp class=\"wp-block-paragraph\">Julia Feinberg feels like she’s living in a sinister version of Groundhog Day. For the second year in a row \u003ca href=\"https://www.kqed.org/news/tag/california\">California\u003c/a> lawmakers have made it tougher for seniors and people with disabilities to qualify for state-funded health benefits. \u003c/p>\n\n\n\n\u003cp class=\"wp-block-paragraph\">Feinberg, 37, who has a degenerative neuromuscular disorder, said without Medi-Cal she would be confined to a nursing home rather than living and working as a therapist in Oakland.\u003c/p>\n\n\n\n\u003cp class=\"wp-block-paragraph\">“We keep having to have the same fight over and over and over again,” Feinberg said. She requires a power wheelchair and about 19 hours of caregiving each day, which Medi-Cal covers.\u003c/p>\n\n\n\n\u003cp class=\"wp-block-paragraph\">California is cutting Medi-Cal after a decade of expansion, part of \u003ca href=\"https://calmatters.org/health/2026/08/medi-cal-the-cut-healthcare-threatened/\">sweeping federal and state cuts\u003c/a> that experts estimate will kick more than 2.2 million Californians off coverage in the next four years, doubling the state’s uninsured rate. \u003c/p>\n\n\n\n\u003cfigure class=\"wp-block-image size-full\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"1333\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/11/CaregiverGetty.jpg\" alt=\"\" class=\"wp-image-12063947\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/11/CaregiverGetty.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/11/CaregiverGetty-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/11/CaregiverGetty-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">A senior woman at home receiving health care. (LPETTET via Getty Images)\u003c/figcaption>\u003c/figure>\n\n\n\n\u003cp class=\"wp-block-paragraph\">The latest cut came in June, when state leaders approved a budget that will lower the asset limit for low-income seniors and people with disabilities to $21,000 to qualify for Medi-Cal, starting in July 2027. Feinberg, who has built up emergency savings, will have to spend about $10,000 to get under the cap.\u003c/p>\n\n\n\n\u003cp class=\"wp-block-paragraph\">In 2024, the state eliminated longstanding Medi-Cal asset limits, but since then lawmakers have chipped away at that policy. At the beginning of this year, state leaders reinstated an asset limit of $130,000, and the June budget lowered it further. \u003c/p>\n\n\n\n\u003cp class=\"wp-block-paragraph\">A primary residence and one vehicle are exempt from the new limit, but people 65 and older as well as those with disabilities cannot own a second home or car, and they can’t have more than $21,000 in \u003ca href=\"https://www.dhcs.ca.gov/wp-content/uploads/2025/10/MC007-ENG.pdf\">savings accounts, certain retirement accounts, life insurance policies or even burial plots\u003c/a>. They must still meet \u003ca href=\"https://www.dhcs.ca.gov/medi-cal/qualify/qualify-for-medi-cal-eligibility-chart/\">Medi-Cal income eligibility limits\u003c/a> of about $1,800 a month for a single person.\u003c/p>\n\n\n\n\u003cp class=\"wp-block-paragraph\">Advocates say the rules unfairly target older people and those with disabilities. \u003c/p>\n\n\n\n\u003cfigure class=\"wp-block-image size-full\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"1333\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/10/101926_ASSET-LIMIT_LV_CM_04-a244a4ca.jpg\" alt=\"\" class=\"wp-image-12106309\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/10/101926_ASSET-LIMIT_LV_CM_04-a244a4ca.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/10/101926_ASSET-LIMIT_LV_CM_04-a244a4ca-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/10/101926_ASSET-LIMIT_LV_CM_04-a244a4ca-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">Caretaker Lexi Marsh assists Elizabette Guéçamburu with various day-to-day tasks. (Larry Valenzuela/CalMatters)\u003c/figcaption>\u003c/figure>\n\n\n\n\u003cp class=\"wp-block-paragraph\">“It’s really expensive to be disabled,” said Elizabette Guéçamburu, 44, who like Feinberg has spinal muscular atrophy and requires a power wheelchair as well as daily caregiving.\u003c/p>\n\n\n\n\u003cp class=\"wp-block-paragraph\">Guéçamburu said she’s saving up for a used wheelchair-accessible van, which costs about $75,000. Home modifications such as adding ramps and making bathrooms accessible also cost tens of thousands of dollars, none of which are covered by Medi-Cal. Guéçamburu said those expenses would be impossible to afford if she couldn’t save.\u003c/p>\n\n\n\n\u003cp class=\"wp-block-paragraph\">Guéçamburu lives on her family’s farm in Patterson where they grow walnuts, almonds and alfalfa. She works part time as the farm’s bookkeeper. In 2024, doctors diagnosed Guéçamburu’s father with prostate cancer, and he could no longer act as her caregiver. The same year, California eliminated asset limits for people with disabilities and seniors — Guéçamburu cried, able to qualify for Medi-Cal for the first time. \u003c/p>\n\n\n\n\u003cp class=\"wp-block-paragraph\">“The timing was a godsend,” she said.\u003c/p>\n\n\n\n\u003cfigure class=\"wp-block-gallery has-nested-images columns-default is-cropped wp-block-gallery-1 is-layout-flex wp-block-gallery-is-layout-flex\">\n\u003cfigure class=\"wp-block-image size-large\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"1333\" data-id=\"12106310\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/10/101926-ASSET-LIMIT-LV_CM_24-4689659e.jpg\" alt=\"\" class=\"wp-image-12106310\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/10/101926-ASSET-LIMIT-LV_CM_24-4689659e.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/10/101926-ASSET-LIMIT-LV_CM_24-4689659e-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/10/101926-ASSET-LIMIT-LV_CM_24-4689659e-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">Caretaker Lexi Marsh helps Elizabette Guecamburu get inside her van in the garage of her home outside Patterson on Oct. 16, 2026. Guecamburu is afraid that recently passed state Medi-Cal cuts will disqualify her from benefits. (Larry Valenzuela/CalMatters)\u003c/figcaption>\u003c/figure>\n\n\n\n\u003cfigure class=\"wp-block-image size-large\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"1333\" data-id=\"12106311\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/10/101926_ASSET-LIMIT_LV_CM_20-967a950c.jpg\" alt=\"\" class=\"wp-image-12106311\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/10/101926_ASSET-LIMIT_LV_CM_20-967a950c.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/10/101926_ASSET-LIMIT_LV_CM_20-967a950c-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/10/101926_ASSET-LIMIT_LV_CM_20-967a950c-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">Caretaker Lexi Marsh feeds Elizabette Guéçamburu her food. (Larry Valenzuela/CalMatters)\u003c/figcaption>\u003c/figure>\n\u003c/figure>\n\n\n\n\u003cp class=\"wp-block-paragraph\">Now, her aging father is unable to take care of her should she lose Medi-Cal, and Guéçamburu is struggling to figure out what to do with money left to her by her grandmother. She’ll likely have to put it into a special needs trust controlled by a family member and give up financial independence. She also had her family strike her from inheriting any portion of their 100-year-old farm. \u003ca href=\"https://www.aarp.org/caregiving/financial-legal/long-term-care-affordability-report/\">Private home care costs thousands of dollars a month\u003c/a>, making it hard for lower- and middle-income people to pay for it out-of-pocket.\u003c/p>\n\n\n\n\u003cp class=\"wp-block-paragraph\">“I have to surrender our legacy just to have medical security and have the ability to live my life,” Guéçamburu said. \u003c/p>\n\n\n\n\u003ch2 class=\"wp-block-heading\">Asset limit flip-flop\u003c/h2>\n\n\n\n\u003cp class=\"wp-block-paragraph\">Gov. Gavin Newsom eliminated Medi-Cal asset requirements in 2024 after a yearslong campaign by senior and disability rights advocates. In a \u003ca href=\"https://www.gov.ca.gov/2023/05/01/governor-newsom-proclaims-older-californians-month-2023/\">statement before the elimination\u003c/a>, Newsom said he was proud of the “bold investments” his administration was making to “protect life savings and homes.”\u003c/p>\n\n\n\n\u003cp class=\"wp-block-paragraph\">But two years later, faced with a $12 billion budget shortfall, Newsom proposed reinstating the former $2,000 limit, arguing that more than twice as many people enrolled as previously estimated. The Legislature opposed that proposal and compromised at the current higher limit of $130,000, lowering it again to $21,000 starting next July. \u003c/p>\n\n\n\n\u003cfigure class=\"wp-block-image size-full\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"1333\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/10/261023-PROP50VICTORYLAP-33-BL-KQED-7273678d.jpg\" alt=\"\" class=\"wp-image-12106175\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/10/261023-PROP50VICTORYLAP-33-BL-KQED-7273678d.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/10/261023-PROP50VICTORYLAP-33-BL-KQED-7273678d-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/10/261023-PROP50VICTORYLAP-33-BL-KQED-7273678d-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">Gov. Gavin Newsom speaks at a rally alongside California Democratic Party members, labor leaders and advocates in San Francisco on Oct. 23, 2026. (Beth LaBerge/KQED)\u003c/figcaption>\u003c/figure>\n\n\n\n\u003cp class=\"wp-block-paragraph\">Lindsay Imai Hong, California director for Hand In Hand, an advocacy group supporting families that need caregiving, said organizers are looking to the next governor for change.\u003c/p>\n\n\n\n\u003cp class=\"wp-block-paragraph\">“We would love to see the asset test permanently taken off of the chopping block,” Imai Hong said.\u003c/p>\n\n\n\n\u003cp class=\"wp-block-paragraph\">Republican gubernatorial candidate Steve Hilton said in a statement to CalMatters that he opposes asset limits. He criticized the state for extending other Medi-Cal benefits beyond what it could afford, including coverage for immigrants without legal status.\u003c/p>\n\n\n\n\u003cp class=\"wp-block-paragraph\">“Seniors and people with disabilities shouldn’t lose their coverage because they’ve managed to save some money. They’ve done the responsible thing. Why punish them for it?” he said.\u003c/p>\n\n\n\n\u003cp class=\"wp-block-paragraph\">Democratic gubernatorial candidate and front-runner Xavier Becerra did not answer specific questions about the asset limit policy, but a campaign spokesperson blamed the Trump administration’s federal cuts for “squeezing” California’s Medi-Cal program.\u003c/p>\n\n\n\n\u003cfigure class=\"wp-block-image size-full\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"1333\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/10/101926_ASSET-LIMIT_LV_CM_07-2a2066eb.jpg\" alt=\"\" class=\"wp-image-12106312\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/10/101926_ASSET-LIMIT_LV_CM_07-2a2066eb.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/10/101926_ASSET-LIMIT_LV_CM_07-2a2066eb-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/10/101926_ASSET-LIMIT_LV_CM_07-2a2066eb-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">Elizabette Guecamburu does her circulation exercises in the living room of her home outside of Patterson on Oct. 16, 2026. Guecamburu is afraid that recently passed state Medi-Cal cuts will disqualify her from benefits. (Larry Valenzuela/CalMatters)\u003c/figcaption>\u003c/figure>\n\n\n\n\u003cp class=\"wp-block-paragraph\">Becerra will be “focused on protecting access to care and demand savings that are real, measurable and sustainable,” spokesperson Johnathan Underland said. On the campaign trail, Becerra has called himself California’s next “healthcare governor” and has \u003ca href=\"https://www.politico.com/news/2025/08/27/xavier-becerra-wants-to-be-the-health-care-governor-00532691\">previously floated raising taxes\u003c/a> to reverse Medi-Cal cuts, but \u003ca href=\"https://calmatters.org/health/2026/09/california-governor-healthcare-plans-2026/\">has not released detailed health policy plans\u003c/a>.\u003c/p>\n\n\n\n\u003cp class=\"wp-block-paragraph\">Camille Nguyen, an attorney with the Legal Aid Society of San Mateo County, said most people who struggle to stay under the limit have little financial security.\u003c/p>\n\n\n\n\u003cp class=\"wp-block-paragraph\">“They have all of their life savings in cash savings instead of a house. That’s their retirement. That is the amount they are expecting to live off of for the rest of their life,” Nguyen said.\u003c/p>\n\n\n\n\u003cp class=\"wp-block-paragraph\">State data shows about 600 people lost Medi-Cal when California reinstated the $130,000 limit. Advocates expect many more to lose Medi-Cal at the lower limit, but the state never released budget estimates before lawmakers approved the $21,000 limit. If the state reinstated the much lower $2,000 limit, the Department of Finance estimated 62,000 seniors and people with disabilities would lose Medi-Cal over two years. \u003c/p>\n\n\n\n\u003ch2 class=\"wp-block-heading\">Limit fuels anxiety, anger among people with disabilities\u003c/h2>\n\n\n\n\u003cp class=\"wp-block-paragraph\">Feinberg said the prospect of losing Medi-Cal is especially scary because she would also lose access to a special disability program that pays for extra caregiving hours and has a multiyear waitlist. Caregivers help Feinberg get in and out of bed, dress and prepare her meals.\u003c/p>\n\n\n\n\u003cp class=\"wp-block-paragraph\">Before the limit was erased in 2024, Feinberg said she checked her bank account every day to make sure the balance was low. At the time, Feinberg was a graduate student and did not earn very much money. Now, as a licensed therapist Feinberg has been able to squirrel away some money.\u003c/p>\n\n\n\n\n\n\u003cp class=\"wp-block-paragraph\">“I don’t want to spend down that money. I want to save that for retirement, maybe buying a house in the future,” Feinberg said. “The prospect of not being able to have a nest egg is very unsettling.”\u003c/p>\n\n\n\n\u003cp class=\"wp-block-paragraph\">Guéçamburu said she’s angry and frustrated that the state views services for people with disabilities as expendable.\u003c/p>\n\n\n\n\u003cp class=\"wp-block-paragraph\">“It’s exhausting to have to justify your existence every legislative cycle,” she said.\u003c/p>\n\n\n\n\u003cp class=\"wp-block-paragraph\">\u003cem>Supported by the California Health Care Foundation (CHCF), which works to ensure that people have access to the care they need, when they need it, at a price they can afford. Visit www.chcf.org to learn more.\u003c/em>\u003c/p>\n\n\n\n\u003cp class=\"wp-block-paragraph\">\u003cem>This article was \u003ca href=\"https://calmatters.org/health/2026/10/california-medi-cal-asset-limit-cut/\">originally published on CalMatters\u003c/a> and was republished under the \u003ca href=\"https://creativecommons.org/licenses/by-nc-nd/4.0/\">Creative Commons Attribution-NonCommercial-NoDerivatives\u003c/a> license.\u003c/em>\u003c/p>\n\u003c/div>\u003c/p>",
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"slug": "medi-cal-wont-pay-for-assisted-living-in-most-of-california-one-brother-fought-back",
"title": "Medi-Cal Won’t Pay for Assisted Living in Most of California. One Brother Fought Back",
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"headTitle": "Medi-Cal Won’t Pay for Assisted Living in Most of California. One Brother Fought Back | KQED",
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"content": "\n\u003cp>\u003cem>Welcome to CalMatters, the only nonprofit newsroom devoted solely to covering issues that affect all Californians. Sign up for \u003ca href=\"https://calmatters.org/subscribe-to-calmatters/whatmatters\">WhatMatters\u003c/a> to receive the latest news and commentary on the most important issues in the Golden State.\u003c/em>\u003c/p>\n\n\n\n\u003cp>Last summer, siblings Roselie and John Aiello decided it was time for Roselie to leave her home of 73 years. \u003c/p>\n\n\n\n\u003cp>Raised on a cattle ranch in the small town of Mount Shasta, Roselie spent her life working as a butcher and handling animals, assisting her father until his death. When her three brothers moved away, she stayed at home on the ranch, with its winding dirt roads and green pastures. But over the years, the hard manual labor left her bones weak and her back curved, slowing her pace. \u003c/p>\n\n\n\n\u003cp>John moved back to the ranch in far \u003ca href=\"https://www.kqed.org/news/tag/northern-california\">Northern California\u003c/a> to take care of Roselie, who needed some assistance with showering and getting dressed. But these tasks began to weigh on John as he balanced his career as a writer with tending to the land, which was getting more difficult for Roselie to navigate. \u003c/p>\n\n\n\n\u003cp>The two siblings made a decision: Roselie, who qualified for Medicaid, would move into assisted living. John would find an appropriate place for her to live and receive care.\u003c/p>\n\n\n\n\u003cp>But when John tried to apply for assisted living benefits on his sister’s behalf, he found that Medi-Cal — California’s version of Medicaid — does not offer a waiver to pay for assisted living care in Siskiyou County, nor does it in 42 others across the state. Only \u003ca href=\"https://www.dhcs.ca.gov/services/long-term-care-alternatives-home-and-community-based-service-options/assisted-living-waiver/\">15 California counties\u003c/a>, most of them urban, offer this option.\u003c/p>\n\n\n\n\u003cp>This has created geographic disparity that gives aging adults in urban areas more options for care than those in rural areas, pushing Northern California seniors like Roselie Aiello into nursing homes or out of their communities, not because they need that level of care, but because they can’t afford to pay out of pocket for assisted living. \u003c/p>\n\n\n\n\u003cp>“You’re wasting money by dumping somebody like my sister in a skilled nursing facility and lessening her quality of life and her chance at doing better,” John said. “By doing this, it makes no fundamental sense.”\u003c/p>\n\n\n\n\u003cfigure class=\"wp-block-gallery has-nested-images columns-default is-cropped wp-block-gallery-1 is-layout-flex wp-block-gallery-is-layout-flex\">\n\u003cfigure class=\"wp-block-image size-large\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"1333\" data-id=\"12098658\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/CMHealthCare2.jpg\" alt=\"\" class=\"wp-image-12098658\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/CMHealthCare2.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/CMHealthCare2-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/CMHealthCare2-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">Roselie Aiello at Sundial Assisted Living in Shasta County on March 25, 2026. \u003cbr> (Jessica Blough for CalMatters)\u003c/figcaption>\u003c/figure>\n\n\n\n\u003cfigure class=\"wp-block-image size-large\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"1333\" data-id=\"12098659\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/CMHealthCare3.jpg\" alt=\"\" class=\"wp-image-12098659\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/CMHealthCare3.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/CMHealthCare3-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/CMHealthCare3-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">Roselie Aiello at Sundial Assisted Living in Shasta County on March 25, 2026. (Jessica Blough for CalMatters)\u003c/figcaption>\u003c/figure>\n\u003c/figure>\n\n\n\n\u003cp>In the coming decade, many more Californians may face the same predicament, given that one in four will be older than 60. As the state prepares for this explosion in the older adult population, it is prioritizing the ability to age in community-based settings like homes or assisted living facilities. \u003c/p>\n\n\n\n\u003cp>But availability of assisted living options varies county to county and is based on decisions by the various managed care providers contracted to deliver healthcare to the state’s lowest-income residents.\u003c/p>\n\n\n\n\u003cp>“There’s not a lot of options to begin with in rural counties. You take (the assisted living waiver) off a table, which already has a history of a long waiting list, and the options are pretty bleak,” said Maura Gibney, executive director of California Advocates for Nursing Home Reform.\u003c/p>\n\n\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr />\n\u003ciframe loading=\"lazy\" src=\"https://datawrapper.dwcdn.net/PCZuA/\" width=\"800\" height=\"800\" scrolling=\"yes\" class=\"iframe-class\" frameborder=\"0\">\u003c/iframe>\u003c/p>\n\n\n\n\u003cp>Partnership HealthPlan, which Roselie Aiello is enrolled in, contracts with the state to provide coverage to almost a million Californians on Medi-Cal, making it the largest Medi-Cal managed care plan in Northern California. It is the only Medi-Cal managed care plan available in a separate set of 15 California counties. \u003c/p>\n\n\n\n\u003cp>Managed care providers are encouraged, but not required, to offer as many “\u003ca href=\"https://calaim.dhcs.ca.gov/pages/community-supports\">community supports\u003c/a>” as they can, Tessa Outhyse, a spokesperson for the California Department of Health Care Services, said in an email. CalAIM, the state’s multiyear initiative to overhaul Medi-Cal, includes community supports such as assistance transitioning to an assisted living facility as well as transitional rent, caregiver respite and personal care services. \u003c/p>\n\n\n\n\u003cp>These services are intended to offer healthcare options to Medi-Cal members before their conditions escalate to needing more serious care, therefore saving money. Even when CalAIM’s current waivers expire at the end of the year, the community supports benefits will continue through the managed care plans. \u003c/p>\n\n\n\n\u003cp>When determining which supports to offer, managed care plans take into consideration provider availability and local capacity to offer care, Outhyse said. Partnership chose not to offer assisted living support based on financial factors and a lack of appropriate facilities in the rural areas where it provides care, said Dustin Lyda, spokesperson for the organization. \u003c/p>\n\n\n\n\u003cp>Lyda said any change in what the organization offers would require proof that assisted living facilities would be safer and healthier for members than nursing homes. But he acknowledged that options are more limited for rural members. \u003c/p>\n\n\n\n\u003cp>“There’s definitely a lot more work that we need to do on our end to navigate the more rural areas,” Lyda said. \u003c/p>\n\n\n\n\u003ch2 class=\"wp-block-heading\" id=\"hitting-roadblocks\">Hitting roadblocks\u003c/h2>\n\n\n\n\u003cp>When John Aiello heard about assisted living benefits through Medi-Cal, he saw it as the perfect match for his sister’s needs. He knew that he likely would have to move her out of Siskiyou County, where there was only one facility for Medi-Cal recipients, a nursing home.\u003c/p>\n\n\n\n\u003cp>Roselie had spent some time at an assisted living facility in neighboring Shasta County, which they saw as a better fit. But Partnership didn’t offer assisted living as a community support in that county. \u003c/p>\n\n\n\n\n\n\u003cp>Instead, the provider offered Roselie a waiver to go into assisted living in Sonoma County, which is about five hours from her home. The Aiellos turned that down, thinking it would not be good for Roselie. \u003c/p>\n\n\n\n\u003cp>“If you remove her totally from a family contact, she would not be thriving right now. She needs to see family,” John Aiello said. “When there were resources available that fit her needs in Redding — that’s the closest point to her home county — why do I need to move her to Oakland, to Los Angeles, to San Diego?”\u003c/p>\n\n\n\n\u003cp>Over the course of nine months, John sent dozens of emails and spent hours on phone calls to get Partnership HealthPlan to cover Roselie’s placement in assisted living. He had the support of her doctor and a spot for Roselie at the residence in Shasta County. \u003c/p>\n\n\n\n\u003cp>The process was so intense and frustrating that it drove a wedge between him and his sister in their final months of living together. \u003c/p>\n\n\n\n\u003cp>“He was doing all of this to help me,” Roselie said. “Where was it going to end?”\u003c/p>\n\n\n\n\u003ch2 class=\"wp-block-heading\" id=\"encouraged-or-required\">Encouraged or required? \u003c/h2>\n\n\n\n\u003cp>Most people prefer community-based services over skilled nursing care, which is \u003ca href=\"https://heller.brandeis.edu/community-living-policy/research-policy/publications/pdfs/briefs/hcbs-improve-outcomes-and-reduce-costs.pdf\">generally more expensive\u003c/a>. But nursing home beds are in short supply and should be reserved for those who truly need them, Gibney said.\u003c/p>\n\n\n\n\u003cp>“We really try to help people look at the other options that exist for remaining in the community,” Gibney said. “You’re going to have better health outcomes, better quality of care, if you can stay in the community and out of an institutional setting.”\u003c/p>\n\n\n\n\u003cp>Research indicates that while assisted living may provide better outcomes for some, people in assisted living are more likely than nursing home residents to be hospitalized, which can drive up costs, said Dr. Kenneth Lam, a geriatrician and assistant professor at the University of Colorado Anschutz Medical Campus. \u003c/p>\n\n\n\n\u003cp>“The evidence suggests that it’s a trade-off,” he said. \u003c/p>\n\n\n\n\n\n\u003cp>Contracts for managed care plans are not competitively bid, Outhyse said. And potential contractors aren’t asked to include specific community supports, such as assisted living, in their managed care plans.\u003c/p>\n\n\n\n\u003cp>“Whether a plan chooses to provide specific community supports is not a factor in contract renewal, which focuses instead on overall compliance with state and federal performance standards,” Outhyse wrote in the email.\u003c/p>\n\n\n\n\u003cp>Partnership’s contract with the state was set to expire in December, but will be extended until 2029 because the state \u003ca href=\"https://www.dhcs.ca.gov/services/Pages/ManagedCarePlanProcurementUpdate.aspx\">delayed\u003c/a> the process of soliciting managed care contracts. Lyda said Partnership is facing increasing demand for its community supports — which mainly address social needs, such as housing and food security — and for assisted living benefits. But even people in counties where the managed care provider offers an assisted living benefit can have a long wait for placement. \u003c/p>\n\n\n\n\u003cp>After years of constant increases, the number of Californians receiving an assisted living waiver for the first time dropped at the beginning of 2025, though the waitlist continued to climb. \u003c/p>\n\n\n\n\u003cp>By September, the number of Californians waiting for a waiver had surpassed the number of people who were being supported by it.\u003c/p>\n\n\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr />\n\u003ciframe loading=\"lazy\" src=\"https://datawrapper.dwcdn.net/kH9D7\" width=\"800\" height=\"800\" scrolling=\"yes\" class=\"iframe-class\" frameborder=\"0\">\u003c/iframe>\u003c/p>\n\n\n\n\u003cp>Gibney said that Medi-Cal members are often encouraged to get on the waitlist before applying for assisted living funding, which could contribute to the long wait. \u003c/p>\n\n\n\n\u003cp>Older adults might spend months on a waitlist, only to be told that they are ineligible for assisted living coverage. \u003c/p>\n\n\n\n\u003cp>“It’s a lot of shifting sand, that’s what people are finding themselves in the middle of,” Lam said. “They’re being told that they get to choose, but it’s a complex choice.”\u003c/p>\n\n\n\n\u003ch2 class=\"wp-block-heading\" id=\"a-new-home\">A new home\u003c/h2>\n\n\n\n\u003cp>In March, Roselie moved into her new home, Sundial Assisted Living, the Shasta County facility where she had previously spent some time. Two months earlier, Partnership had informed the Aiellos that it would cover Roselie’s assisted living care. \u003c/p>\n\n\n\n\u003cp>Partnership offered Roselie early access to a pilot program that launched on July 1, which extends the assisted living options to select members of the network. There will be no open application process, but members can ask to be considered or referred through a healthcare provider. \u003c/p>\n\n\n\n\u003cp>The goal is to discover if offering the assisted living option will provide better health outcomes at a lower price.\u003c/p>\n\n\n\n\u003cp>“Success would also be having these individuals being able to continue to receive care within their community setting, being in their home,” Lyda said. “We know that that is more impactful to health than being completely taken out of a familiar area.” \u003c/p>\n\n\n\n\u003cp>The adjustment has not been easy for Roselie. She has been hospitalized twice since she moved to Sundial and briefly entered a nursing home. \u003cs> \u003c/s>\u003c/p>\n\n\n\n\u003cp>Socially, things have gone better. Roselie has made friends and is often called on to teach card games to her fellow Sundial residents. While she was hospitalized, her neighbors and caretakers at Sundial visited her. She’s grateful to John for navigating through red tape to get her here. \u003c/p>\n\n\n\n\u003cp>“I’m looking at it like this: It’s a new adventure,” she said. \u003c/p>\n\n\n\n\u003cp>John worries about his sister’s health issues and whether Sundial will be a long-term solution for her. He’s gratified that his fight ended with his sister’s placement in their chosen facility. But he resents having to wage the battle.\u003c/p>\n\n\n\n\u003cp>“I don’t understand why I was the guy fighting for everybody,” John said. “I’m just one person trying to support myself, trying to take care of a family member.”\u003c/p>\n\n\n\n\u003cp>\u003cem>Jessica Blough reported on this story while with the\u003c/em> \u003ca href=\"https://journalism.berkeley.edu/programs/mj/investigative-reporting/\">\u003cem>Investigative Reporting Program\u003c/em>\u003c/a> \u003cem>at UC Berkeley Journalism School, with a grant from\u003c/em> \u003ca href=\"https://www.thescanfoundation.org/\">\u003cem>The SCAN Foundation\u003c/em>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n",
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"innerHTML": "\n\u003cp>\u003cem>Welcome to CalMatters, the only nonprofit newsroom devoted solely to covering issues that affect all Californians. Sign up for \u003ca href=\"https://calmatters.org/subscribe-to-calmatters/whatmatters\">WhatMatters\u003c/a> to receive the latest news and commentary on the most important issues in the Golden State.\u003c/em>\u003c/p>\n",
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"\n\u003cp>\u003cem>Welcome to CalMatters, the only nonprofit newsroom devoted solely to covering issues that affect all Californians. Sign up for \u003ca href=\"https://calmatters.org/subscribe-to-calmatters/whatmatters\">WhatMatters\u003c/a> to receive the latest news and commentary on the most important issues in the Golden State.\u003c/em>\u003c/p>\n"
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"innerHTML": "\n\u003cp>Last summer, siblings Roselie and John Aiello decided it was time for Roselie to leave her home of 73 years. \u003c/p>\n",
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"innerHTML": "\n\u003cp>Raised on a cattle ranch in the small town of Mount Shasta, Roselie spent her life working as a butcher and handling animals, assisting her father until his death. When her three brothers moved away, she stayed at home on the ranch, with its winding dirt roads and green pastures. But over the years, the hard manual labor left her bones weak and her back curved, slowing her pace. \u003c/p>\n",
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"innerHTML": "\n\u003cp>John moved back to the ranch in far \u003ca href=\"https://www.kqed.org/news/tag/northern-california\">Northern California\u003c/a> to take care of Roselie, who needed some assistance with showering and getting dressed. But these tasks began to weigh on John as he balanced his career as a writer with tending to the land, which was getting more difficult for Roselie to navigate. \u003c/p>\n",
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"\n\u003cp>John moved back to the ranch in far \u003ca href=\"https://www.kqed.org/news/tag/northern-california\">Northern California\u003c/a> to take care of Roselie, who needed some assistance with showering and getting dressed. But these tasks began to weigh on John as he balanced his career as a writer with tending to the land, which was getting more difficult for Roselie to navigate. \u003c/p>\n"
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"innerHTML": "\n\u003cp>But when John tried to apply for assisted living benefits on his sister’s behalf, he found that Medi-Cal — California’s version of Medicaid — does not offer a waiver to pay for assisted living care in Siskiyou County, nor does it in 42 others across the state. Only \u003ca href=\"https://www.dhcs.ca.gov/services/long-term-care-alternatives-home-and-community-based-service-options/assisted-living-waiver/\">15 California counties\u003c/a>, most of them urban, offer this option.\u003c/p>\n",
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"\n\u003cp>But when John tried to apply for assisted living benefits on his sister’s behalf, he found that Medi-Cal — California’s version of Medicaid — does not offer a waiver to pay for assisted living care in Siskiyou County, nor does it in 42 others across the state. Only \u003ca href=\"https://www.dhcs.ca.gov/services/long-term-care-alternatives-home-and-community-based-service-options/assisted-living-waiver/\">15 California counties\u003c/a>, most of them urban, offer this option.\u003c/p>\n"
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"innerHTML": "\n\u003cp>This has created geographic disparity that gives aging adults in urban areas more options for care than those in rural areas, pushing Northern California seniors like Roselie Aiello into nursing homes or out of their communities, not because they need that level of care, but because they can’t afford to pay out of pocket for assisted living. \u003c/p>\n",
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"\n\u003cp>This has created geographic disparity that gives aging adults in urban areas more options for care than those in rural areas, pushing Northern California seniors like Roselie Aiello into nursing homes or out of their communities, not because they need that level of care, but because they can’t afford to pay out of pocket for assisted living. \u003c/p>\n"
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"innerHTML": "\n\u003cp>“You’re wasting money by dumping somebody like my sister in a skilled nursing facility and lessening her quality of life and her chance at doing better,” John said. “By doing this, it makes no fundamental sense.”\u003c/p>\n",
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"innerHTML": "\n\u003cp>In the coming decade, many more Californians may face the same predicament, given that one in four will be older than 60. As the state prepares for this explosion in the older adult population, it is prioritizing the ability to age in community-based settings like homes or assisted living facilities. \u003c/p>\n",
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"innerHTML": "\n\u003cp>“There’s not a lot of options to begin with in rural counties. You take (the assisted living waiver) off a table, which already has a history of a long waiting list, and the options are pretty bleak,” said Maura Gibney, executive director of California Advocates for Nursing Home Reform.\u003c/p>\n",
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"innerHTML": "\n\u003cp>Partnership HealthPlan, which Roselie Aiello is enrolled in, contracts with the state to provide coverage to almost a million Californians on Medi-Cal, making it the largest Medi-Cal managed care plan in Northern California. It is the only Medi-Cal managed care plan available in a separate set of 15 California counties. \u003c/p>\n",
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"innerHTML": "\n\u003cp>When determining which supports to offer, managed care plans take into consideration provider availability and local capacity to offer care, Outhyse said. Partnership chose not to offer assisted living support based on financial factors and a lack of appropriate facilities in the rural areas where it provides care, said Dustin Lyda, spokesperson for the organization. \u003c/p>\n",
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"innerHTML": "\n\u003cp>Lyda said any change in what the organization offers would require proof that assisted living facilities would be safer and healthier for members than nursing homes. But he acknowledged that options are more limited for rural members. \u003c/p>\n",
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"innerHTML": "\n\u003cp>When John Aiello heard about assisted living benefits through Medi-Cal, he saw it as the perfect match for his sister’s needs. He knew that he likely would have to move her out of Siskiyou County, where there was only one facility for Medi-Cal recipients, a nursing home.\u003c/p>\n",
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"innerHTML": "\n\u003cp>Instead, the provider offered Roselie a waiver to go into assisted living in Sonoma County, which is about five hours from her home. The Aiellos turned that down, thinking it would not be good for Roselie. \u003c/p>\n",
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"innerHTML": "\n\u003cp>“If you remove her totally from a family contact, she would not be thriving right now. She needs to see family,” John Aiello said. “When there were resources available that fit her needs in Redding — that’s the closest point to her home county — why do I need to move her to Oakland, to Los Angeles, to San Diego?”\u003c/p>\n",
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"\n\u003cp>“If you remove her totally from a family contact, she would not be thriving right now. She needs to see family,” John Aiello said. “When there were resources available that fit her needs in Redding — that’s the closest point to her home county — why do I need to move her to Oakland, to Los Angeles, to San Diego?”\u003c/p>\n"
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"innerHTML": "\n\u003cp>Over the course of nine months, John sent dozens of emails and spent hours on phone calls to get Partnership HealthPlan to cover Roselie’s placement in assisted living. He had the support of her doctor and a spot for Roselie at the residence in Shasta County. \u003c/p>\n",
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"innerHTML": "\n\u003cp>Most people prefer community-based services over skilled nursing care, which is \u003ca href=\"https://heller.brandeis.edu/community-living-policy/research-policy/publications/pdfs/briefs/hcbs-improve-outcomes-and-reduce-costs.pdf\">generally more expensive\u003c/a>. But nursing home beds are in short supply and should be reserved for those who truly need them, Gibney said.\u003c/p>\n",
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"\n\u003cp>Most people prefer community-based services over skilled nursing care, which is \u003ca href=\"https://heller.brandeis.edu/community-living-policy/research-policy/publications/pdfs/briefs/hcbs-improve-outcomes-and-reduce-costs.pdf\">generally more expensive\u003c/a>. But nursing home beds are in short supply and should be reserved for those who truly need them, Gibney said.\u003c/p>\n"
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"innerHTML": "\n\u003cp>“We really try to help people look at the other options that exist for remaining in the community,” Gibney said. “You’re going to have better health outcomes, better quality of care, if you can stay in the community and out of an institutional setting.”\u003c/p>\n",
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"\n\u003cp>“We really try to help people look at the other options that exist for remaining in the community,” Gibney said. “You’re going to have better health outcomes, better quality of care, if you can stay in the community and out of an institutional setting.”\u003c/p>\n"
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"innerHTML": "\n\u003cp>Research indicates that while assisted living may provide better outcomes for some, people in assisted living are more likely than nursing home residents to be hospitalized, which can drive up costs, said Dr. Kenneth Lam, a geriatrician and assistant professor at the University of Colorado Anschutz Medical Campus. \u003c/p>\n",
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"innerHTML": "\n\u003cp>Contracts for managed care plans are not competitively bid, Outhyse said. And potential contractors aren’t asked to include specific community supports, such as assisted living, in their managed care plans.\u003c/p>\n",
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"innerHTML": "\n\u003cp>“Whether a plan chooses to provide specific community supports is not a factor in contract renewal, which focuses instead on overall compliance with state and federal performance standards,” Outhyse wrote in the email.\u003c/p>\n",
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"innerHTML": "\n\u003cp>Partnership’s contract with the state was set to expire in December, but will be extended until 2029 because the state \u003ca href=\"https://www.dhcs.ca.gov/services/Pages/ManagedCarePlanProcurementUpdate.aspx\">delayed\u003c/a> the process of soliciting managed care contracts. Lyda said Partnership is facing increasing demand for its community supports — which mainly address social needs, such as housing and food security — and for assisted living benefits. But even people in counties where the managed care provider offers an assisted living benefit can have a long wait for placement. \u003c/p>\n",
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"\n\u003cp>Partnership’s contract with the state was set to expire in December, but will be extended until 2029 because the state \u003ca href=\"https://www.dhcs.ca.gov/services/Pages/ManagedCarePlanProcurementUpdate.aspx\">delayed\u003c/a> the process of soliciting managed care contracts. Lyda said Partnership is facing increasing demand for its community supports — which mainly address social needs, such as housing and food security — and for assisted living benefits. But even people in counties where the managed care provider offers an assisted living benefit can have a long wait for placement. \u003c/p>\n"
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"innerHTML": "\n\u003cp>After years of constant increases, the number of Californians receiving an assisted living waiver for the first time dropped at the beginning of 2025, though the waitlist continued to climb. \u003c/p>\n",
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"\n\u003cp>After years of constant increases, the number of Californians receiving an assisted living waiver for the first time dropped at the beginning of 2025, though the waitlist continued to climb. \u003c/p>\n"
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"innerHTML": "\n\u003cp>By September, the number of Californians waiting for a waiver had surpassed the number of people who were being supported by it.\u003c/p>\n",
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"innerHTML": "\n\u003cp>Gibney said that Medi-Cal members are often encouraged to get on the waitlist before applying for assisted living funding, which could contribute to the long wait. \u003c/p>\n",
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"innerHTML": "\n\u003cp>Older adults might spend months on a waitlist, only to be told that they are ineligible for assisted living coverage. \u003c/p>\n",
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"innerHTML": "\n\u003cp>“It’s a lot of shifting sand, that’s what people are finding themselves in the middle of,” Lam said. “They’re being told that they get to choose, but it’s a complex choice.”\u003c/p>\n",
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"\n\u003cp>“It’s a lot of shifting sand, that’s what people are finding themselves in the middle of,” Lam said. “They’re being told that they get to choose, but it’s a complex choice.”\u003c/p>\n"
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"innerHTML": "\n\u003cp>In March, Roselie moved into her new home, Sundial Assisted Living, the Shasta County facility where she had previously spent some time. Two months earlier, Partnership had informed the Aiellos that it would cover Roselie’s assisted living care. \u003c/p>\n",
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"innerHTML": "\n\u003cp>Partnership offered Roselie early access to a pilot program that launched on July 1, which extends the assisted living options to select members of the network. There will be no open application process, but members can ask to be considered or referred through a healthcare provider. \u003c/p>\n",
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"\n\u003cp>Partnership offered Roselie early access to a pilot program that launched on July 1, which extends the assisted living options to select members of the network. There will be no open application process, but members can ask to be considered or referred through a healthcare provider. \u003c/p>\n"
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"innerHTML": "\n\u003cp>The goal is to discover if offering the assisted living option will provide better health outcomes at a lower price.\u003c/p>\n",
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"innerHTML": "\n\u003cp>“Success would also be having these individuals being able to continue to receive care within their community setting, being in their home,” Lyda said. “We know that that is more impactful to health than being completely taken out of a familiar area.” \u003c/p>\n",
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"innerHTML": "\n\u003cp>The adjustment has not been easy for Roselie. She has been hospitalized twice since she moved to Sundial and briefly entered a nursing home. \u003cs> \u003c/s>\u003c/p>\n",
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"innerHTML": "\n\u003cp>Socially, things have gone better. Roselie has made friends and is often called on to teach card games to her fellow Sundial residents. While she was hospitalized, her neighbors and caretakers at Sundial visited her. She’s grateful to John for navigating through red tape to get her here. \u003c/p>\n",
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"innerHTML": "\n\u003cp>John worries about his sister’s health issues and whether Sundial will be a long-term solution for her. He’s gratified that his fight ended with his sister’s placement in their chosen facility. But he resents having to wage the battle.\u003c/p>\n",
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"\n\u003cp>John worries about his sister’s health issues and whether Sundial will be a long-term solution for her. He’s gratified that his fight ended with his sister’s placement in their chosen facility. But he resents having to wage the battle.\u003c/p>\n"
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"innerHTML": "\n\u003cp>“I don’t understand why I was the guy fighting for everybody,” John said. “I’m just one person trying to support myself, trying to take care of a family member.”\u003c/p>\n",
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"innerHTML": "\n\u003cp>\u003cem>Jessica Blough reported on this story while with the\u003c/em> \u003ca href=\"https://journalism.berkeley.edu/programs/mj/investigative-reporting/\">\u003cem>Investigative Reporting Program\u003c/em>\u003c/a> \u003cem>at UC Berkeley Journalism School, with a grant from\u003c/em> \u003ca href=\"https://www.thescanfoundation.org/\">\u003cem>The SCAN Foundation\u003c/em>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n",
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"excerpt": "A pilot program providing more assisted living coverage in rural California has emerged from one man’s fight to change his sister’s options.",
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"title": "Medi-Cal Won’t Pay for Assisted Living in Most of California. One Brother Fought Back | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\n\u003cp>\u003cem>Welcome to CalMatters, the only nonprofit newsroom devoted solely to covering issues that affect all Californians. Sign up for \u003ca href=\"https://calmatters.org/subscribe-to-calmatters/whatmatters\">WhatMatters\u003c/a> to receive the latest news and commentary on the most important issues in the Golden State.\u003c/em>\u003c/p>\n\n\n\n\u003cp>Last summer, siblings Roselie and John Aiello decided it was time for Roselie to leave her home of 73 years. \u003c/p>\n\n\n\n\u003cp>Raised on a cattle ranch in the small town of Mount Shasta, Roselie spent her life working as a butcher and handling animals, assisting her father until his death. When her three brothers moved away, she stayed at home on the ranch, with its winding dirt roads and green pastures. But over the years, the hard manual labor left her bones weak and her back curved, slowing her pace. \u003c/p>\n\n\n\n\u003cp>John moved back to the ranch in far \u003ca href=\"https://www.kqed.org/news/tag/northern-california\">Northern California\u003c/a> to take care of Roselie, who needed some assistance with showering and getting dressed. But these tasks began to weigh on John as he balanced his career as a writer with tending to the land, which was getting more difficult for Roselie to navigate. \u003c/p>\n\n\n\n\u003cp>The two siblings made a decision: Roselie, who qualified for Medicaid, would move into assisted living. John would find an appropriate place for her to live and receive care.\u003c/p>\n\n\n\n\u003cp>But when John tried to apply for assisted living benefits on his sister’s behalf, he found that Medi-Cal — California’s version of Medicaid — does not offer a waiver to pay for assisted living care in Siskiyou County, nor does it in 42 others across the state. Only \u003ca href=\"https://www.dhcs.ca.gov/services/long-term-care-alternatives-home-and-community-based-service-options/assisted-living-waiver/\">15 California counties\u003c/a>, most of them urban, offer this option.\u003c/p>\n\n\n\n\u003cp>This has created geographic disparity that gives aging adults in urban areas more options for care than those in rural areas, pushing Northern California seniors like Roselie Aiello into nursing homes or out of their communities, not because they need that level of care, but because they can’t afford to pay out of pocket for assisted living. \u003c/p>\n\n\n\n\u003cp>“You’re wasting money by dumping somebody like my sister in a skilled nursing facility and lessening her quality of life and her chance at doing better,” John said. “By doing this, it makes no fundamental sense.”\u003c/p>\n\n\n\n\u003cfigure class=\"wp-block-gallery has-nested-images columns-default is-cropped wp-block-gallery-1 is-layout-flex wp-block-gallery-is-layout-flex\">\n\u003cfigure class=\"wp-block-image size-large\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"1333\" data-id=\"12098658\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/CMHealthCare2.jpg\" alt=\"\" class=\"wp-image-12098658\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/CMHealthCare2.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/CMHealthCare2-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/CMHealthCare2-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">Roselie Aiello at Sundial Assisted Living in Shasta County on March 25, 2026. \u003cbr> (Jessica Blough for CalMatters)\u003c/figcaption>\u003c/figure>\n\n\n\n\u003cfigure class=\"wp-block-image size-large\">\u003cimg loading=\"lazy\" decoding=\"async\" width=\"2000\" height=\"1333\" data-id=\"12098659\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/CMHealthCare3.jpg\" alt=\"\" class=\"wp-image-12098659\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/CMHealthCare3.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/CMHealthCare3-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/09/CMHealthCare3-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\" />\u003cfigcaption class=\"wp-element-caption\">Roselie Aiello at Sundial Assisted Living in Shasta County on March 25, 2026. (Jessica Blough for CalMatters)\u003c/figcaption>\u003c/figure>\n\u003c/figure>\n\n\n\n\u003cp>In the coming decade, many more Californians may face the same predicament, given that one in four will be older than 60. As the state prepares for this explosion in the older adult population, it is prioritizing the ability to age in community-based settings like homes or assisted living facilities. \u003c/p>\n\n\n\n\u003cp>But availability of assisted living options varies county to county and is based on decisions by the various managed care providers contracted to deliver healthcare to the state’s lowest-income residents.\u003c/p>\n\n\n\n\u003cp>“There’s not a lot of options to begin with in rural counties. You take (the assisted living waiver) off a table, which already has a history of a long waiting list, and the options are pretty bleak,” said Maura Gibney, executive director of California Advocates for Nursing Home Reform.\u003c/p>\n\n\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr />\n\u003ciframe loading=\"lazy\" src=\"https://datawrapper.dwcdn.net/PCZuA/\" width=\"800\" height=\"800\" scrolling=\"yes\" class=\"iframe-class\" frameborder=\"0\">\u003c/iframe>\u003c/p>\n\n\n\n\u003cp>Partnership HealthPlan, which Roselie Aiello is enrolled in, contracts with the state to provide coverage to almost a million Californians on Medi-Cal, making it the largest Medi-Cal managed care plan in Northern California. It is the only Medi-Cal managed care plan available in a separate set of 15 California counties. \u003c/p>\n\n\n\n\u003cp>Managed care providers are encouraged, but not required, to offer as many “\u003ca href=\"https://calaim.dhcs.ca.gov/pages/community-supports\">community supports\u003c/a>” as they can, Tessa Outhyse, a spokesperson for the California Department of Health Care Services, said in an email. CalAIM, the state’s multiyear initiative to overhaul Medi-Cal, includes community supports such as assistance transitioning to an assisted living facility as well as transitional rent, caregiver respite and personal care services. \u003c/p>\n\n\n\n\u003cp>These services are intended to offer healthcare options to Medi-Cal members before their conditions escalate to needing more serious care, therefore saving money. Even when CalAIM’s current waivers expire at the end of the year, the community supports benefits will continue through the managed care plans. \u003c/p>\n\n\n\n\u003cp>When determining which supports to offer, managed care plans take into consideration provider availability and local capacity to offer care, Outhyse said. Partnership chose not to offer assisted living support based on financial factors and a lack of appropriate facilities in the rural areas where it provides care, said Dustin Lyda, spokesperson for the organization. \u003c/p>\n\n\n\n\u003cp>Lyda said any change in what the organization offers would require proof that assisted living facilities would be safer and healthier for members than nursing homes. But he acknowledged that options are more limited for rural members. \u003c/p>\n\n\n\n\u003cp>“There’s definitely a lot more work that we need to do on our end to navigate the more rural areas,” Lyda said. \u003c/p>\n\n\n\n\u003ch2 class=\"wp-block-heading\" id=\"hitting-roadblocks\">Hitting roadblocks\u003c/h2>\n\n\n\n\u003cp>When John Aiello heard about assisted living benefits through Medi-Cal, he saw it as the perfect match for his sister’s needs. He knew that he likely would have to move her out of Siskiyou County, where there was only one facility for Medi-Cal recipients, a nursing home.\u003c/p>\n\n\n\n\u003cp>Roselie had spent some time at an assisted living facility in neighboring Shasta County, which they saw as a better fit. But Partnership didn’t offer assisted living as a community support in that county. \u003c/p>\n\n\n\n\n\n\u003cp>Instead, the provider offered Roselie a waiver to go into assisted living in Sonoma County, which is about five hours from her home. The Aiellos turned that down, thinking it would not be good for Roselie. \u003c/p>\n\n\n\n\u003cp>“If you remove her totally from a family contact, she would not be thriving right now. She needs to see family,” John Aiello said. “When there were resources available that fit her needs in Redding — that’s the closest point to her home county — why do I need to move her to Oakland, to Los Angeles, to San Diego?”\u003c/p>\n\n\n\n\u003cp>Over the course of nine months, John sent dozens of emails and spent hours on phone calls to get Partnership HealthPlan to cover Roselie’s placement in assisted living. He had the support of her doctor and a spot for Roselie at the residence in Shasta County. \u003c/p>\n\n\n\n\u003cp>The process was so intense and frustrating that it drove a wedge between him and his sister in their final months of living together. \u003c/p>\n\n\n\n\u003cp>“He was doing all of this to help me,” Roselie said. “Where was it going to end?”\u003c/p>\n\n\n\n\u003ch2 class=\"wp-block-heading\" id=\"encouraged-or-required\">Encouraged or required? \u003c/h2>\n\n\n\n\u003cp>Most people prefer community-based services over skilled nursing care, which is \u003ca href=\"https://heller.brandeis.edu/community-living-policy/research-policy/publications/pdfs/briefs/hcbs-improve-outcomes-and-reduce-costs.pdf\">generally more expensive\u003c/a>. But nursing home beds are in short supply and should be reserved for those who truly need them, Gibney said.\u003c/p>\n\n\n\n\u003cp>“We really try to help people look at the other options that exist for remaining in the community,” Gibney said. “You’re going to have better health outcomes, better quality of care, if you can stay in the community and out of an institutional setting.”\u003c/p>\n\n\n\n\u003cp>Research indicates that while assisted living may provide better outcomes for some, people in assisted living are more likely than nursing home residents to be hospitalized, which can drive up costs, said Dr. Kenneth Lam, a geriatrician and assistant professor at the University of Colorado Anschutz Medical Campus. \u003c/p>\n\n\n\n\u003cp>“The evidence suggests that it’s a trade-off,” he said. \u003c/p>\n\n\n\n\n\n\u003cp>Contracts for managed care plans are not competitively bid, Outhyse said. And potential contractors aren’t asked to include specific community supports, such as assisted living, in their managed care plans.\u003c/p>\n\n\n\n\u003cp>“Whether a plan chooses to provide specific community supports is not a factor in contract renewal, which focuses instead on overall compliance with state and federal performance standards,” Outhyse wrote in the email.\u003c/p>\n\n\n\n\u003cp>Partnership’s contract with the state was set to expire in December, but will be extended until 2029 because the state \u003ca href=\"https://www.dhcs.ca.gov/services/Pages/ManagedCarePlanProcurementUpdate.aspx\">delayed\u003c/a> the process of soliciting managed care contracts. Lyda said Partnership is facing increasing demand for its community supports — which mainly address social needs, such as housing and food security — and for assisted living benefits. But even people in counties where the managed care provider offers an assisted living benefit can have a long wait for placement. \u003c/p>\n\n\n\n\u003cp>After years of constant increases, the number of Californians receiving an assisted living waiver for the first time dropped at the beginning of 2025, though the waitlist continued to climb. \u003c/p>\n\n\n\n\u003cp>By September, the number of Californians waiting for a waiver had surpassed the number of people who were being supported by it.\u003c/p>\n\n\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr />\n\u003ciframe loading=\"lazy\" src=\"https://datawrapper.dwcdn.net/kH9D7\" width=\"800\" height=\"800\" scrolling=\"yes\" class=\"iframe-class\" frameborder=\"0\">\u003c/iframe>\u003c/p>\n\n\n\n\u003cp>Gibney said that Medi-Cal members are often encouraged to get on the waitlist before applying for assisted living funding, which could contribute to the long wait. \u003c/p>\n\n\n\n\u003cp>Older adults might spend months on a waitlist, only to be told that they are ineligible for assisted living coverage. \u003c/p>\n\n\n\n\u003cp>“It’s a lot of shifting sand, that’s what people are finding themselves in the middle of,” Lam said. “They’re being told that they get to choose, but it’s a complex choice.”\u003c/p>\n\n\n\n\u003ch2 class=\"wp-block-heading\" id=\"a-new-home\">A new home\u003c/h2>\n\n\n\n\u003cp>In March, Roselie moved into her new home, Sundial Assisted Living, the Shasta County facility where she had previously spent some time. Two months earlier, Partnership had informed the Aiellos that it would cover Roselie’s assisted living care. \u003c/p>\n\n\n\n\u003cp>Partnership offered Roselie early access to a pilot program that launched on July 1, which extends the assisted living options to select members of the network. There will be no open application process, but members can ask to be considered or referred through a healthcare provider. \u003c/p>\n\n\n\n\u003cp>The goal is to discover if offering the assisted living option will provide better health outcomes at a lower price.\u003c/p>\n\n\n\n\u003cp>“Success would also be having these individuals being able to continue to receive care within their community setting, being in their home,” Lyda said. “We know that that is more impactful to health than being completely taken out of a familiar area.” \u003c/p>\n\n\n\n\u003cp>The adjustment has not been easy for Roselie. She has been hospitalized twice since she moved to Sundial and briefly entered a nursing home. \u003cs> \u003c/s>\u003c/p>\n\n\n\n\u003cp>Socially, things have gone better. Roselie has made friends and is often called on to teach card games to her fellow Sundial residents. While she was hospitalized, her neighbors and caretakers at Sundial visited her. She’s grateful to John for navigating through red tape to get her here. \u003c/p>\n\n\n\n\u003cp>“I’m looking at it like this: It’s a new adventure,” she said. \u003c/p>\n\n\n\n\u003cp>John worries about his sister’s health issues and whether Sundial will be a long-term solution for her. He’s gratified that his fight ended with his sister’s placement in their chosen facility. But he resents having to wage the battle.\u003c/p>\n\n\n\n\u003cp>“I don’t understand why I was the guy fighting for everybody,” John said. “I’m just one person trying to support myself, trying to take care of a family member.”\u003c/p>\n\n\n\n\u003cp>\u003cem>Jessica Blough reported on this story while with the\u003c/em> \u003ca href=\"https://journalism.berkeley.edu/programs/mj/investigative-reporting/\">\u003cem>Investigative Reporting Program\u003c/em>\u003c/a> \u003cem>at UC Berkeley Journalism School, with a grant from\u003c/em> \u003ca href=\"https://www.thescanfoundation.org/\">\u003cem>The SCAN Foundation\u003c/em>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\u003c/div>\u003c/p>",
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"slug": "californians-face-eviction-as-insurer-cancels-assisted-living-benefit",
"title": "Californians Face Eviction as Insurer Cancels Assisted Living Benefit",
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"headTitle": "Californians Face Eviction as Insurer Cancels Assisted Living Benefit | KQED",
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"content": "\u003cp>\u003c!-- Creative Commons Attribution-NonCommercial-NoDerivatives https://creativecommons.org/licenses/by-nc-nd/4.0/ -->\u003c/p>\n\u003cp>\u003cem>This story was originally published by \u003ca href=\"https://calmatters.org/\">CalMatters\u003c/a>. \u003ca href=\"https://calmatters.org/subscribe-to-calmatters/\">Sign up\u003c/a> for their newsletters.\u003c/em>\u003c/p>\n\u003cp>Four weeks ago, Matt Johnstone received a call from the board-and-care facility in North Hollywood where his 89-year-old father lives. Health Net, the \u003ca href=\"https://www.kqed.org/news/tag/health-insurance\">insurance\u003c/a> company that pays for his care, was eliminating its assisted living benefit, meaning he would have to move out soon.\u003c/p>\n\u003cp>Johnstone panicked. His father has dementia and needs around-the-clock care. Neither Johnstone nor his brother can afford the roughly $6,000 per month the facility costs, and with health problems of their own, they can’t safely meet his needs at home either. Without insurance coverage, their father could end up on the streets, he said.\u003c/p>\n\u003cfigure id=\"attachment_12095716\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12095716\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/081326_Assisted-Living_AD_CM_21.jpeg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/081326_Assisted-Living_AD_CM_21.jpeg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/081326_Assisted-Living_AD_CM_21-160x107.jpeg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/081326_Assisted-Living_AD_CM_21-1536x1024.jpeg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Matt Johnstone helps his dad put on his shoes while he sits at the edge of his bed in his room at an assisted living facility in North Hollywood on Aug. 13, 2026. \u003ccite>(Ariana Drehsler for CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“He’s declining, and I just don’t know what’s going to happen if the program ends,” Johnstone said. CalMatters is not publishing the father’s name because Johnstone fears the plan will target him for speaking with media.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Health Net, one of the largest \u003ca href=\"https://calmatters.org/tag/medi-cal/\">Medi-Cal\u003c/a> insurers in the country, is canceling assisted living benefits for members at the end of the year, according to documents obtained by CalMatters and interviews with providers. Approximately 3,500 Medi-Cal patients like Johnstone’s father rely on Health Net to pay for assisted living costs. Most are elderly, and many have cognitive issues like dementia, senior advocates say. Medi-Cal is the state’s public insurance program for low-income Californians and people with disabilities.\u003c/p>\n\u003cp>CalViva Health and Community Health Plan of Imperial Valley, which contract with Health Net to provide services, have also notified the state of their intent to discontinue assisted living benefits.\u003c/p>\n\u003cp>Health Net’s decision has been shrouded in confusion with little public information. Senior advocates and family members of assisted living residents fear people will become homeless or be shuffled between hospitals and skilled nursing facilities.\u003c/p>\n\u003ch2>A disaster in the making?\u003c/h2>\n\u003cp>Pauline Shatara, deputy director of California Advocates for Nursing Home Reform, said a few assisted living facilities have already confirmed to her organization that residents have been dropped off at emergency rooms.\u003c/p>\n\u003cp>“This is going to be a disaster,” Shatara said.\u003c/p>\n\u003cp>Senior advocates also say the state did not include enough consumer protections to ensure patients stay housed if plans decide to terminate coverage. State regulators dispute that characterization.\u003c/p>\n\u003cfigure id=\"attachment_12095717\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12095717\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/081326_Assisted-Living_AD_CM_27.jpeg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/081326_Assisted-Living_AD_CM_27.jpeg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/081326_Assisted-Living_AD_CM_27-160x107.jpeg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/081326_Assisted-Living_AD_CM_27-1536x1024.jpeg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Pictures of Johnstone’s father with puppies, books, a stuffed animal and a first-prize award for a motorcycle show sit on a nightstand in his room. \u003ccite>(Ariana Drehsler for CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The assisted living support is an optional Medi-Cal benefit, meaning plans can opt-into offering it to members and decide annually whether the program will continue.\u003c/p>\n\u003cp>Assisted living support is part of CalAIM, California’s broad effort to improve Medi-Cal services and save money by stabilizing high-cost users who often end up repeatedly in emergency rooms. It pays a majority of the 24-hour service costs at board-and-care homes, memory care facilities, or larger group settings, while residents cover room-and-board fees.\u003c/p>\n\u003cp>The average nursing home, which offers a higher level of medical care, costs upwards of \u003ca href=\"https://ltsschoices.aarp.org/scorecard-report/2023/dimensions-and-indicators/nursing-home-cost\">$10,000 per month\u003c/a>, while an assisted living facility costs between $5,000 to $7,000 monthly.\u003c/p>\n\u003cp>The state created the benefit in part to relieve pressure on a \u003ca href=\"https://calmatters.org/health/2022/09/medi-cal-assisted-living/\">separate assisted living program for low-income patients\u003c/a> managed directly by the state, which has an 18,000 person cap and a three- to four-year waitlist.\u003c/p>\n\u003cp>Health Net operates Medi-Cal plans in 10 counties: Amador, Calaveras, Fresno, Inyo, Los Angeles, Mono, Sacramento, San Joaquin, Stanislaus, Tulare.\u003cspan style=\"font-weight: 400;\">[aside postID=news_12095504 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/gettyimages-1257858410-scaled.jpeg']\u003c/span>In an unsigned statement, a spokesperson for the company disputed the assertion that patients would be left without services and would end up unhoused. Affected members will receive care through their individual authorization date, and could be transitioned to nursing homes, back home with in-home supportive services, or to other programs, according to the statement.\u003c/p>\n\u003cp>“We are working closely with members, providers and care management teams to develop individualized transition plans based on each member’s clinical needs and eligibility for other available programs and services,” the company statement said.\u003cstrong> \u003c/strong>\u003c/p>\n\u003cp>The statement also said internal data showed the assisted living program “has not led to better care” in terms of fewer emergency room visits or days hospitalized.\u003c/p>\n\u003cp>Health Net told state regulators its decision was fueled partly by an increase in members moving from home to assisted living rather than from nursing homes, a trend that costs the plan money instead of generating savings, according to a termination notice sent to the Department of Health Care Services. The plan also blames regulators for changing program guidelines that had previously allowed Health Net to limit community transitions.\u003c/p>\n\u003cp>“The guidance raises concerns regarding program integrity and long term viability,” the notice reads.\u003c/p>\n\u003cp>The Department of Health Care Services, which oversees the program, refused an interview request. In an emailed statement, officials said the department would communicate with Health Net to “ensure member protections and continuity of care”\u003c/p>\n\u003cp>Health Net’s decision follows a \u003ca href=\"https://laist.com/news/health/recuperative-care-soul-housing-health-net-discharge-contract-terminate-transition-plan-respite\">similar one last year to terminate a separate CalAIM benefit with a provider in L.A. County\u003c/a>, affecting hundreds of people in temporary medical housing.\u003c/p>\n\u003cp>“Their position is it’s less costly to offer no services than some services,” said Hagar Dickman, director of long-term services and supports for Justice In Aging.\u003c/p>\n\u003ch2>No information sparks confusion, ‘rumor mill’\u003c/h2>\n\u003cp>When Johnstone first heard about Health Net’s decision, he searched the company’s website for information about the change: Nothing. Then, he picked up the phone.\u003c/p>\n\u003cp>“When I called into Health Net customer service, they didn’t even know what the program is,” Johnstone said. He has not received a letter notifying him of the upcoming termination.\u003c/p>\n\u003cp>Jennifer Horcasitas-Glenn ran into the same problem. Her 75-year-old mother-in-law, Jacqueline Glenn, has dementia and Alzheimer’s. Horcasistas-Glenn and her husband spent nine years caring for Jacqueline at home until recent hospitalizations made it impossible to continue. She has been in a memory care facility since May.\u003c/p>\n\u003cfigure id=\"attachment_12095719\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12095719\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/081326_Assisted-Living_AD_CM_23.jpeg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/081326_Assisted-Living_AD_CM_23.jpeg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/081326_Assisted-Living_AD_CM_23-160x107.jpeg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/081326_Assisted-Living_AD_CM_23-1536x1024.jpeg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Johnstone’s father smokes his pipe outside an assisted living facility in North Hollywood on Aug. 13, 2026. \u003ccite>(Ariana Drehsler for CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Horcasitas-Glenn said she was also notified of the change by a third-party provider, not Health Net, and hasn’t gotten answers from the insurer. Horcasitas-Glenn said she spent days bouncing between customer service representatives and supervisors who had never heard of the program before being transferred to a Health Net social worker who was aware of the changes but had no further information.\u003c/p>\n\u003cp>“I told her I have a plethora of questions I need answered. She said ‘I think you should forward all of your questions to this email,’” Horcasitas-Glenn said. To-date she has not received answers.\u003c/p>\n\u003cp>The health plan notified some major contractors that services would be terminated Oct. 7, according to providers interviewed by CalMatters. But Medi-Cal enrollees themselves have not been notified of changes by Health Net, according to advocates and multiple families interviewed for this story.\u003c/p>\n\u003cp>One of the biggest sources of confusion is when services will actually stop. Many of the plan contracts end in October, but the plan has an obligation to continue services until the end of the year, Dickman said.\u003c/p>\n\u003cp>“The question is, what’s Health Net going to do after October 7? They don’t have contracts with these facilities, so how are they going to provide?” said Jonathan Istrin, chairman of Libertana, one of the groups whose contracts were terminated. Libertana subcontracts with hundreds of assisted living facilities in California, Istrin said, and Health Net doesn’t have the infrastructure to pay those places directly.\u003c/p>\n\u003cfigure id=\"attachment_12028053\" class=\"wp-caption aligncenter\" style=\"max-width: 2048px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12028053\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/02/GettyImages-1434072256-copy.jpg\" alt=\"\" width=\"2048\" height=\"1365\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/02/GettyImages-1434072256-copy.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/02/GettyImages-1434072256-copy-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/02/GettyImages-1434072256-copy-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/02/GettyImages-1434072256-copy-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/02/GettyImages-1434072256-copy-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/02/GettyImages-1434072256-copy-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2048px) 100vw, 2048px\">\u003cfigcaption class=\"wp-caption-text\">Various analyses have found that many who escalate complaints to government regulators successfully get insurance denials overturned. Consumer advocates and policymakers say that’s a clear sign insurance companies routinely deny care they shouldn’t. \u003ccite>(Skynesher/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Health Net must notify members of termination 30 days before the service end date. Providers aren’t certain whether notices will go out at the end of September or beginning of December. For some, the notices may come after members are already evicted, Shatara said..\u003c/p>\n\u003cp>“Right now it can feel like a rumor mill and nobody knows what they should do because Health Net has not been giving anyone any information,” Shatara said.\u003c/p>\n\u003cp>On Aug. 10, Horcasitas-Glenn said she received a letter from Health Net stating that approval for her mother’s memory care facility would be revoked a month early “at the request of the provider.” The provider told Horcasitas-Glenn that they had not requested an early termination and had instead asked Health Net how to accommodate patients who have a right to services until the end of the year. CalMatters independently confirmed this information.\u003c/p>\n\u003cp>“This is baloney. They’re not being transparent about anything, and they’re lying on documents,” Horcasitas-Glenn said. Customer service still doesn’t know what program she’s talking about when she calls.\u003c/p>\n\u003cp>According to state regulators, Health Net members are entitled to services until Dec. 31 as long as it is “clinically appropriate.” If the authorization for a member’s assisted living expires before the end of the year, they should request an extension.\u003c/p>\n\u003ch2>State offers few consumer protections\u003c/h2>\n\u003cp>Other than the 30-day notice, advocates say, the state has very few protections for patients when services are terminated.\u003c/p>\n\u003cp>Health Net has not given patients transition plans, and the state cannot guarantee patients will receive the same level of care elsewhere, Shatara said. Advocates and providers told CalMatters the Department of Health Care Services and Health Net have mutually referred questions to the other organization, offering no clear answers.\u003c/p>\n\u003cp>The Department of Health Care Services in an email argued its patient notification requirements are adequate, stating “Medi-Cal members have strong protections.” Some patient protections include the right to appeal or file a grievance with the plan, access to alternative services, and continuity-of-care requirements. The state also places responsibility with Health Net.\u003c/p>\n\u003cfigure id=\"attachment_12095729\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12095729\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/081326_Assisted-Living_AD_CM_14.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/081326_Assisted-Living_AD_CM_14.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/081326_Assisted-Living_AD_CM_14-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/081326_Assisted-Living_AD_CM_14-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Matt Johnstone, left, and Russell Granger, right, help their father Jim get up from his bed at an assisted living facility in North Hollywood on Aug. 13, 2026. \u003ccite>(Ariana Drehsler for CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>According to the termination notice filed with the state, Health Net members “will be transitioned to alternative care settings, including home, as appropriate.”\u003c/p>\n\u003cfigure>\u003cfigcaption>\u003c/figcaption>\u003c/figure>\n\u003cp>For most patients, home is not an option, Shatara said. Many live on fixed Social Security incomes and give up their primary residence in order to pay room and board fees at care facilities that Medi-Cal doesn’t cover. Their needs are also too acute for family members to meet. The only other appropriate alternative care settings, Shatara said, are nursing homes and hospitals, which may not be able to handle the influx.\u003c/p>\n\u003cp>“It’s inevitable that people will end up in ERs and on the streets,” Shatara said.\u003c/p>\n\u003cp>Some families like Horcasitas-Glenn are contemplating switching to another Medi-Cal insurer that still provides the benefit, but have been told other plans don’t want to approve these expensive long-term services for new patients. Others, like Johnstone, are at a loss.\u003c/p>\n\u003cp>Johnstone’s dad turned a lifelong love of motorcycles and racecars into a successful autobody repair and restoration business in Southern California. Eventually, in his later years, undiagnosed dementia would trap his mind 20 years in the past, Johnstone said, causing him to make poor business decisions and take on enormous amounts of debt and work he could no longer perform. A terminal cancer diagnosis for Johnstone’s mother would also wipe out all of the family’s savings.\u003c/p>\n\u003cp>“There is nothing else,” Johnstone said.\u003c/p>\n\u003cp>\u003cem>Worried your loved one will be affected by changes to Medi-Cal services? Send tips to health@calmatters.org.\u003c/em>\u003c/p>\n\u003cp>\u003cem>Supported by the California Health Care Foundation (CHCF), which works to ensure that people have access to the care they need, when they need it, at a price they can afford. Visit www.chcf.org to learn more.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This article was \u003ca href=\"https://calmatters.org/health/2026/08/assisted-living-healthnet-coverage/\">originally published on CalMatters\u003c/a> and was republished under the \u003ca href=\"https://creativecommons.org/licenses/by-nc-nd/4.0/\">Creative Commons Attribution-NonCommercial-NoDerivatives\u003c/a> license.\u003c/em>\u003c/p>\n\n",
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"excerpt": "Health Net’s decision to cut assisted living benefits for roughly 3,500 low-income seniors could force some of them onto the streets, critics fear.",
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"title": "Californians Face Eviction as Insurer Cancels Assisted Living Benefit | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003c!-- Creative Commons Attribution-NonCommercial-NoDerivatives https://creativecommons.org/licenses/by-nc-nd/4.0/ -->\u003c/p>\n\u003cp>\u003cem>This story was originally published by \u003ca href=\"https://calmatters.org/\">CalMatters\u003c/a>. \u003ca href=\"https://calmatters.org/subscribe-to-calmatters/\">Sign up\u003c/a> for their newsletters.\u003c/em>\u003c/p>\n\u003cp>Four weeks ago, Matt Johnstone received a call from the board-and-care facility in North Hollywood where his 89-year-old father lives. Health Net, the \u003ca href=\"https://www.kqed.org/news/tag/health-insurance\">insurance\u003c/a> company that pays for his care, was eliminating its assisted living benefit, meaning he would have to move out soon.\u003c/p>\n\u003cp>Johnstone panicked. His father has dementia and needs around-the-clock care. Neither Johnstone nor his brother can afford the roughly $6,000 per month the facility costs, and with health problems of their own, they can’t safely meet his needs at home either. Without insurance coverage, their father could end up on the streets, he said.\u003c/p>\n\u003cfigure id=\"attachment_12095716\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12095716\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/081326_Assisted-Living_AD_CM_21.jpeg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/081326_Assisted-Living_AD_CM_21.jpeg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/081326_Assisted-Living_AD_CM_21-160x107.jpeg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/081326_Assisted-Living_AD_CM_21-1536x1024.jpeg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Matt Johnstone helps his dad put on his shoes while he sits at the edge of his bed in his room at an assisted living facility in North Hollywood on Aug. 13, 2026. \u003ccite>(Ariana Drehsler for CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“He’s declining, and I just don’t know what’s going to happen if the program ends,” Johnstone said. CalMatters is not publishing the father’s name because Johnstone fears the plan will target him for speaking with media.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Health Net, one of the largest \u003ca href=\"https://calmatters.org/tag/medi-cal/\">Medi-Cal\u003c/a> insurers in the country, is canceling assisted living benefits for members at the end of the year, according to documents obtained by CalMatters and interviews with providers. Approximately 3,500 Medi-Cal patients like Johnstone’s father rely on Health Net to pay for assisted living costs. Most are elderly, and many have cognitive issues like dementia, senior advocates say. Medi-Cal is the state’s public insurance program for low-income Californians and people with disabilities.\u003c/p>\n\u003cp>CalViva Health and Community Health Plan of Imperial Valley, which contract with Health Net to provide services, have also notified the state of their intent to discontinue assisted living benefits.\u003c/p>\n\u003cp>Health Net’s decision has been shrouded in confusion with little public information. Senior advocates and family members of assisted living residents fear people will become homeless or be shuffled between hospitals and skilled nursing facilities.\u003c/p>\n\u003ch2>A disaster in the making?\u003c/h2>\n\u003cp>Pauline Shatara, deputy director of California Advocates for Nursing Home Reform, said a few assisted living facilities have already confirmed to her organization that residents have been dropped off at emergency rooms.\u003c/p>\n\u003cp>“This is going to be a disaster,” Shatara said.\u003c/p>\n\u003cp>Senior advocates also say the state did not include enough consumer protections to ensure patients stay housed if plans decide to terminate coverage. State regulators dispute that characterization.\u003c/p>\n\u003cfigure id=\"attachment_12095717\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12095717\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/081326_Assisted-Living_AD_CM_27.jpeg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/081326_Assisted-Living_AD_CM_27.jpeg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/081326_Assisted-Living_AD_CM_27-160x107.jpeg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/081326_Assisted-Living_AD_CM_27-1536x1024.jpeg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Pictures of Johnstone’s father with puppies, books, a stuffed animal and a first-prize award for a motorcycle show sit on a nightstand in his room. \u003ccite>(Ariana Drehsler for CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The assisted living support is an optional Medi-Cal benefit, meaning plans can opt-into offering it to members and decide annually whether the program will continue.\u003c/p>\n\u003cp>Assisted living support is part of CalAIM, California’s broad effort to improve Medi-Cal services and save money by stabilizing high-cost users who often end up repeatedly in emergency rooms. It pays a majority of the 24-hour service costs at board-and-care homes, memory care facilities, or larger group settings, while residents cover room-and-board fees.\u003c/p>\n\u003cp>The average nursing home, which offers a higher level of medical care, costs upwards of \u003ca href=\"https://ltsschoices.aarp.org/scorecard-report/2023/dimensions-and-indicators/nursing-home-cost\">$10,000 per month\u003c/a>, while an assisted living facility costs between $5,000 to $7,000 monthly.\u003c/p>\n\u003cp>The state created the benefit in part to relieve pressure on a \u003ca href=\"https://calmatters.org/health/2022/09/medi-cal-assisted-living/\">separate assisted living program for low-income patients\u003c/a> managed directly by the state, which has an 18,000 person cap and a three- to four-year waitlist.\u003c/p>\n\u003cp>Health Net operates Medi-Cal plans in 10 counties: Amador, Calaveras, Fresno, Inyo, Los Angeles, Mono, Sacramento, San Joaquin, Stanislaus, Tulare.\u003cspan style=\"font-weight: 400;\">\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/span>In an unsigned statement, a spokesperson for the company disputed the assertion that patients would be left without services and would end up unhoused. Affected members will receive care through their individual authorization date, and could be transitioned to nursing homes, back home with in-home supportive services, or to other programs, according to the statement.\u003c/p>\n\u003cp>“We are working closely with members, providers and care management teams to develop individualized transition plans based on each member’s clinical needs and eligibility for other available programs and services,” the company statement said.\u003cstrong> \u003c/strong>\u003c/p>\n\u003cp>The statement also said internal data showed the assisted living program “has not led to better care” in terms of fewer emergency room visits or days hospitalized.\u003c/p>\n\u003cp>Health Net told state regulators its decision was fueled partly by an increase in members moving from home to assisted living rather than from nursing homes, a trend that costs the plan money instead of generating savings, according to a termination notice sent to the Department of Health Care Services. The plan also blames regulators for changing program guidelines that had previously allowed Health Net to limit community transitions.\u003c/p>\n\u003cp>“The guidance raises concerns regarding program integrity and long term viability,” the notice reads.\u003c/p>\n\u003cp>The Department of Health Care Services, which oversees the program, refused an interview request. In an emailed statement, officials said the department would communicate with Health Net to “ensure member protections and continuity of care”\u003c/p>\n\u003cp>Health Net’s decision follows a \u003ca href=\"https://laist.com/news/health/recuperative-care-soul-housing-health-net-discharge-contract-terminate-transition-plan-respite\">similar one last year to terminate a separate CalAIM benefit with a provider in L.A. County\u003c/a>, affecting hundreds of people in temporary medical housing.\u003c/p>\n\u003cp>“Their position is it’s less costly to offer no services than some services,” said Hagar Dickman, director of long-term services and supports for Justice In Aging.\u003c/p>\n\u003ch2>No information sparks confusion, ‘rumor mill’\u003c/h2>\n\u003cp>When Johnstone first heard about Health Net’s decision, he searched the company’s website for information about the change: Nothing. Then, he picked up the phone.\u003c/p>\n\u003cp>“When I called into Health Net customer service, they didn’t even know what the program is,” Johnstone said. He has not received a letter notifying him of the upcoming termination.\u003c/p>\n\u003cp>Jennifer Horcasitas-Glenn ran into the same problem. Her 75-year-old mother-in-law, Jacqueline Glenn, has dementia and Alzheimer’s. Horcasistas-Glenn and her husband spent nine years caring for Jacqueline at home until recent hospitalizations made it impossible to continue. She has been in a memory care facility since May.\u003c/p>\n\u003cfigure id=\"attachment_12095719\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12095719\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/081326_Assisted-Living_AD_CM_23.jpeg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/081326_Assisted-Living_AD_CM_23.jpeg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/081326_Assisted-Living_AD_CM_23-160x107.jpeg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/081326_Assisted-Living_AD_CM_23-1536x1024.jpeg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Johnstone’s father smokes his pipe outside an assisted living facility in North Hollywood on Aug. 13, 2026. \u003ccite>(Ariana Drehsler for CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Horcasitas-Glenn said she was also notified of the change by a third-party provider, not Health Net, and hasn’t gotten answers from the insurer. Horcasitas-Glenn said she spent days bouncing between customer service representatives and supervisors who had never heard of the program before being transferred to a Health Net social worker who was aware of the changes but had no further information.\u003c/p>\n\u003cp>“I told her I have a plethora of questions I need answered. She said ‘I think you should forward all of your questions to this email,’” Horcasitas-Glenn said. To-date she has not received answers.\u003c/p>\n\u003cp>The health plan notified some major contractors that services would be terminated Oct. 7, according to providers interviewed by CalMatters. But Medi-Cal enrollees themselves have not been notified of changes by Health Net, according to advocates and multiple families interviewed for this story.\u003c/p>\n\u003cp>One of the biggest sources of confusion is when services will actually stop. Many of the plan contracts end in October, but the plan has an obligation to continue services until the end of the year, Dickman said.\u003c/p>\n\u003cp>“The question is, what’s Health Net going to do after October 7? They don’t have contracts with these facilities, so how are they going to provide?” said Jonathan Istrin, chairman of Libertana, one of the groups whose contracts were terminated. Libertana subcontracts with hundreds of assisted living facilities in California, Istrin said, and Health Net doesn’t have the infrastructure to pay those places directly.\u003c/p>\n\u003cfigure id=\"attachment_12028053\" class=\"wp-caption aligncenter\" style=\"max-width: 2048px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12028053\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/02/GettyImages-1434072256-copy.jpg\" alt=\"\" width=\"2048\" height=\"1365\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/02/GettyImages-1434072256-copy.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/02/GettyImages-1434072256-copy-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/02/GettyImages-1434072256-copy-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/02/GettyImages-1434072256-copy-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/02/GettyImages-1434072256-copy-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/02/GettyImages-1434072256-copy-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2048px) 100vw, 2048px\">\u003cfigcaption class=\"wp-caption-text\">Various analyses have found that many who escalate complaints to government regulators successfully get insurance denials overturned. Consumer advocates and policymakers say that’s a clear sign insurance companies routinely deny care they shouldn’t. \u003ccite>(Skynesher/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Health Net must notify members of termination 30 days before the service end date. Providers aren’t certain whether notices will go out at the end of September or beginning of December. For some, the notices may come after members are already evicted, Shatara said..\u003c/p>\n\u003cp>“Right now it can feel like a rumor mill and nobody knows what they should do because Health Net has not been giving anyone any information,” Shatara said.\u003c/p>\n\u003cp>On Aug. 10, Horcasitas-Glenn said she received a letter from Health Net stating that approval for her mother’s memory care facility would be revoked a month early “at the request of the provider.” The provider told Horcasitas-Glenn that they had not requested an early termination and had instead asked Health Net how to accommodate patients who have a right to services until the end of the year. CalMatters independently confirmed this information.\u003c/p>\n\u003cp>“This is baloney. They’re not being transparent about anything, and they’re lying on documents,” Horcasitas-Glenn said. Customer service still doesn’t know what program she’s talking about when she calls.\u003c/p>\n\u003cp>According to state regulators, Health Net members are entitled to services until Dec. 31 as long as it is “clinically appropriate.” If the authorization for a member’s assisted living expires before the end of the year, they should request an extension.\u003c/p>\n\u003ch2>State offers few consumer protections\u003c/h2>\n\u003cp>Other than the 30-day notice, advocates say, the state has very few protections for patients when services are terminated.\u003c/p>\n\u003cp>Health Net has not given patients transition plans, and the state cannot guarantee patients will receive the same level of care elsewhere, Shatara said. Advocates and providers told CalMatters the Department of Health Care Services and Health Net have mutually referred questions to the other organization, offering no clear answers.\u003c/p>\n\u003cp>The Department of Health Care Services in an email argued its patient notification requirements are adequate, stating “Medi-Cal members have strong protections.” Some patient protections include the right to appeal or file a grievance with the plan, access to alternative services, and continuity-of-care requirements. The state also places responsibility with Health Net.\u003c/p>\n\u003cfigure id=\"attachment_12095729\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12095729\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/081326_Assisted-Living_AD_CM_14.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/081326_Assisted-Living_AD_CM_14.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/081326_Assisted-Living_AD_CM_14-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/08/081326_Assisted-Living_AD_CM_14-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Matt Johnstone, left, and Russell Granger, right, help their father Jim get up from his bed at an assisted living facility in North Hollywood on Aug. 13, 2026. \u003ccite>(Ariana Drehsler for CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>According to the termination notice filed with the state, Health Net members “will be transitioned to alternative care settings, including home, as appropriate.”\u003c/p>\n\u003cfigure>\u003cfigcaption>\u003c/figcaption>\u003c/figure>\n\u003cp>For most patients, home is not an option, Shatara said. Many live on fixed Social Security incomes and give up their primary residence in order to pay room and board fees at care facilities that Medi-Cal doesn’t cover. Their needs are also too acute for family members to meet. The only other appropriate alternative care settings, Shatara said, are nursing homes and hospitals, which may not be able to handle the influx.\u003c/p>\n\u003cp>“It’s inevitable that people will end up in ERs and on the streets,” Shatara said.\u003c/p>\n\u003cp>Some families like Horcasitas-Glenn are contemplating switching to another Medi-Cal insurer that still provides the benefit, but have been told other plans don’t want to approve these expensive long-term services for new patients. Others, like Johnstone, are at a loss.\u003c/p>\n\u003cp>Johnstone’s dad turned a lifelong love of motorcycles and racecars into a successful autobody repair and restoration business in Southern California. Eventually, in his later years, undiagnosed dementia would trap his mind 20 years in the past, Johnstone said, causing him to make poor business decisions and take on enormous amounts of debt and work he could no longer perform. A terminal cancer diagnosis for Johnstone’s mother would also wipe out all of the family’s savings.\u003c/p>\n\u003cp>“There is nothing else,” Johnstone said.\u003c/p>\n\u003cp>\u003cem>Worried your loved one will be affected by changes to Medi-Cal services? Send tips to health@calmatters.org.\u003c/em>\u003c/p>\n\u003cp>\u003cem>Supported by the California Health Care Foundation (CHCF), which works to ensure that people have access to the care they need, when they need it, at a price they can afford. Visit www.chcf.org to learn more.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>\u003cb>Here are the morning’s top stories on Monday, February 9, 2026\u003c/b>\u003c/p>\n\u003cul>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">It was another historic halftime show at this year’s Super Bowl at Levi’s Stadium in Santa Clara as global superstar Bad Bunny took the stage. \u003c/span>\u003c/li>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">2025 was a pivotal year for health insurance reform: more than two dozen states, including California, passed laws limiting insurers’ ability to delay or deny medical services after a doctor has ordered them. The practice is known as prior authorization. Criticism of it reached a fever pitch last year and California is leading the way with reform.\u003c/span>\u003c/li>\n\u003c/ul>\n\u003ch2>\u003ca href=\"https://www.npr.org/2026/02/09/nx-s1-5698519/bad-bunny-super-bowl-halftime\">\u003cstrong>Bad Bunny Makes Puerto Rico The Home Team In A Vivid Super Bowl Halftime Show\u003c/strong>\u003c/a>\u003c/h2>\n\u003cp>During the halftime show at Super Bowl LX at Levi’s Stadium in Santa Clara, Bad Bunny paid homage to his home of Puerto Rico. He weaved his way through a set that featured barber shops and bodegas, family gatherings and elders playing dominos. But he also expanded his lens to make an argument about the place of Puerto Rico within a larger American context.\u003c/p>\n\u003cp>Over a 13-minute set that included more than a dozen of his songs, almost all in Spanish, the artist born Benito Antonio Martínez Ocasio made the perpetual in-betweenness of his home sing. Puerto Rico has long struggled to find its place in the Americas. Too Latin for some in the United States, as reinforced by much of the controversy leading up to Sunday night’s performance and too closely associated with the United States to be fully accepted by some in Latin America. As Bad Bunny often does, he turned not fitting in into a super power, leveraging Puerto Rico’s caught-between-two-worlds cultural identity to create an inclusive, All-American image.\u003c/p>\n\u003cp>Bad Bunny’s opening words are always worth paying attention to. “Que rico es ser Latino,” he said to start the show at Levi’s Stadium in Santa Clara, Calif. Though there isn’t really a proper English translation, the phrase means something close to, “How wonderful it is to be Latino,” though the understanding of the Spanish phrase is more indulgent. Bad Bunny’s opening line on each of the 31 nights of his residency last summer in San Juan was “Puerto Rico, estamos en casa.” From beat one at the Super Bowl, he made it clear that the casa had expanded. He packed a vibrant punch with quick passes of some of his most popular tracks, like “Tití Me Preguntó” and “Yo Perreo Sola,” mostly leaning on heart-thumping hits. He made major nods to his latest album, the Grammy-winning \u003cem>DeBI TiRAR MaS FOToS,\u003c/em> with “Voy a Llevarte pa PR,” “Eoo,” “Baile Inolvidable” and “Café Con Ron.” Like only the most adept DJ or your favorite salsa band, he infused his mix with the kind of energy that could have kept people dancing ’til sunrise.\u003c/p>\n\u003cp>A watch party at Xingones Cantina in Oakland was sold out. It was specifically Bad Bunny-themed. “I’m a girl who loves Bad Bunny and I wanted to have a Bad Bunny-themed Super watch party,” said organizer Leticia Navarro. And in speaking with the people at the restaurant, there was a real sense of pride. “I have goosebumps right now. I cried last week when he won Album of the Year. This is a real cultural milestone. To see this man representing all Latinos, all people, I think means something so significant,” said Vanessa Rodriguez of Oakland. Jennifer Sanchez of San Jose agreed with those sentiments. “One of the reasons why I got so emotional is because seeing us Latinos being represented so well and all in Spanish, and knowing that in this America, it’s not really accepted. I think it was the most amazing thing he could have done,” she said.\u003c/p>\n\u003ch2>\u003cstrong>Prior Authorization Laws Reformed\u003c/strong>\u003c/h2>\n\u003cp>2025 was a pivotal year for health insurance reform: more than two dozen states, including California, passed laws limiting insurers’ ability to delay or deny medical services after a doctor has ordered them. The practice is known as prior authorization.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Ocean McIntyre has worked as a tattoo artist, a private pilot, and a research assistant at NASA near Pasadena. But not anymore. “A lot of that changed. A lot of that changed,” she said. McIntyre started having vision problems and it took her health plan a month to authorize a doctor visit. When pressure in her brain started crushing her optic nerve, she had to wait three months for permission to see a specialist. “He said if you had been seen earlier, we could have preserved your vision. Now we’re just trying to see if we can save any of your vision,” she said. “And I think that was the first time it really clicked that the life that I had before, was over.”\u003c/p>\n\u003cp>After years of tests and surgeries, she can see again, but barely. She’s legally blind. McIntyre’s is an extreme case, but far from an isolated one. In a survey, 23% of doctors say their patients have been hospitalized because of prior authorization delays and 18% say they’ve experienced a life-threatening event. “There is nothing that causes physicians’ blood pressure to elevate like prior authorization. You just say the word and doctors bristle,” said René Bravo, a pediatrician and president of the California Medical Association. He said authorization started as a reasonable mechanism for insurers to control costs. But it ballooned into unreasonable levels of paperwork and second-guessing.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Doctors have been fighting for years to address this problem. But something was different about 2025. An unprecedented 31 states passed laws reforming prior authorization, almost all with bipartisan, near unanimous support. University of Pittsburgh health policy professor Miranda Yaver says there was one pivotal event that changed the conversation: the murder of the UnitedHealth CEO in December 2024. The accused gunman used bullets etched with the words “delay” and “deny.” “It really highlighted for the country this amount of anger and I think that placed pressure on state legislatures,” Yaver said.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cb>Here are the morning’s top stories on Monday, February 9, 2026\u003c/b>\u003c/p>\n\u003cul>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">It was another historic halftime show at this year’s Super Bowl at Levi’s Stadium in Santa Clara as global superstar Bad Bunny took the stage. \u003c/span>\u003c/li>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">2025 was a pivotal year for health insurance reform: more than two dozen states, including California, passed laws limiting insurers’ ability to delay or deny medical services after a doctor has ordered them. The practice is known as prior authorization. Criticism of it reached a fever pitch last year and California is leading the way with reform.\u003c/span>\u003c/li>\n\u003c/ul>\n\u003ch2>\u003ca href=\"https://www.npr.org/2026/02/09/nx-s1-5698519/bad-bunny-super-bowl-halftime\">\u003cstrong>Bad Bunny Makes Puerto Rico The Home Team In A Vivid Super Bowl Halftime Show\u003c/strong>\u003c/a>\u003c/h2>\n\u003cp>During the halftime show at Super Bowl LX at Levi’s Stadium in Santa Clara, Bad Bunny paid homage to his home of Puerto Rico. He weaved his way through a set that featured barber shops and bodegas, family gatherings and elders playing dominos. But he also expanded his lens to make an argument about the place of Puerto Rico within a larger American context.\u003c/p>\n\u003cp>Over a 13-minute set that included more than a dozen of his songs, almost all in Spanish, the artist born Benito Antonio Martínez Ocasio made the perpetual in-betweenness of his home sing. Puerto Rico has long struggled to find its place in the Americas. Too Latin for some in the United States, as reinforced by much of the controversy leading up to Sunday night’s performance and too closely associated with the United States to be fully accepted by some in Latin America. As Bad Bunny often does, he turned not fitting in into a super power, leveraging Puerto Rico’s caught-between-two-worlds cultural identity to create an inclusive, All-American image.\u003c/p>\n\u003cp>Bad Bunny’s opening words are always worth paying attention to. “Que rico es ser Latino,” he said to start the show at Levi’s Stadium in Santa Clara, Calif. Though there isn’t really a proper English translation, the phrase means something close to, “How wonderful it is to be Latino,” though the understanding of the Spanish phrase is more indulgent. Bad Bunny’s opening line on each of the 31 nights of his residency last summer in San Juan was “Puerto Rico, estamos en casa.” From beat one at the Super Bowl, he made it clear that the casa had expanded. He packed a vibrant punch with quick passes of some of his most popular tracks, like “Tití Me Preguntó” and “Yo Perreo Sola,” mostly leaning on heart-thumping hits. He made major nods to his latest album, the Grammy-winning \u003cem>DeBI TiRAR MaS FOToS,\u003c/em> with “Voy a Llevarte pa PR,” “Eoo,” “Baile Inolvidable” and “Café Con Ron.” Like only the most adept DJ or your favorite salsa band, he infused his mix with the kind of energy that could have kept people dancing ’til sunrise.\u003c/p>\n\u003cp>A watch party at Xingones Cantina in Oakland was sold out. It was specifically Bad Bunny-themed. “I’m a girl who loves Bad Bunny and I wanted to have a Bad Bunny-themed Super watch party,” said organizer Leticia Navarro. And in speaking with the people at the restaurant, there was a real sense of pride. “I have goosebumps right now. I cried last week when he won Album of the Year. This is a real cultural milestone. To see this man representing all Latinos, all people, I think means something so significant,” said Vanessa Rodriguez of Oakland. Jennifer Sanchez of San Jose agreed with those sentiments. “One of the reasons why I got so emotional is because seeing us Latinos being represented so well and all in Spanish, and knowing that in this America, it’s not really accepted. I think it was the most amazing thing he could have done,” she said.\u003c/p>\n\u003ch2>\u003cstrong>Prior Authorization Laws Reformed\u003c/strong>\u003c/h2>\n\u003cp>2025 was a pivotal year for health insurance reform: more than two dozen states, including California, passed laws limiting insurers’ ability to delay or deny medical services after a doctor has ordered them. The practice is known as prior authorization.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Ocean McIntyre has worked as a tattoo artist, a private pilot, and a research assistant at NASA near Pasadena. But not anymore. “A lot of that changed. A lot of that changed,” she said. McIntyre started having vision problems and it took her health plan a month to authorize a doctor visit. When pressure in her brain started crushing her optic nerve, she had to wait three months for permission to see a specialist. “He said if you had been seen earlier, we could have preserved your vision. Now we’re just trying to see if we can save any of your vision,” she said. “And I think that was the first time it really clicked that the life that I had before, was over.”\u003c/p>\n\u003cp>After years of tests and surgeries, she can see again, but barely. She’s legally blind. McIntyre’s is an extreme case, but far from an isolated one. In a survey, 23% of doctors say their patients have been hospitalized because of prior authorization delays and 18% say they’ve experienced a life-threatening event. “There is nothing that causes physicians’ blood pressure to elevate like prior authorization. You just say the word and doctors bristle,” said René Bravo, a pediatrician and president of the California Medical Association. He said authorization started as a reasonable mechanism for insurers to control costs. But it ballooned into unreasonable levels of paperwork and second-guessing.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Doctors have been fighting for years to address this problem. But something was different about 2025. An unprecedented 31 states passed laws reforming prior authorization, almost all with bipartisan, near unanimous support. University of Pittsburgh health policy professor Miranda Yaver says there was one pivotal event that changed the conversation: the murder of the UnitedHealth CEO in December 2024. The accused gunman used bullets etched with the words “delay” and “deny.” “It really highlighted for the country this amount of anger and I think that placed pressure on state legislatures,” Yaver said.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"slug": "what-to-know-about-californias-law-expanding-ivf-access-in-2026",
"title": "What to Know about California’s Law Expanding IVF Access in 2026",
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"content": "\u003cp>Sarah Jolly has been trying to conceive with her husband for five years.\u003c/p>\n\u003cp>The couple bought a house on the Central Coast in 2021 as newlyweds and thought they were “doing everything correct, financially,” Jolly said.\u003c/p>\n\u003cp>But in reality, “we had no idea how many years infertility would strap us” when it came to their finances, she said. “It is one of the hardest things I’ve ever been through.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Testing, \u003cem>traveling \u003c/em>to get tested, seeking a diagnosis and treatments like intrauterine insemination have so far cost the couple around $15,000.\u003c/p>\n\u003cp>In vitro fertilization — when \u003ca href=\"https://crh.ucsf.edu/fertility-treatment/in-vitro-fertilization-ivf/\">eggs are paired with sperm in a lab and placed in the uterus\u003c/a> — was out of their reach, price-wise. One cycle of IVF in California could \u003ca href=\"https://www.pfcla.com/blog/ivf-costs-california\">potentially cost more than $20,000\u003c/a>.\u003c/p>\n\u003cfigure id=\"attachment_12070657\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12070657\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/01/embryologist.jpg\" alt=\"\" width=\"2000\" height=\"1334\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/01/embryologist.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/01/embryologist-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/01/embryologist-1536x1025.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Illia Brusianskyi, a senior embryologist in Fountain Valley, CA., prepares embryos for genetic testing on Feb. 29, 2024. \u003ccite>(Jay L. Clendenin via Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“There are so many people in our situation, but also learning that infertility is not covered by insurance,” Jolly said. “It’s not really supported.”\u003c/p>\n\u003cp>It’s why Jolly is so encouraged by \u003ca href=\"https://www.kqed.org/forum/2010101912616/new-california-ivf-law-dramatically-expands-access\">a new state law\u003c/a> kicking in this month, which requires large employer-sponsored health plans to cover up to three cycles of IVF, plus other infertility services.\u003c/p>\n\u003cp>“I love that this law is being passed,” she said. “Taking the financial burden out of those choices would be life-changing for us.”[aside postID=news_12069971 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2025/09/GavinNewsomAP.jpg']California is now the \u003ca href=\"https://www.kqed.org/forum/2010101912616/new-california-ivf-law-dramatically-expands-access\">15th state in the country\u003c/a> to adopt insurance mandates around IVF. The Society for Assisted Reproductive Technology’s most recent numbers show that in 2023 alone, \u003ca href=\"https://www.asrm.org/news-and-events/asrm-news/press-releasesbulletins/us-ivf-usage-increases-in-2023-leads-to-over-95000-babies-born/\">95,000 babies were born through IVF usage\u003c/a> in the United States.\u003c/p>\n\u003cp>As \u003ca href=\"https://stateline.org/2025/08/25/as-republicans-spar-over-ivf-some-turn-to-obscure-maha-backed-alternative/\">conservative attacks on IVF\u003c/a> and \u003ca href=\"https://fightforfamilies.resolve.org/\">the overturning of \u003cem>Roe v. Wade\u003c/em>\u003c/a>\u003cem> — \u003c/em>which previously protected \u003ca href=\"https://www.kqed.org/news/tag/abortion\">abortion rights\u003c/a> in the U.S. — have left \u003ca href=\"https://www.americanprogress.org/article/how-the-alabama-ivf-ruling-is-connected-to-upcoming-supreme-court-cases-on-abortion/\">IVF and its providers with an uncertain legal future\u003c/a>, this new state law is another example of how California has been \u003ca href=\"https://www.kqed.org/news/tag/abortion\">strengthening its reproductive rights\u003c/a> amidst an increasingly hostile federal landscape.\u003c/p>\n\u003cp>\u003ca href=\"https://www.kqed.org/forum/2010101912616/new-california-ivf-law-dramatically-expands-access\">KQED \u003cem>Forum’s\u003c/em>\u003c/a> Mina Kim spoke to Jolly, the bill’s author, San Fernando Valley state Sen. Caroline Menjivar and Shefali Luthra, \u003ca href=\"https://19thnews.org/author/shefali-luthra/\">reporter at The 19th \u003c/a>on what Californians can expect to see from the new IVF law kicking in this January.\u003c/p>\n\u003ch2>\u003cstrong>What is the new California IVF law? \u003c/strong>\u003c/h2>\n\u003cp>The \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202320240SB729\">new law\u003c/a>, Senate Bill 729, dictates that large insurance groups (defined as \u003ca href=\"https://www.ivyfertility.com/news/california-senate-bill-729-faq\">101 or more employees\u003c/a>) must expand their services to cover infertility treatments and diagnoses.\u003c/p>\n\u003cp>In addition, according to \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202320240SB729\">the bill’s text\u003c/a>, large health insurance groups also must be able to cover “a maximum of 3 completed \u003ca href=\"https://www.pfcla.com/blog/egg-retrieval-process-what-to-expect\">oocyte retrievals\u003c/a>.”\u003c/p>\n\u003cp>An array of other \u003ca href=\"https://www.dmhc.ca.gov/Portals/0/Docs/OPL/APL25-021-ImplementationofSenateBill729(2024)(12_30_2025).pdf?ver=U9xFsGl6wZuNEyfFwRISFw%3d%3d\">fertility-related services (link to PDF)\u003c/a> may include:\u003c/p>\n\u003cul>\n\u003cli>Unlimited embryo transfers\u003c/li>\n\u003cli>Tubal evaluation and uterine evaluation\u003c/li>\n\u003cli>Sperm DNA fragmentation analysis\u003c/li>\n\u003cli>Thyroid function testing\u003c/li>\n\u003cli>Ovarian reserve testing\u003c/li>\n\u003cli>Procurement of donor semen, oocyte and embryo\u003c/li>\n\u003cli>Physician services, including consultation and referral.\u003c/li>\n\u003cli>Surgery to treat infertility\u003c/li>\n\u003cli>Medication to treat infertility\u003c/li>\n\u003cli>Infectious disease screening and testing\u003c/li>\n\u003cli>Medication to induce ovulation.\u003c/li>\n\u003c/ul>\n\u003cp>Keep in mind that some of these services are for \u003ca href=\"https://www.dmhc.ca.gov/Portals/0/Docs/OPL/APL25-021-ImplementationofSenateBill729(2024)(12_30_2025).pdf?ver=U9xFsGl6wZuNEyfFwRISFw%3d%3d\">“medically necessary”\u003c/a> cases of infertility — like \u003ca href=\"https://resolve.org/learn/financial-resources/insurance-coverage/understanding-californias-ivf-insurance-law/\">egg freezing before cancer treatment\u003c/a>. But the law is “pretty broad in some ways,” \u003ca href=\"https://19thnews.org/author/shefali-luthra/\">The 19th\u003c/a>’s Luthra said.\u003c/p>\n\u003cp>“It’s for treatment of infertility diagnosis and fertility treatment even beyond IVF,” Luthra said. “This creates a benefit structure for anyone who is navigating fertility to really get a sense of what might be causing that and how to treat that — whether it is IVF or something else that could help you become a parent.”\u003c/p>\n\u003ch2>\u003cstrong>When does this law kick in?\u003c/strong>\u003c/h2>\n\u003cp>The law kicks in for health insurance contracts \u003ca href=\"https://sd20.senate.ca.gov/news/millions-californians-now-have-health-plan-coverage-infertility-and-fertility-services\">issued or renewed\u003c/a> on or after January 2026.\u003c/p>\n\u003cp>According to the national fertility organization Resolve, if an \u003ca href=\"https://resolve.org/learn/financial-resources/insurance-coverage/understanding-californias-ivf-insurance-law/\">“employer’s plan renews later in the year, coverage under California’s IVF mandate may not begin until that renewal date.”\u003c/a>\u003c/p>\n\u003cp>The law will be \u003ca href=\"https://sd20.senate.ca.gov/news/millions-californians-now-have-health-plan-coverage-infertility-and-fertility-services\">delayed\u003c/a> for public employees who work for entities like the state government and are covered by \u003ca href=\"https://www.calpers.ca.gov/\">CalPERS\u003c/a>. For them, the law will start on July 1, 2027.\u003c/p>\n\u003ch2>\u003cstrong>Who does this law impact?\u003c/strong>\u003c/h2>\n\u003cp>Anyone interested in having children. By adjusting the definition of infertility, the state law has now \u003ca href=\"https://calmatters.org/health/2025/12/aetna-lawsuit-lgbtq-ivf-fertility/\">expanded access\u003c/a> to LGBTQ+ couples or single people who would often have to pay out of pocket for multiple treatments, Mejivar said.\u003c/p>\n\u003cp>Previously, the definition of infertility for major insurance companies like Aetna would include a person \u003ca href=\"https://calmatters.org/health/2025/12/aetna-lawsuit-lgbtq-ivf-fertility/\">attesting they’d been having heterosexual sex for a year\u003c/a>.\u003c/p>\n\u003cp>“I’m glad that we outlawed that 30-year-old description,” Mejivar said.\u003c/p>\n\u003ch2>\u003cstrong>Are there exceptions to the law? \u003c/strong>\u003c/h2>\n\u003cp>\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202320240SB729\">Religious employers\u003c/a>, small group employers and self-funded employers are \u003ca href=\"https://www.ccrmivf.com/blog/california-sb729-fertility-coverage/\">exempt\u003c/a> from this law. (But they can \u003ca href=\"https://www.blueshieldca.com/en/broker/resources/mandates\">opt to offer\u003c/a> these services, and employees of such organizations can \u003ca href=\"https://www.ccrmivf.com/blog/california-sb729-fertility-coverage/\">discuss options\u003c/a> with their human resources team.)\u003c/p>\n\u003cp>In addition to expanding to small individual health plans, Mejivar is also hoping to see the expansion reach Covered California: the state’s marketplace for plans offered under the Affordable Care Act.\u003c/p>\n\u003cfigure id=\"attachment_12052572\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12052572\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/042924_Covered-CA_AH_06.jpg\" alt='A woman wearing a black and white striped shirt walks past a building with a sign that says \"Health Insurance Covered California.\"' width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/042924_Covered-CA_AH_06.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/042924_Covered-CA_AH_06-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/042924_Covered-CA_AH_06-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">A Covered California Enrollment Center in Chula Vista on April 29, 2024. \u003ccite>(Adriana Heldiz / CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“We passed my bill, the governor signed it, and it’s now up to the federal government to approve it,” she said. “But we just got a letter that said that [federal officials are] putting a pause on all approvals.”\u003c/p>\n\u003cp>“It wasn’t a rejection. They’re just putting a pause,” she added. “We’re hopeful that they’re going to be coming back in approving what’s called the essential health benefits so that we can get more millions of people under other plans covered for IVF and fertility services.”\u003c/p>\n\u003cp>\u003c/p>\n",
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"excerpt": "A new California state is rapidly expanding access to fertility treatments. Here’s what to know.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Sarah Jolly has been trying to conceive with her husband for five years.\u003c/p>\n\u003cp>The couple bought a house on the Central Coast in 2021 as newlyweds and thought they were “doing everything correct, financially,” Jolly said.\u003c/p>\n\u003cp>But in reality, “we had no idea how many years infertility would strap us” when it came to their finances, she said. “It is one of the hardest things I’ve ever been through.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Testing, \u003cem>traveling \u003c/em>to get tested, seeking a diagnosis and treatments like intrauterine insemination have so far cost the couple around $15,000.\u003c/p>\n\u003cp>In vitro fertilization — when \u003ca href=\"https://crh.ucsf.edu/fertility-treatment/in-vitro-fertilization-ivf/\">eggs are paired with sperm in a lab and placed in the uterus\u003c/a> — was out of their reach, price-wise. One cycle of IVF in California could \u003ca href=\"https://www.pfcla.com/blog/ivf-costs-california\">potentially cost more than $20,000\u003c/a>.\u003c/p>\n\u003cfigure id=\"attachment_12070657\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12070657\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/01/embryologist.jpg\" alt=\"\" width=\"2000\" height=\"1334\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/01/embryologist.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/01/embryologist-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/01/embryologist-1536x1025.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Illia Brusianskyi, a senior embryologist in Fountain Valley, CA., prepares embryos for genetic testing on Feb. 29, 2024. \u003ccite>(Jay L. Clendenin via Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“There are so many people in our situation, but also learning that infertility is not covered by insurance,” Jolly said. “It’s not really supported.”\u003c/p>\n\u003cp>It’s why Jolly is so encouraged by \u003ca href=\"https://www.kqed.org/forum/2010101912616/new-california-ivf-law-dramatically-expands-access\">a new state law\u003c/a> kicking in this month, which requires large employer-sponsored health plans to cover up to three cycles of IVF, plus other infertility services.\u003c/p>\n\u003cp>“I love that this law is being passed,” she said. “Taking the financial burden out of those choices would be life-changing for us.”\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>California is now the \u003ca href=\"https://www.kqed.org/forum/2010101912616/new-california-ivf-law-dramatically-expands-access\">15th state in the country\u003c/a> to adopt insurance mandates around IVF. The Society for Assisted Reproductive Technology’s most recent numbers show that in 2023 alone, \u003ca href=\"https://www.asrm.org/news-and-events/asrm-news/press-releasesbulletins/us-ivf-usage-increases-in-2023-leads-to-over-95000-babies-born/\">95,000 babies were born through IVF usage\u003c/a> in the United States.\u003c/p>\n\u003cp>As \u003ca href=\"https://stateline.org/2025/08/25/as-republicans-spar-over-ivf-some-turn-to-obscure-maha-backed-alternative/\">conservative attacks on IVF\u003c/a> and \u003ca href=\"https://fightforfamilies.resolve.org/\">the overturning of \u003cem>Roe v. Wade\u003c/em>\u003c/a>\u003cem> — \u003c/em>which previously protected \u003ca href=\"https://www.kqed.org/news/tag/abortion\">abortion rights\u003c/a> in the U.S. — have left \u003ca href=\"https://www.americanprogress.org/article/how-the-alabama-ivf-ruling-is-connected-to-upcoming-supreme-court-cases-on-abortion/\">IVF and its providers with an uncertain legal future\u003c/a>, this new state law is another example of how California has been \u003ca href=\"https://www.kqed.org/news/tag/abortion\">strengthening its reproductive rights\u003c/a> amidst an increasingly hostile federal landscape.\u003c/p>\n\u003cp>\u003ca href=\"https://www.kqed.org/forum/2010101912616/new-california-ivf-law-dramatically-expands-access\">KQED \u003cem>Forum’s\u003c/em>\u003c/a> Mina Kim spoke to Jolly, the bill’s author, San Fernando Valley state Sen. Caroline Menjivar and Shefali Luthra, \u003ca href=\"https://19thnews.org/author/shefali-luthra/\">reporter at The 19th \u003c/a>on what Californians can expect to see from the new IVF law kicking in this January.\u003c/p>\n\u003ch2>\u003cstrong>What is the new California IVF law? \u003c/strong>\u003c/h2>\n\u003cp>The \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202320240SB729\">new law\u003c/a>, Senate Bill 729, dictates that large insurance groups (defined as \u003ca href=\"https://www.ivyfertility.com/news/california-senate-bill-729-faq\">101 or more employees\u003c/a>) must expand their services to cover infertility treatments and diagnoses.\u003c/p>\n\u003cp>In addition, according to \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202320240SB729\">the bill’s text\u003c/a>, large health insurance groups also must be able to cover “a maximum of 3 completed \u003ca href=\"https://www.pfcla.com/blog/egg-retrieval-process-what-to-expect\">oocyte retrievals\u003c/a>.”\u003c/p>\n\u003cp>An array of other \u003ca href=\"https://www.dmhc.ca.gov/Portals/0/Docs/OPL/APL25-021-ImplementationofSenateBill729(2024)(12_30_2025).pdf?ver=U9xFsGl6wZuNEyfFwRISFw%3d%3d\">fertility-related services (link to PDF)\u003c/a> may include:\u003c/p>\n\u003cul>\n\u003cli>Unlimited embryo transfers\u003c/li>\n\u003cli>Tubal evaluation and uterine evaluation\u003c/li>\n\u003cli>Sperm DNA fragmentation analysis\u003c/li>\n\u003cli>Thyroid function testing\u003c/li>\n\u003cli>Ovarian reserve testing\u003c/li>\n\u003cli>Procurement of donor semen, oocyte and embryo\u003c/li>\n\u003cli>Physician services, including consultation and referral.\u003c/li>\n\u003cli>Surgery to treat infertility\u003c/li>\n\u003cli>Medication to treat infertility\u003c/li>\n\u003cli>Infectious disease screening and testing\u003c/li>\n\u003cli>Medication to induce ovulation.\u003c/li>\n\u003c/ul>\n\u003cp>Keep in mind that some of these services are for \u003ca href=\"https://www.dmhc.ca.gov/Portals/0/Docs/OPL/APL25-021-ImplementationofSenateBill729(2024)(12_30_2025).pdf?ver=U9xFsGl6wZuNEyfFwRISFw%3d%3d\">“medically necessary”\u003c/a> cases of infertility — like \u003ca href=\"https://resolve.org/learn/financial-resources/insurance-coverage/understanding-californias-ivf-insurance-law/\">egg freezing before cancer treatment\u003c/a>. But the law is “pretty broad in some ways,” \u003ca href=\"https://19thnews.org/author/shefali-luthra/\">The 19th\u003c/a>’s Luthra said.\u003c/p>\n\u003cp>“It’s for treatment of infertility diagnosis and fertility treatment even beyond IVF,” Luthra said. “This creates a benefit structure for anyone who is navigating fertility to really get a sense of what might be causing that and how to treat that — whether it is IVF or something else that could help you become a parent.”\u003c/p>\n\u003ch2>\u003cstrong>When does this law kick in?\u003c/strong>\u003c/h2>\n\u003cp>The law kicks in for health insurance contracts \u003ca href=\"https://sd20.senate.ca.gov/news/millions-californians-now-have-health-plan-coverage-infertility-and-fertility-services\">issued or renewed\u003c/a> on or after January 2026.\u003c/p>\n\u003cp>According to the national fertility organization Resolve, if an \u003ca href=\"https://resolve.org/learn/financial-resources/insurance-coverage/understanding-californias-ivf-insurance-law/\">“employer’s plan renews later in the year, coverage under California’s IVF mandate may not begin until that renewal date.”\u003c/a>\u003c/p>\n\u003cp>The law will be \u003ca href=\"https://sd20.senate.ca.gov/news/millions-californians-now-have-health-plan-coverage-infertility-and-fertility-services\">delayed\u003c/a> for public employees who work for entities like the state government and are covered by \u003ca href=\"https://www.calpers.ca.gov/\">CalPERS\u003c/a>. For them, the law will start on July 1, 2027.\u003c/p>\n\u003ch2>\u003cstrong>Who does this law impact?\u003c/strong>\u003c/h2>\n\u003cp>Anyone interested in having children. By adjusting the definition of infertility, the state law has now \u003ca href=\"https://calmatters.org/health/2025/12/aetna-lawsuit-lgbtq-ivf-fertility/\">expanded access\u003c/a> to LGBTQ+ couples or single people who would often have to pay out of pocket for multiple treatments, Mejivar said.\u003c/p>\n\u003cp>Previously, the definition of infertility for major insurance companies like Aetna would include a person \u003ca href=\"https://calmatters.org/health/2025/12/aetna-lawsuit-lgbtq-ivf-fertility/\">attesting they’d been having heterosexual sex for a year\u003c/a>.\u003c/p>\n\u003cp>“I’m glad that we outlawed that 30-year-old description,” Mejivar said.\u003c/p>\n\u003ch2>\u003cstrong>Are there exceptions to the law? \u003c/strong>\u003c/h2>\n\u003cp>\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202320240SB729\">Religious employers\u003c/a>, small group employers and self-funded employers are \u003ca href=\"https://www.ccrmivf.com/blog/california-sb729-fertility-coverage/\">exempt\u003c/a> from this law. (But they can \u003ca href=\"https://www.blueshieldca.com/en/broker/resources/mandates\">opt to offer\u003c/a> these services, and employees of such organizations can \u003ca href=\"https://www.ccrmivf.com/blog/california-sb729-fertility-coverage/\">discuss options\u003c/a> with their human resources team.)\u003c/p>\n\u003cp>In addition to expanding to small individual health plans, Mejivar is also hoping to see the expansion reach Covered California: the state’s marketplace for plans offered under the Affordable Care Act.\u003c/p>\n\u003cfigure id=\"attachment_12052572\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12052572\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/042924_Covered-CA_AH_06.jpg\" alt='A woman wearing a black and white striped shirt walks past a building with a sign that says \"Health Insurance Covered California.\"' width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/042924_Covered-CA_AH_06.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/042924_Covered-CA_AH_06-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/08/042924_Covered-CA_AH_06-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">A Covered California Enrollment Center in Chula Vista on April 29, 2024. \u003ccite>(Adriana Heldiz / CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“We passed my bill, the governor signed it, and it’s now up to the federal government to approve it,” she said. “But we just got a letter that said that [federal officials are] putting a pause on all approvals.”\u003c/p>\n\u003cp>“It wasn’t a rejection. They’re just putting a pause,” she added. “We’re hopeful that they’re going to be coming back in approving what’s called the essential health benefits so that we can get more millions of people under other plans covered for IVF and fertility services.”\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"slug": "covered-california-health-insurance-will-cost-more-in-2026-heres-why",
"title": "Covered California Health Insurance Will Cost More in 2026. Here’s Why",
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"headTitle": "Covered California Health Insurance Will Cost More in 2026. Here’s Why | KQED",
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"content": "\u003cp>Californians who get their health insurance through the state’s marketplace will see \u003ca href=\"https://www.coveredca.com/newsroom/news-releases/2025/08/14/covered-california-rates-and-plans-for-2026-consumer-affordability-on-the-line-with-uncertainty-surrounding-federal-premium-tax-credit-extension/\">premiums increase by an average of 10.3%\u003c/a> next year.\u003c/p>\n\u003cp>Covered California officials on Thursday announced the first double-digit rate increase since 2018, saying it represents a “confluence” of factors putting upward pressure on the market.\u003c/p>\n\u003cp>Rising health care costs, the expiration of enhanced federal subsidies and policy-driven market uncertainty together are fueling the hike, Covered California Director Jessica Altman said.\u003c/p>\n\u003cp>Insurers in recent years have expected health care costs to increase by about 8% each year. That makes up the bulk of next year’s increase. But Altman said about 2% of the rate increase in the state’s version of the Affordable Care Act marketplace is based on \u003ca href=\"https://calmatters.org/health/2025/07/gop-budget-increases-health-insurance-costs/\">federal financial assistance that expires at the end of the year\u003c/a>.\u003c/p>\n\u003cp>\u003ca href=\"https://calmatters.org/health/2025/07/federal-budget-health-care-medicaid-medi-cal/\">President Donald Trump’s signature spending and tax reform bill\u003c/a> — the “One Big Beautiful Bill Act” — left out funding for enhanced premium tax credits used by more than 90% of Affordable Care Act enrollees nationwide. Congress enacted these subsidies during the COVID-19 pandemic to ensure people had health insurance. Since then, Affordable Care Act enrollment has nearly doubled nationwide from 12 million to 24 million people.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“We’ve never been through a loss in affordability like the expiration of the enhanced tax credits,” Altman said.\u003c/p>\n\u003cp>\u003ca href=\"https://www.modernhealthcare.com/politics-regulation/mh-congress-medicare-advantage-telehealth-doctor-pay/\">Congress could still decide to re-up the subsidies in September\u003c/a>. If it doesn’t, California will lose about $2.1 billion in enhanced tax credits for consumers.\u003c/p>\n\u003ch2>Double whammy for consumers\u003c/h2>\n\u003cp>Ariana Brill, a certified health insurance agent who helps people enroll in Covered California, said if the enhanced subsidies aren’t renewed, consumers’ pocketbooks will be hit twice next year.\u003c/p>\n\u003cp>“We’ll see rates go up. We’ll see assistance go down. And the net premium, the consumer’s take home price, is going to go up considerably,” Brill said.\u003c/p>\n\u003cp>Open enrollment typically starts on Nov. 1, but Brill said clients are already calling her with concerns about increases. A majority of her clients, about 2,600 of them, will have to pay significantly more for health care if Congress doesn’t extend the enhanced subsidies, she said.\u003c/p>\n\u003cp>If that happens, Brill said she expects some people to switch to less comprehensive, lower-cost plans to make ends meet. Others will drop coverage altogether. [aside postID=\"news_12049673,news_12051104\" label=\"Related Stories\"]\u003c/p>\n\u003cp>“For most people, affordability is a huge part of their decision making. Very few of us have the luxury of buying things without looking at the price,” Brill said.\u003c/p>\n\u003cp>State officials recently took steps to ease the potential loss of federal subsidies for the lowest-income Covered California members. The state will spend $190 million to maintain subsidies for people earning up to 150% of the federal poverty level (individuals earning about $23,000 or families of four earning about $48,000).\u003c/p>\n\u003cp>Still, that investment is far short of the $2.1 billion the state stands to lose.\u003c/p>\n\u003cp>Covered California’s previous estimates indicate that 600,000 people could drop coverage as a result of lost subsidies and rising costs. That, in turn, could make health care even more expensive, experts say. That’s because younger and healthier people tend to forego coverage first, leaving sicker and more costly people behind. To meet their needs, insurers have to charge more.\u003c/p>\n\u003cp>“With those lower utilization people leaving the marketplace, which leaves only the high cost users in the pool, it drives up premiums for those who are left,” said Matthew McGough, a policy analyst for KFF’s Affordable Care Act program who co-authored a recent\u003ca href=\"https://www.healthsystemtracker.org/brief/how-much-and-why-aca-marketplace-premiums-are-going-up-in-2026/#Distribution%20of%20proposed%202026%20rate%20changes%20among%20312%20ACA%20Marketplace%20insurers\"> study looking at 2026 premium increases\u003c/a>.\u003c/p>\n\u003cp>More people seeking health care and higher prices are already the primary factor driving annual rate increases, McGough said. Some of that can be attributed to the aging population and widespread use of costly pharmaceuticals like Ozempic and Wegovy to treat diabetes and other chronic health conditions.\u003c/p>\n\u003cp>But insurers nationally and in California have pointed out other factors contributing significantly to increased costs. These include tariffs on drugs and medical devices, enrollment and eligibility changes included in Trump’s budget package, and inflation. Most insurers are assuming Congress won’t extend the enhanced premium tax credits.\u003c/p>\n\u003cp>Nationally, the median premium increase for next year is 18%, according to the KFF analysis. Loss of subsidies accounts for 4%, McGough said.\u003c/p>\n\u003cp>“It’s definitely a significant factor this year and that along with the general environment of uncertainty are what is pushing these rates above what we’ve seen in the past few years,” McGough said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Supported by the California Health Care Foundation (CHCF), which works to ensure that people have access to the care they need, when they need it, at a price they can afford. Visit www.chcf.org to learn more.\u003c/em>\u003c/p>\n\n",
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"excerpt": "Millions of consumers will feel the pinch when rates already expected to rise will jump even further. Federal subsidies, set to expire at year’s end, are partly to blame.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Californians who get their health insurance through the state’s marketplace will see \u003ca href=\"https://www.coveredca.com/newsroom/news-releases/2025/08/14/covered-california-rates-and-plans-for-2026-consumer-affordability-on-the-line-with-uncertainty-surrounding-federal-premium-tax-credit-extension/\">premiums increase by an average of 10.3%\u003c/a> next year.\u003c/p>\n\u003cp>Covered California officials on Thursday announced the first double-digit rate increase since 2018, saying it represents a “confluence” of factors putting upward pressure on the market.\u003c/p>\n\u003cp>Rising health care costs, the expiration of enhanced federal subsidies and policy-driven market uncertainty together are fueling the hike, Covered California Director Jessica Altman said.\u003c/p>\n\u003cp>Insurers in recent years have expected health care costs to increase by about 8% each year. That makes up the bulk of next year’s increase. But Altman said about 2% of the rate increase in the state’s version of the Affordable Care Act marketplace is based on \u003ca href=\"https://calmatters.org/health/2025/07/gop-budget-increases-health-insurance-costs/\">federal financial assistance that expires at the end of the year\u003c/a>.\u003c/p>\n\u003cp>\u003ca href=\"https://calmatters.org/health/2025/07/federal-budget-health-care-medicaid-medi-cal/\">President Donald Trump’s signature spending and tax reform bill\u003c/a> — the “One Big Beautiful Bill Act” — left out funding for enhanced premium tax credits used by more than 90% of Affordable Care Act enrollees nationwide. Congress enacted these subsidies during the COVID-19 pandemic to ensure people had health insurance. Since then, Affordable Care Act enrollment has nearly doubled nationwide from 12 million to 24 million people.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“We’ve never been through a loss in affordability like the expiration of the enhanced tax credits,” Altman said.\u003c/p>\n\u003cp>\u003ca href=\"https://www.modernhealthcare.com/politics-regulation/mh-congress-medicare-advantage-telehealth-doctor-pay/\">Congress could still decide to re-up the subsidies in September\u003c/a>. If it doesn’t, California will lose about $2.1 billion in enhanced tax credits for consumers.\u003c/p>\n\u003ch2>Double whammy for consumers\u003c/h2>\n\u003cp>Ariana Brill, a certified health insurance agent who helps people enroll in Covered California, said if the enhanced subsidies aren’t renewed, consumers’ pocketbooks will be hit twice next year.\u003c/p>\n\u003cp>“We’ll see rates go up. We’ll see assistance go down. And the net premium, the consumer’s take home price, is going to go up considerably,” Brill said.\u003c/p>\n\u003cp>Open enrollment typically starts on Nov. 1, but Brill said clients are already calling her with concerns about increases. A majority of her clients, about 2,600 of them, will have to pay significantly more for health care if Congress doesn’t extend the enhanced subsidies, she said.\u003c/p>\n\u003cp>If that happens, Brill said she expects some people to switch to less comprehensive, lower-cost plans to make ends meet. Others will drop coverage altogether. \u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“For most people, affordability is a huge part of their decision making. Very few of us have the luxury of buying things without looking at the price,” Brill said.\u003c/p>\n\u003cp>State officials recently took steps to ease the potential loss of federal subsidies for the lowest-income Covered California members. The state will spend $190 million to maintain subsidies for people earning up to 150% of the federal poverty level (individuals earning about $23,000 or families of four earning about $48,000).\u003c/p>\n\u003cp>Still, that investment is far short of the $2.1 billion the state stands to lose.\u003c/p>\n\u003cp>Covered California’s previous estimates indicate that 600,000 people could drop coverage as a result of lost subsidies and rising costs. That, in turn, could make health care even more expensive, experts say. That’s because younger and healthier people tend to forego coverage first, leaving sicker and more costly people behind. To meet their needs, insurers have to charge more.\u003c/p>\n\u003cp>“With those lower utilization people leaving the marketplace, which leaves only the high cost users in the pool, it drives up premiums for those who are left,” said Matthew McGough, a policy analyst for KFF’s Affordable Care Act program who co-authored a recent\u003ca href=\"https://www.healthsystemtracker.org/brief/how-much-and-why-aca-marketplace-premiums-are-going-up-in-2026/#Distribution%20of%20proposed%202026%20rate%20changes%20among%20312%20ACA%20Marketplace%20insurers\"> study looking at 2026 premium increases\u003c/a>.\u003c/p>\n\u003cp>More people seeking health care and higher prices are already the primary factor driving annual rate increases, McGough said. Some of that can be attributed to the aging population and widespread use of costly pharmaceuticals like Ozempic and Wegovy to treat diabetes and other chronic health conditions.\u003c/p>\n\u003cp>But insurers nationally and in California have pointed out other factors contributing significantly to increased costs. These include tariffs on drugs and medical devices, enrollment and eligibility changes included in Trump’s budget package, and inflation. Most insurers are assuming Congress won’t extend the enhanced premium tax credits.\u003c/p>\n\u003cp>Nationally, the median premium increase for next year is 18%, according to the KFF analysis. Loss of subsidies accounts for 4%, McGough said.\u003c/p>\n\u003cp>“It’s definitely a significant factor this year and that along with the general environment of uncertainty are what is pushing these rates above what we’ve seen in the past few years,” McGough said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Supported by the California Health Care Foundation (CHCF), which works to ensure that people have access to the care they need, when they need it, at a price they can afford. Visit www.chcf.org to learn more.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"slug": "trumps-health-law-spurs-big-medi-cal-changes-what-californians-need-to-know",
"title": "On Medi-Cal? When to Expect New Rules, Higher Costs and Enrollment Freezes",
"publishDate": 1752332404,
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"headTitle": "On Medi-Cal? When to Expect New Rules, Higher Costs and Enrollment Freezes | KQED",
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"content": "\u003cp>Weeks before President Donald Trump signed into law the \u003ca href=\"https://www.kqed.org/news/12047037/a-betrayal-bay-area-leaders-react-to-us-house-passing-trumps-tax-and-welfare-cuts\">massive spending and tax plan\u003c/a> known as the One Big Beautiful Bill, California officials warned about its potential impacts on \u003ca href=\"https://www.coveredca.com/health/medi-cal/\">Medi-Cal\u003c/a>, the state’s Medicaid program that covers over 15 million lower-income Californians.\u003c/p>\n\u003cp>Gov. Gavin Newsom \u003ca href=\"https://www.youtube.com/watch?v=5qqbn1FK1Ac\">called Trump’s budget plan\u003c/a> “reckless, cruel and damaging,” citing \u003ca href=\"https://www.gov.ca.gov/wp-content/uploads/2025/05/newsom-medicaid-impacts-memo.pdf\">state estimates\u003c/a> that up to 3.4 million Medi-Cal recipients could lose their coverage if the legislation moved forward. While the White House insists that the OBBB \u003ca href=\"https://www.whitehouse.gov/articles/2025/06/myth-vs-fact-the-one-big-beautiful-bill/\">will not kick people off their health care plan\u003c/a>, the back-and-forth has sown confusion among many Californians about their Medi-Cal coverage.\u003c/p>\n\u003cp>“What we’re hearing from members is: One, is my information protected? And two, have there been any changes to my benefits and when can I expect a change?” said Michael Hunn, CEO of CalOptima Health, which serves Medi-Cal patients in Orange County.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Hunn said that his team has been assuring members that their personal health information is protected and that “there have been no changes to either benefits or eligibility right now in California.”\u003c/p>\n\u003cp>“We don’t want any of our members to think that somehow their coverage or their health insurance has gone away because it has not,” he said. “Please continue to get the care you need.”\u003c/p>\n\u003cfigure id=\"attachment_12029302\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12029302\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/072820-Doctor-Pediatrician-Kid-GETTY-CM-01-copy.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/072820-Doctor-Pediatrician-Kid-GETTY-CM-01-copy.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/072820-Doctor-Pediatrician-Kid-GETTY-CM-01-copy-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/072820-Doctor-Pediatrician-Kid-GETTY-CM-01-copy-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/072820-Doctor-Pediatrician-Kid-GETTY-CM-01-copy-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/072820-Doctor-Pediatrician-Kid-GETTY-CM-01-copy-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/072820-Doctor-Pediatrician-Kid-GETTY-CM-01-copy-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">A doctor examines a child at Southern Orange County Pediatric Associates in Ladera Ranch on July 28, 2020. \u003ccite>(Paul Bersebach/Orange County Register via Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>While Medi-Cal remains the same for the time being, the OBBB — along with other state and federal legislation — is expected to bring \u003ca href=\"https://www.congress.gov/119/bills/hr1/BILLS-119hr1eas.pdf\">big changes to the program\u003c/a> in the coming years, impacting different groups of recipients.\u003c/p>\n\u003cp>Keep reading for a timeline of when these changes will kick in and how to prepare. We will be updating this guide as more information becomes available.\u003c/p>\n\u003ch2>\u003cstrong>Dec. 31, 2025: \u003c/strong>\u003c/h2>\n\u003cp>\u003cstrong>End of subsidies for those who bought health coverage through Covered California\u003c/strong>\u003c/p>\n\u003cp>In 2021, Congress approved additional tax credits for people who bought health insurance through an Affordable Care Act marketplace, with Covered California being one.[aside postID=news_12033802 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/250323-DEM-TOWN-HALLS-MD-14-KQED-1-1020x680.jpg']The subsidies include both Medicare and market-rate plans, making it easier for \u003ca href=\"https://www.kff.org/affordable-care-act/issue-brief/inflation-reduction-act-health-insurance-subsidies-what-is-their-impact-and-what-would-happen-if-they-expire/\">millions of Americans to buy health insurance\u003c/a>. But when the credits expire, it will be more expensive for folks to keep their current coverage.\u003c/p>\n\u003cp>According to the \u003ca href=\"https://www.kff.org/affordable-care-act/issue-brief/inflation-reduction-act-health-insurance-subsidies-what-is-their-impact-and-what-would-happen-if-they-expire/#:~:text=The%20enhanced%20subsidies%20in%20the%20Inflation%20Reduction%20Act%20reduce%20net%20premium%20costs%20by%2044%25%2C%20on%20average%2C%20for%20enrollees%20receiving%20premium%20tax%20credits%2C%20though%20the%20amount%20of%20savings%20varies%20by%20person.\">Kaiser Family Foundation\u003c/a>, a San Francisco-based public health research nonprofit, the average annual premium payment for Medicaid in 2024 decreased from $1,593 to $888 — a difference of $705.\u003c/p>\n\u003cp>Two income groups could see the biggest changes in their premiums, said Dylan Roby, professor of health, society and behavior at UC Irvine. “When people start getting their renewals this year for coverage, they will probably see their premiums skyrocket if they make under 150% of the federal poverty level or above 400% of the federal poverty level,” he said.\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>\u003ca href=\"https://www.coveredca.com/pdfs/FPL-chart.pdf\">CHART: See where your income falls according to the federal poverty level\u003c/a>\u003c/strong>\u003c/li>\n\u003c/ul>\n\u003cp>Without enhanced subsidies, people above 400% of the federal poverty level may have to pay the full monthly premium for their insurance. On the other hand, those under 150% of the federal poverty level who previously received enough subsidies to cover all their premiums would have to start paying for part of their coverage.\u003c/p>\n\u003cp>While Congress failed to renew the subsidies in the OBBB, it still has time to extend them this year before they end.\u003c/p>\n\u003ch2>\u003cstrong>Jan. 1, 2026: \u003c/strong>\u003c/h2>\n\u003cp>\u003cstrong>Medi-Cal begins to freeze new enrollment for undocumented Californians \u003c/strong>\u003c/p>\n\u003cp>California has gradually expanded Medi-Cal enrollment to lower-income undocumented immigrants, adding new age groups every few years. About 1.6 million undocumented Californians are now covered by Medi-Cal, but the expansion cost the state \u003ca href=\"https://www.kqed.org/news/12031544/providing-health-care-for-immigrants-is-costing-california-more-than-expected-is-coverage-at-risk\">$2.7 billion more than it originally projected\u003c/a>, CalMatters reported.[aside postID=forum_2010101908967 hero='https://cdn.kqed.org/wp-content/uploads/sites/43/2025/02/iStock-1156622320-1-1020x574.jpg']As the state faces a growing deficit, \u003ca href=\"https://calmatters.org/politics/2025/06/california-budget-newsom-democrats/\">Newsom and the state Legislature agreed\u003c/a> to freeze Medi-Cal enrollment for undocumented immigrants who are 19 and older at the start of 2026. Then, on July 1, Medi-Cal will stop covering dental services for both undocumented individuals and those with an immigration status the \u003ca href=\"https://www.dhcs.ca.gov/Budget/Documents/DHCS-TBL-Policy-Changes-to-Individuals-with-UIS-Fact-Sheet.pdf\">state considers\u003c/a> “unsatisfactory.”\u003c/p>\n\u003cp>These cuts put at risk the yearslong work to improve health care access among the state’s undocumented community, said Adriana Ramos-Yamamoto, senior policy analyst at the California Budget and Policy Center.\u003c/p>\n\u003cp>“All of this progress is now under threat because of our own state budget deficit,” she said, adding that lawmakers in Sacramento are now under greater pressure as the federal government cuts down on funding for state programs. “We currently do not have the funding to help backfill any loss in federal funds.\u003c/p>\n\u003cp>“We really need state leaders to take bold action to equitably raise revenues to help mitigate the impact of these federal funding cuts to our state and Medi-Cal specifically.\u003c/p>\n\u003ch2>\u003cstrong>Dec. 31, 2026: \u003c/strong>\u003c/h2>\n\u003cp>\u003cstrong>States begin to roll out new Medicaid eligibility rules\u003c/strong>\u003c/p>\n\u003cp>When then-President Barack Obama \u003ca href=\"https://www.kqed.org/news/tag/affordable-care-act\">signed the Affordable Care Act\u003c/a> in 2010, it allowed adults ages 19–64 with incomes below 138% of the federal poverty level to qualify for Medicaid. Since then, \u003ca href=\"https://www.kff.org/medicaid/issue-brief/medicaid-expansion-is-a-red-and-blue-state-issue/\">over 21 million adults\u003c/a> have enrolled nationwide, including 5 million in Medi-Cal.\u003c/p>\n\u003cp>Under the OBBB, states must implement new eligibility requirements for this “expansion population”:\u003c/p>\n\u003cul>\n\u003cli>Individuals will now have to go through the Medicaid renewal process \u003ca href=\"https://www.kqed.org/news/11944543/on-medi\">with their county’s health and human services agency\u003c/a> every six months, instead of once a year.\u003c/li>\n\u003cli>Able-bodied adults without dependents must work, attend school classes or do community service for at least 80 hours each month. There are several exceptions, including if your state’s unemployment rate rises above 8%.\u003c/li>\n\u003c/ul>\n\u003cp>This will mean a lot more paperwork for both Medi-Cal recipients and the county offices managing these requirements, UC Irvine’s Roby said. “You could have somebody working two different jobs, but they don’t see the email coming from their eligibility office or maybe they changed addresses,” he said. “Because they don’t turn in proof that they’re working, they could lose their coverage.”\u003c/p>\n\u003cp>Individual states and counties will have two years to fully implement these changes, said Hunn from CalOptima Health, who added that his team will be working with Orange County officials to make sure that their members are aware of all the new forms they need to complete. “So they know when to look for certain envelopes,” he said, “and that they understand they have X number of days to complete that application redetermination package and turn it in.”\u003c/p>\n\u003cdiv class=\"mceTemp\">\u003c/div>\n\u003cfigure id=\"attachment_12047349\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-12047349\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/GettyImages-2216476723-2000x1363.jpg\" alt=\"\" width=\"2000\" height=\"1363\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/GettyImages-2216476723-2000x1363.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/GettyImages-2216476723-160x109.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/GettyImages-2216476723-1536x1047.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/GettyImages-2216476723-2048x1396.jpg 2048w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">US Speaker of the House Mike Johnson (R-La.) speaks to the media after the House narrowly passed a bill forwarding President Donald Trump’s agenda at the US Capitol on May 22, 2025, in Washington, DC. \u003ccite>(Kevin Dietsch/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch2>\u003cstrong>Jan. 1, 2027: \u003c/strong>\u003c/h2>\n\u003cp>\u003cstrong>Higher premiums for undocumented immigrants on Medi-Cal\u003c/strong>\u003c/p>\n\u003cp>As part of this year’s state budget deal, Medi-Cal recipients ages 19–59 with an immigration status \u003ca href=\"https://www.dhcs.ca.gov/Budget/Documents/DHCS-TBL-Policy-Changes-to-Individuals-with-UIS-Fact-Sheet.pdf\">the state considers “unsatisfactory”\u003c/a> — which includes both undocumented immigrants and those with a temporary status — will have to pay a $30 monthly premium starting in 2027.\u003c/p>\n\u003cp>Pregnant people will be exempt.\u003c/p>\n\u003cp>If someone misses three consecutive premium payments, they will be dropped from their coverage — and because of the 2026 enrollment freeze, they would be unable to reenroll.\u003c/p>\n\u003cp>\u003cstrong>Oct. 1, 2028: Minimum copays begin at the national level\u003c/strong>\u003c/p>\n\u003cp>The OBBB will also require Medicaid recipients in the “expansion population” to begin paying copays for medical care or services. States will set their own copays, but the OBBB requires the amount to be between $1 and $35 per service. There is an exception to this rule: copays are not required for primary care and services for mental health or substance use disorders.\u003c/p>\n\u003cp>Another caveat: The total amount that someone pays in copays in one year cannot exceed 5% of their income. This could make things confusing for individual states, Roby said.\u003c/p>\n\u003cp>“The state would have to track how much people are spending out of pocket on their cost sharing in order to make sure they don’t hit the 5% level,” he said.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"excerpt": "Medi-Cal faces major changes under Trump’s new health care law, including enrollment freezes, premium hikes for undocumented immigrants and stricter eligibility rules that could impact millions of lower-income Californians.",
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"title": "On Medi-Cal? When to Expect New Rules, Higher Costs and Enrollment Freezes | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Weeks before President Donald Trump signed into law the \u003ca href=\"https://www.kqed.org/news/12047037/a-betrayal-bay-area-leaders-react-to-us-house-passing-trumps-tax-and-welfare-cuts\">massive spending and tax plan\u003c/a> known as the One Big Beautiful Bill, California officials warned about its potential impacts on \u003ca href=\"https://www.coveredca.com/health/medi-cal/\">Medi-Cal\u003c/a>, the state’s Medicaid program that covers over 15 million lower-income Californians.\u003c/p>\n\u003cp>Gov. Gavin Newsom \u003ca href=\"https://www.youtube.com/watch?v=5qqbn1FK1Ac\">called Trump’s budget plan\u003c/a> “reckless, cruel and damaging,” citing \u003ca href=\"https://www.gov.ca.gov/wp-content/uploads/2025/05/newsom-medicaid-impacts-memo.pdf\">state estimates\u003c/a> that up to 3.4 million Medi-Cal recipients could lose their coverage if the legislation moved forward. While the White House insists that the OBBB \u003ca href=\"https://www.whitehouse.gov/articles/2025/06/myth-vs-fact-the-one-big-beautiful-bill/\">will not kick people off their health care plan\u003c/a>, the back-and-forth has sown confusion among many Californians about their Medi-Cal coverage.\u003c/p>\n\u003cp>“What we’re hearing from members is: One, is my information protected? And two, have there been any changes to my benefits and when can I expect a change?” said Michael Hunn, CEO of CalOptima Health, which serves Medi-Cal patients in Orange County.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Hunn said that his team has been assuring members that their personal health information is protected and that “there have been no changes to either benefits or eligibility right now in California.”\u003c/p>\n\u003cp>“We don’t want any of our members to think that somehow their coverage or their health insurance has gone away because it has not,” he said. “Please continue to get the care you need.”\u003c/p>\n\u003cfigure id=\"attachment_12029302\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12029302\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/072820-Doctor-Pediatrician-Kid-GETTY-CM-01-copy.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/072820-Doctor-Pediatrician-Kid-GETTY-CM-01-copy.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/072820-Doctor-Pediatrician-Kid-GETTY-CM-01-copy-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/072820-Doctor-Pediatrician-Kid-GETTY-CM-01-copy-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/072820-Doctor-Pediatrician-Kid-GETTY-CM-01-copy-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/072820-Doctor-Pediatrician-Kid-GETTY-CM-01-copy-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/072820-Doctor-Pediatrician-Kid-GETTY-CM-01-copy-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">A doctor examines a child at Southern Orange County Pediatric Associates in Ladera Ranch on July 28, 2020. \u003ccite>(Paul Bersebach/Orange County Register via Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>While Medi-Cal remains the same for the time being, the OBBB — along with other state and federal legislation — is expected to bring \u003ca href=\"https://www.congress.gov/119/bills/hr1/BILLS-119hr1eas.pdf\">big changes to the program\u003c/a> in the coming years, impacting different groups of recipients.\u003c/p>\n\u003cp>Keep reading for a timeline of when these changes will kick in and how to prepare. We will be updating this guide as more information becomes available.\u003c/p>\n\u003ch2>\u003cstrong>Dec. 31, 2025: \u003c/strong>\u003c/h2>\n\u003cp>\u003cstrong>End of subsidies for those who bought health coverage through Covered California\u003c/strong>\u003c/p>\n\u003cp>In 2021, Congress approved additional tax credits for people who bought health insurance through an Affordable Care Act marketplace, with Covered California being one.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The subsidies include both Medicare and market-rate plans, making it easier for \u003ca href=\"https://www.kff.org/affordable-care-act/issue-brief/inflation-reduction-act-health-insurance-subsidies-what-is-their-impact-and-what-would-happen-if-they-expire/\">millions of Americans to buy health insurance\u003c/a>. But when the credits expire, it will be more expensive for folks to keep their current coverage.\u003c/p>\n\u003cp>According to the \u003ca href=\"https://www.kff.org/affordable-care-act/issue-brief/inflation-reduction-act-health-insurance-subsidies-what-is-their-impact-and-what-would-happen-if-they-expire/#:~:text=The%20enhanced%20subsidies%20in%20the%20Inflation%20Reduction%20Act%20reduce%20net%20premium%20costs%20by%2044%25%2C%20on%20average%2C%20for%20enrollees%20receiving%20premium%20tax%20credits%2C%20though%20the%20amount%20of%20savings%20varies%20by%20person.\">Kaiser Family Foundation\u003c/a>, a San Francisco-based public health research nonprofit, the average annual premium payment for Medicaid in 2024 decreased from $1,593 to $888 — a difference of $705.\u003c/p>\n\u003cp>Two income groups could see the biggest changes in their premiums, said Dylan Roby, professor of health, society and behavior at UC Irvine. “When people start getting their renewals this year for coverage, they will probably see their premiums skyrocket if they make under 150% of the federal poverty level or above 400% of the federal poverty level,” he said.\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>\u003ca href=\"https://www.coveredca.com/pdfs/FPL-chart.pdf\">CHART: See where your income falls according to the federal poverty level\u003c/a>\u003c/strong>\u003c/li>\n\u003c/ul>\n\u003cp>Without enhanced subsidies, people above 400% of the federal poverty level may have to pay the full monthly premium for their insurance. On the other hand, those under 150% of the federal poverty level who previously received enough subsidies to cover all their premiums would have to start paying for part of their coverage.\u003c/p>\n\u003cp>While Congress failed to renew the subsidies in the OBBB, it still has time to extend them this year before they end.\u003c/p>\n\u003ch2>\u003cstrong>Jan. 1, 2026: \u003c/strong>\u003c/h2>\n\u003cp>\u003cstrong>Medi-Cal begins to freeze new enrollment for undocumented Californians \u003c/strong>\u003c/p>\n\u003cp>California has gradually expanded Medi-Cal enrollment to lower-income undocumented immigrants, adding new age groups every few years. About 1.6 million undocumented Californians are now covered by Medi-Cal, but the expansion cost the state \u003ca href=\"https://www.kqed.org/news/12031544/providing-health-care-for-immigrants-is-costing-california-more-than-expected-is-coverage-at-risk\">$2.7 billion more than it originally projected\u003c/a>, CalMatters reported.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>As the state faces a growing deficit, \u003ca href=\"https://calmatters.org/politics/2025/06/california-budget-newsom-democrats/\">Newsom and the state Legislature agreed\u003c/a> to freeze Medi-Cal enrollment for undocumented immigrants who are 19 and older at the start of 2026. Then, on July 1, Medi-Cal will stop covering dental services for both undocumented individuals and those with an immigration status the \u003ca href=\"https://www.dhcs.ca.gov/Budget/Documents/DHCS-TBL-Policy-Changes-to-Individuals-with-UIS-Fact-Sheet.pdf\">state considers\u003c/a> “unsatisfactory.”\u003c/p>\n\u003cp>These cuts put at risk the yearslong work to improve health care access among the state’s undocumented community, said Adriana Ramos-Yamamoto, senior policy analyst at the California Budget and Policy Center.\u003c/p>\n\u003cp>“All of this progress is now under threat because of our own state budget deficit,” she said, adding that lawmakers in Sacramento are now under greater pressure as the federal government cuts down on funding for state programs. “We currently do not have the funding to help backfill any loss in federal funds.\u003c/p>\n\u003cp>“We really need state leaders to take bold action to equitably raise revenues to help mitigate the impact of these federal funding cuts to our state and Medi-Cal specifically.\u003c/p>\n\u003ch2>\u003cstrong>Dec. 31, 2026: \u003c/strong>\u003c/h2>\n\u003cp>\u003cstrong>States begin to roll out new Medicaid eligibility rules\u003c/strong>\u003c/p>\n\u003cp>When then-President Barack Obama \u003ca href=\"https://www.kqed.org/news/tag/affordable-care-act\">signed the Affordable Care Act\u003c/a> in 2010, it allowed adults ages 19–64 with incomes below 138% of the federal poverty level to qualify for Medicaid. Since then, \u003ca href=\"https://www.kff.org/medicaid/issue-brief/medicaid-expansion-is-a-red-and-blue-state-issue/\">over 21 million adults\u003c/a> have enrolled nationwide, including 5 million in Medi-Cal.\u003c/p>\n\u003cp>Under the OBBB, states must implement new eligibility requirements for this “expansion population”:\u003c/p>\n\u003cul>\n\u003cli>Individuals will now have to go through the Medicaid renewal process \u003ca href=\"https://www.kqed.org/news/11944543/on-medi\">with their county’s health and human services agency\u003c/a> every six months, instead of once a year.\u003c/li>\n\u003cli>Able-bodied adults without dependents must work, attend school classes or do community service for at least 80 hours each month. There are several exceptions, including if your state’s unemployment rate rises above 8%.\u003c/li>\n\u003c/ul>\n\u003cp>This will mean a lot more paperwork for both Medi-Cal recipients and the county offices managing these requirements, UC Irvine’s Roby said. “You could have somebody working two different jobs, but they don’t see the email coming from their eligibility office or maybe they changed addresses,” he said. “Because they don’t turn in proof that they’re working, they could lose their coverage.”\u003c/p>\n\u003cp>Individual states and counties will have two years to fully implement these changes, said Hunn from CalOptima Health, who added that his team will be working with Orange County officials to make sure that their members are aware of all the new forms they need to complete. “So they know when to look for certain envelopes,” he said, “and that they understand they have X number of days to complete that application redetermination package and turn it in.”\u003c/p>\n\u003cdiv class=\"mceTemp\">\u003c/div>\n\u003cfigure id=\"attachment_12047349\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-12047349\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/GettyImages-2216476723-2000x1363.jpg\" alt=\"\" width=\"2000\" height=\"1363\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/GettyImages-2216476723-2000x1363.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/GettyImages-2216476723-160x109.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/GettyImages-2216476723-1536x1047.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/GettyImages-2216476723-2048x1396.jpg 2048w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">US Speaker of the House Mike Johnson (R-La.) speaks to the media after the House narrowly passed a bill forwarding President Donald Trump’s agenda at the US Capitol on May 22, 2025, in Washington, DC. \u003ccite>(Kevin Dietsch/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch2>\u003cstrong>Jan. 1, 2027: \u003c/strong>\u003c/h2>\n\u003cp>\u003cstrong>Higher premiums for undocumented immigrants on Medi-Cal\u003c/strong>\u003c/p>\n\u003cp>As part of this year’s state budget deal, Medi-Cal recipients ages 19–59 with an immigration status \u003ca href=\"https://www.dhcs.ca.gov/Budget/Documents/DHCS-TBL-Policy-Changes-to-Individuals-with-UIS-Fact-Sheet.pdf\">the state considers “unsatisfactory”\u003c/a> — which includes both undocumented immigrants and those with a temporary status — will have to pay a $30 monthly premium starting in 2027.\u003c/p>\n\u003cp>Pregnant people will be exempt.\u003c/p>\n\u003cp>If someone misses three consecutive premium payments, they will be dropped from their coverage — and because of the 2026 enrollment freeze, they would be unable to reenroll.\u003c/p>\n\u003cp>\u003cstrong>Oct. 1, 2028: Minimum copays begin at the national level\u003c/strong>\u003c/p>\n\u003cp>The OBBB will also require Medicaid recipients in the “expansion population” to begin paying copays for medical care or services. States will set their own copays, but the OBBB requires the amount to be between $1 and $35 per service. There is an exception to this rule: copays are not required for primary care and services for mental health or substance use disorders.\u003c/p>\n\u003cp>Another caveat: The total amount that someone pays in copays in one year cannot exceed 5% of their income. This could make things confusing for individual states, Roby said.\u003c/p>\n\u003cp>“The state would have to track how much people are spending out of pocket on their cost sharing in order to make sure they don’t hit the 5% level,” he said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>\u003c!-- Creative Commons Attribution-NonCommercial-NoDerivatives https://creativecommons.org/licenses/by-nc-nd/4.0/ -->\u003c/p>\n\u003cp>\u003cem>This story was originally published by \u003ca href=\"https://calmatters.org/\">CalMatters\u003c/a>. \u003ca href=\"https://calmatters.org/subscribe-to-calmatters/\">Sign up\u003c/a> for their newsletters.\u003c/em>\u003c/p>\n\u003cp>If Congress moves forward with a controversial \u003ca href=\"https://www.nytimes.com/2025/05/22/upshot/medicaid-republicans-work-requirement.html\">proposal to require people to report work hours\u003c/a> to keep Medicaid, more than a million of California’s poorest residents could lose their health insurance.\u003c/p>\n\u003cp>The budget bill that the U.S. House advanced last week includes a requirement that certain adults — largely those under 65 without children or a disability — meet work reporting rules. In California, about a third of them could lose their health coverage, according to an analysis by the research group Urban Institute. Based on 2026 enrollment projections, that’s \u003ca href=\"https://www.urban.org/research/publication/expanding-federal-work-requirements-medicaid-expansion-coverage-age-64-would\">between 1.2 and 1.4 million\u003c/a> Californians.\u003c/p>\n\u003cp>As Congress looks at Medicaid for ways to help offset the cost of extending President Donald Trump’s 2017 tax cuts, imposing work requirements has increasingly been deemed as one of the most feasible and significant cost-savings actions. House Speaker Mike Johnson \u003ca href=\"https://www.cbsnews.com/news/mike-johnson-house-speaker-trump-bill-medicaid-work-requirements/\">told CBS that work requirements\u003c/a> have a “moral component” and that people who don’t work are “defrauding the system.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>But health policy researchers and advocates point to New Hampshire and Arkansas, where state-imposed work requirements failed in recent years. Their \u003ca href=\"https://www.healthaffairs.org/doi/10.1377/hlthaff.2020.00538\">policies didn’t actually boost employment\u003c/a>; they did, however, leave thousands of eligible people without health insurance within a matter of months. Both states have since canceled their work policies. Georgia is the only state that currently has work requirements.\u003c/p>\n\u003cp>Nationwide and in California, about two-thirds of Medicaid enrollees work, according to the health research firm KFF. Another 29% care for children, attend school or have a disability that would exempt them. But health advocates say the additional red tape to prove employment could be so cumbersome that many eligible people would fall out of the health insurance program.\u003c/p>\n\u003cp>“You might say you’re combating waste, fraud and abuse,” said Katherine Hempstead, a senior policy officer at the Robert Wood Johnson Foundation, a nonprofit health advocacy organization that funds policy research. But “the way you’re going to save money is by people inadvertently or accidentally losing their coverage. The program saves money through mistakes. And that’s not a good way to run social insurance or to run policy.”\u003c/p>\n\u003cp>Medi-Cal — the California version of Medicaid — provides health insurance to almost 15 million people.\u003c/p>\n\u003cp>Diana Alfaro, associate executive director of Central City Neighborhood Partners, a nonprofit that helps people enroll in public benefits and services, says some of her low-income clients in Los Angeles who rely on Medi-Cal are employed — but not always in “typical” paying jobs. They are housekeepers, gardeners, construction workers and others who don’t have a regular paycheck or a single employer.\u003c/p>\n\u003cfigure>\u003cimg decoding=\"async\" src=\"https://calmatters.org/wp-content/uploads/2025/05/052825_WorkRequirements_JC_CM_16-819x1024.jpg\" alt=\"A person with long, wavy dark hair smiles while leaning on a podium decorated with various organizational logos. They wear a navy blouse with white trim and black pants, standing against a bright blue background. The overall mood is confident and welcoming.\">\u003cfigcaption>Diana Alfaro, shown at the Central City Neighborhood Partners office in Los Angeles, worries about people who will have trouble documenting work requirements if Congress’ proposal is enacted. Many are housekeepers, gardeners or others without a single employer and pay stubs. \u003cem>Jill Connelly for CalMatters\u003c/em>\u003c/figcaption>\u003c/figure>\n\u003cp>So far, it’s unclear exactly what documentation enrollees would need to show if a work requirement is enacted. But Alfaro is concerned that it could be especially challenging for people whose schedules fluctuate or who are paid in cash and don’t receive a pay stub that shows their hours worked. Some enrollees use a copy of their taxes, a letter from their employer or in some cases self-attestation to verify income eligibility when first applying for Medi-Cal.\u003c/p>\n\u003cp>“Some of them are doing those jobs of gardening or being a nanny or a housekeeper, and so they’re already going to have a hard time getting a letter that certifies the amount of hours that they’re doing if this were to pass,” Alfaro said.\u003c/p>\n\u003ch2>House proposal requires 80 hours a month of work or school\u003c/h2>\n\u003cp>The work requirement proposal is part of President Donald Trump’s “big beautiful bill,” which the U.S. House passed last week and is now in the hands of the Senate. All nine of California’s House Republicans voted in favor of the bill, while all Democrats voted against it.[aside postID=news_12039465 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/250323-DEM-TOWN-HALLS-MD-13-KQED-1-1020x680.jpg']The current version requires certain adults to log at least 80 hours a month of “community engagement,” which could be employment, school or volunteer work. As proposed, the rule would pertain specifically to adults ages 19 to 64 who qualify for Medicaid as part of an expansion under the Affordable Care Act. Pregnant women, parents and caregivers of young children, and people with mental and physical disabilities would be exempt.\u003c/p>\n\u003cp>Rep. David Valadao, a California Republican who represents portions of the San Joaquin Valley that have some of the highest Medicaid enrollment, \u003ca href=\"https://www.youtube.com/watch?v=mBNAOogpqGs\">told ABC’s Bakersfield affiliate\u003c/a> that work requirements are a fair ask.\u003c/p>\n\u003cp>“For those who are able-bodied with no dependents and you choose not to try to make that effort to go get a job, go to school or volunteer, do something in your community, yeah you’re probably going to be affected by this, but the average person who is working really hard to provide for their family thinks that’s the right thing to do,” Valadao said.\u003c/p>\n\u003cp>But Rep. Laura Friedman, a California Democrat representing Los Angeles, said it is the responsibility of the government to help people stay safe and healthy, but work requirements would do the opposite.\u003c/p>\n\u003cp>“They want to make it so hard for you and your family to access care with these onerous work requirements that you say ‘I’m not even going to bother, I’ll just try not to get sick,’” Friedman said during a press conference this week.\u003c/p>\n\u003cp>Friedman said the proposed cuts and requirements in the House bill would lead to more uncompensated care costs for clinics and hospitals, which ultimately could lead to reduced services for entire communities.\u003c/p>\n\u003cfigure>\u003cimg decoding=\"async\" src=\"https://calmatters.org/wp-content/uploads/2025/05/052825_WorkRequirements_JC_CM_02-1024x683.jpg\" alt=\"Two people sit across from each other at a white table in a brightly lit community center. One person, wearing a blue blazer, types on a laptop and speaks while holding a pen. The other person listens attentively, seated with hands on the table. Papers, folders, and a red wallet are spread out between them. The background includes folding chairs, a table with flowers, and yellow walls.\">\u003cfigcaption>Health navigator Elba Medina, right, works with Carmen Umana to apply for Medi-Cal. \u003cem>Jill Connelly for CalMatters\u003c/em>\u003c/figcaption>\u003c/figure>\n\u003cp>As currently drafted in the House bill, work requirements would kick in on Dec. 31, 2026. States would have the option to start earlier.\u003c/p>\n\u003cp>In addition to the work rules, the House budget bill proposes several other changes, including requiring these enrollees to verify their income every six months, rather than once a year. A separate measure seeks to financially penalize states that offer non-emergency Medicaid coverage to undocumented people, even if it’s with state-only funds, as California does. And less federal funding may force states to reduce benefits or enrollment.\u003c/p>\n\u003cp>The federal proposals are on top of changes that Gov. Gavin Newsom is already eyeing that could also force people to lose their health insurance. In his most recent budget proposal, Newsom proposed \u003ca href=\"https://calmatters.org/health/2025/05/newsom-freeze-medi-cal-undocumented-immigrants/\">benefit reductions, a premium charge and enrollment freezes\u003c/a> for undocumented residents as the state deals with a projected $12 billion shortfall.\u003c/p>\n\u003cp>All of the proposals at the federal and state level are bound to result in confusion and disruption for patients, Alfaro said.\u003c/p>\n\u003cp>“Last year we were doing a bunch of promotion around how easier it is to get health insurance,” she said. “And it seems like now we’re going a step backwards.”\u003c/p>\n\u003ch2>The Arkansas and New Hampshire experience\u003c/h2>\n\u003cp>Currently about 5 million Californians with Medi-Cal are eligible because of the Affordable Care Act’s Medicaid expansion. The 2010 health law allowed states to add adults without children or a disability to their rolls. It’s this group of enrollees that would be subject to the work requirements.\u003c/p>\n\u003cp>The Urban Institute’s estimate of more than a million of them losing coverage in 2026 is based on multiple factors, including trends and experiences observed in Arkansas and New Hampshire.\u003c/p>\n\u003cp>In 2018, Arkansas became the first state to implement work rules as a condition for Medicaid coverage. The rule applied to adults ages 30 to 49 who had to show 80 hours of work a month. Within six months, 18,000 adults had lost their coverage. In 2019, \u003ca href=\"https://www.npr.org/2019/03/27/707425729/federal-judge-strikes-down-medicaid-work-requirements-in-arkansas-and-kentucky\">a federal judge struck down\u003c/a> the state’s work requirement.\u003c/p>\n\u003cp>State lawmakers in New Hampshire said they’d do a better job than Arkansas in rolling out their own 2019 work requirement, but they faced similar challenges. The state had \u003ca href=\"https://www.unionleader.com/news/health/spreading-the-word-on-medicaid-work-requirement-proves-challenging/article_740b99e7-9f48-52d4-b2d8-030167e66af8.html\">a difficult time reaching enrollees\u003c/a> and notifying them about the changes, news reports at the time show. On track to lose thousands of people more than anticipated, the state suspended its rule.\u003c/p>\n\u003cp>“Based on the experience of other states, even if you spend a ton of energy on outreach, a lot of people just don’t realize what they have to do,” said Nari Rhee, director of the Retirement Security Program at the UC Berkeley Labor Center. “People have a bunch of questions: ‘Am I exempt? What do I have to do?’\u003c/p>\n\u003cp>“Even in New Hampshire, where they thought they were being gentle about the rollout, people had a hard time getting through (phone lines) to ask questions,” Rhee said. “So you can expect a pretty large percentage of people who could meet the requirements just fine, basically falling through the cracks and losing coverage because they just didn’t know or couldn’t get the information they needed.”\u003c/p>\n\u003cp>\u003cem>This article was \u003ca href=\"https://calmatters.org/health/2025/05/medicaid-work-requirement-california-congress/\">originally published on CalMatters\u003c/a> and was republished under the \u003ca href=\"https://creativecommons.org/licenses/by-nc-nd/4.0/\">Creative Commons Attribution-NonCommercial-NoDerivatives\u003c/a> license.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"excerpt": "A proposal in Congress would require some adults to document 80 hours a month of work or school. Experts say the red tape and paperwork is so cumbersome that even people who work will lose their health insurance.",
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"nprByline": "\u003ca href=\"https://calmatters.org/author/anaibarra/\">Ana B. Ibarra\u003c/a>, CalMatters",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003c!-- Creative Commons Attribution-NonCommercial-NoDerivatives https://creativecommons.org/licenses/by-nc-nd/4.0/ -->\u003c/p>\n\u003cp>\u003cem>This story was originally published by \u003ca href=\"https://calmatters.org/\">CalMatters\u003c/a>. \u003ca href=\"https://calmatters.org/subscribe-to-calmatters/\">Sign up\u003c/a> for their newsletters.\u003c/em>\u003c/p>\n\u003cp>If Congress moves forward with a controversial \u003ca href=\"https://www.nytimes.com/2025/05/22/upshot/medicaid-republicans-work-requirement.html\">proposal to require people to report work hours\u003c/a> to keep Medicaid, more than a million of California’s poorest residents could lose their health insurance.\u003c/p>\n\u003cp>The budget bill that the U.S. House advanced last week includes a requirement that certain adults — largely those under 65 without children or a disability — meet work reporting rules. In California, about a third of them could lose their health coverage, according to an analysis by the research group Urban Institute. Based on 2026 enrollment projections, that’s \u003ca href=\"https://www.urban.org/research/publication/expanding-federal-work-requirements-medicaid-expansion-coverage-age-64-would\">between 1.2 and 1.4 million\u003c/a> Californians.\u003c/p>\n\u003cp>As Congress looks at Medicaid for ways to help offset the cost of extending President Donald Trump’s 2017 tax cuts, imposing work requirements has increasingly been deemed as one of the most feasible and significant cost-savings actions. House Speaker Mike Johnson \u003ca href=\"https://www.cbsnews.com/news/mike-johnson-house-speaker-trump-bill-medicaid-work-requirements/\">told CBS that work requirements\u003c/a> have a “moral component” and that people who don’t work are “defrauding the system.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But health policy researchers and advocates point to New Hampshire and Arkansas, where state-imposed work requirements failed in recent years. Their \u003ca href=\"https://www.healthaffairs.org/doi/10.1377/hlthaff.2020.00538\">policies didn’t actually boost employment\u003c/a>; they did, however, leave thousands of eligible people without health insurance within a matter of months. Both states have since canceled their work policies. Georgia is the only state that currently has work requirements.\u003c/p>\n\u003cp>Nationwide and in California, about two-thirds of Medicaid enrollees work, according to the health research firm KFF. Another 29% care for children, attend school or have a disability that would exempt them. But health advocates say the additional red tape to prove employment could be so cumbersome that many eligible people would fall out of the health insurance program.\u003c/p>\n\u003cp>“You might say you’re combating waste, fraud and abuse,” said Katherine Hempstead, a senior policy officer at the Robert Wood Johnson Foundation, a nonprofit health advocacy organization that funds policy research. But “the way you’re going to save money is by people inadvertently or accidentally losing their coverage. The program saves money through mistakes. And that’s not a good way to run social insurance or to run policy.”\u003c/p>\n\u003cp>Medi-Cal — the California version of Medicaid — provides health insurance to almost 15 million people.\u003c/p>\n\u003cp>Diana Alfaro, associate executive director of Central City Neighborhood Partners, a nonprofit that helps people enroll in public benefits and services, says some of her low-income clients in Los Angeles who rely on Medi-Cal are employed — but not always in “typical” paying jobs. They are housekeepers, gardeners, construction workers and others who don’t have a regular paycheck or a single employer.\u003c/p>\n\u003cfigure>\u003cimg decoding=\"async\" src=\"https://calmatters.org/wp-content/uploads/2025/05/052825_WorkRequirements_JC_CM_16-819x1024.jpg\" alt=\"A person with long, wavy dark hair smiles while leaning on a podium decorated with various organizational logos. They wear a navy blouse with white trim and black pants, standing against a bright blue background. The overall mood is confident and welcoming.\">\u003cfigcaption>Diana Alfaro, shown at the Central City Neighborhood Partners office in Los Angeles, worries about people who will have trouble documenting work requirements if Congress’ proposal is enacted. Many are housekeepers, gardeners or others without a single employer and pay stubs. \u003cem>Jill Connelly for CalMatters\u003c/em>\u003c/figcaption>\u003c/figure>\n\u003cp>So far, it’s unclear exactly what documentation enrollees would need to show if a work requirement is enacted. But Alfaro is concerned that it could be especially challenging for people whose schedules fluctuate or who are paid in cash and don’t receive a pay stub that shows their hours worked. Some enrollees use a copy of their taxes, a letter from their employer or in some cases self-attestation to verify income eligibility when first applying for Medi-Cal.\u003c/p>\n\u003cp>“Some of them are doing those jobs of gardening or being a nanny or a housekeeper, and so they’re already going to have a hard time getting a letter that certifies the amount of hours that they’re doing if this were to pass,” Alfaro said.\u003c/p>\n\u003ch2>House proposal requires 80 hours a month of work or school\u003c/h2>\n\u003cp>The work requirement proposal is part of President Donald Trump’s “big beautiful bill,” which the U.S. House passed last week and is now in the hands of the Senate. All nine of California’s House Republicans voted in favor of the bill, while all Democrats voted against it.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The current version requires certain adults to log at least 80 hours a month of “community engagement,” which could be employment, school or volunteer work. As proposed, the rule would pertain specifically to adults ages 19 to 64 who qualify for Medicaid as part of an expansion under the Affordable Care Act. Pregnant women, parents and caregivers of young children, and people with mental and physical disabilities would be exempt.\u003c/p>\n\u003cp>Rep. David Valadao, a California Republican who represents portions of the San Joaquin Valley that have some of the highest Medicaid enrollment, \u003ca href=\"https://www.youtube.com/watch?v=mBNAOogpqGs\">told ABC’s Bakersfield affiliate\u003c/a> that work requirements are a fair ask.\u003c/p>\n\u003cp>“For those who are able-bodied with no dependents and you choose not to try to make that effort to go get a job, go to school or volunteer, do something in your community, yeah you’re probably going to be affected by this, but the average person who is working really hard to provide for their family thinks that’s the right thing to do,” Valadao said.\u003c/p>\n\u003cp>But Rep. Laura Friedman, a California Democrat representing Los Angeles, said it is the responsibility of the government to help people stay safe and healthy, but work requirements would do the opposite.\u003c/p>\n\u003cp>“They want to make it so hard for you and your family to access care with these onerous work requirements that you say ‘I’m not even going to bother, I’ll just try not to get sick,’” Friedman said during a press conference this week.\u003c/p>\n\u003cp>Friedman said the proposed cuts and requirements in the House bill would lead to more uncompensated care costs for clinics and hospitals, which ultimately could lead to reduced services for entire communities.\u003c/p>\n\u003cfigure>\u003cimg decoding=\"async\" src=\"https://calmatters.org/wp-content/uploads/2025/05/052825_WorkRequirements_JC_CM_02-1024x683.jpg\" alt=\"Two people sit across from each other at a white table in a brightly lit community center. One person, wearing a blue blazer, types on a laptop and speaks while holding a pen. The other person listens attentively, seated with hands on the table. Papers, folders, and a red wallet are spread out between them. The background includes folding chairs, a table with flowers, and yellow walls.\">\u003cfigcaption>Health navigator Elba Medina, right, works with Carmen Umana to apply for Medi-Cal. \u003cem>Jill Connelly for CalMatters\u003c/em>\u003c/figcaption>\u003c/figure>\n\u003cp>As currently drafted in the House bill, work requirements would kick in on Dec. 31, 2026. States would have the option to start earlier.\u003c/p>\n\u003cp>In addition to the work rules, the House budget bill proposes several other changes, including requiring these enrollees to verify their income every six months, rather than once a year. A separate measure seeks to financially penalize states that offer non-emergency Medicaid coverage to undocumented people, even if it’s with state-only funds, as California does. And less federal funding may force states to reduce benefits or enrollment.\u003c/p>\n\u003cp>The federal proposals are on top of changes that Gov. Gavin Newsom is already eyeing that could also force people to lose their health insurance. In his most recent budget proposal, Newsom proposed \u003ca href=\"https://calmatters.org/health/2025/05/newsom-freeze-medi-cal-undocumented-immigrants/\">benefit reductions, a premium charge and enrollment freezes\u003c/a> for undocumented residents as the state deals with a projected $12 billion shortfall.\u003c/p>\n\u003cp>All of the proposals at the federal and state level are bound to result in confusion and disruption for patients, Alfaro said.\u003c/p>\n\u003cp>“Last year we were doing a bunch of promotion around how easier it is to get health insurance,” she said. “And it seems like now we’re going a step backwards.”\u003c/p>\n\u003ch2>The Arkansas and New Hampshire experience\u003c/h2>\n\u003cp>Currently about 5 million Californians with Medi-Cal are eligible because of the Affordable Care Act’s Medicaid expansion. The 2010 health law allowed states to add adults without children or a disability to their rolls. It’s this group of enrollees that would be subject to the work requirements.\u003c/p>\n\u003cp>The Urban Institute’s estimate of more than a million of them losing coverage in 2026 is based on multiple factors, including trends and experiences observed in Arkansas and New Hampshire.\u003c/p>\n\u003cp>In 2018, Arkansas became the first state to implement work rules as a condition for Medicaid coverage. The rule applied to adults ages 30 to 49 who had to show 80 hours of work a month. Within six months, 18,000 adults had lost their coverage. In 2019, \u003ca href=\"https://www.npr.org/2019/03/27/707425729/federal-judge-strikes-down-medicaid-work-requirements-in-arkansas-and-kentucky\">a federal judge struck down\u003c/a> the state’s work requirement.\u003c/p>\n\u003cp>State lawmakers in New Hampshire said they’d do a better job than Arkansas in rolling out their own 2019 work requirement, but they faced similar challenges. The state had \u003ca href=\"https://www.unionleader.com/news/health/spreading-the-word-on-medicaid-work-requirement-proves-challenging/article_740b99e7-9f48-52d4-b2d8-030167e66af8.html\">a difficult time reaching enrollees\u003c/a> and notifying them about the changes, news reports at the time show. On track to lose thousands of people more than anticipated, the state suspended its rule.\u003c/p>\n\u003cp>“Based on the experience of other states, even if you spend a ton of energy on outreach, a lot of people just don’t realize what they have to do,” said Nari Rhee, director of the Retirement Security Program at the UC Berkeley Labor Center. “People have a bunch of questions: ‘Am I exempt? What do I have to do?’\u003c/p>\n\u003cp>“Even in New Hampshire, where they thought they were being gentle about the rollout, people had a hard time getting through (phone lines) to ask questions,” Rhee said. “So you can expect a pretty large percentage of people who could meet the requirements just fine, basically falling through the cracks and losing coverage because they just didn’t know or couldn’t get the information they needed.”\u003c/p>\n\u003cp>\u003cem>This article was \u003ca href=\"https://calmatters.org/health/2025/05/medicaid-work-requirement-california-congress/\">originally published on CalMatters\u003c/a> and was republished under the \u003ca href=\"https://creativecommons.org/licenses/by-nc-nd/4.0/\">Creative Commons Attribution-NonCommercial-NoDerivatives\u003c/a> license.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>The three-way syringe hisses — a dry \u003cem>pssst\u003c/em> followed by the rhythmic \u003cem>chik-chik-chik\u003c/em> of the metal dental scaler on enamel, as hardened tartar is scraped from my teeth, a sound I can almost feel.\u003c/p>\n\u003cp>It had been four years since I last saw my dentist, Dr. Jessica Ngo, and a lot had happened since then.\u003c/p>\n\u003cp>Through the safety glasses I wore to shield my eyes from splashes and debris, I caught sight of her dark eyes and the mole on the skin fold below her left eye. She wore Orascoptic dental loupes — high-powered lenses designed for spotting what eludes the naked eye. I hummed along with Taylor Swift’s “Shake It Off” as I followed the stray wisps of black hair slipping from beneath the satin headgear she wore.\u003c/p>\n\u003cp>“Are you really wearing a bonnet?” I asked.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Ngo — or Dr. J, as I call her — laughed behind her surgical mask.\u003c/p>\n\u003cp>I told her I also wear a bonnet to protect my locs while sleeping. It’s a hair thing. I \u003cem>get\u003c/em> it. We laughed together.\u003c/p>\n\u003cp>Maybe you could use some more laughter these days. National Smile Month, an annual campaign to promote \u003ca href=\"https://www.dentalhealth.org/national-smile-month\">oral health\u003c/a>, began Tuesday, but in 2025, there hasn’t been much to smile about for the people I care for. The ripple effects of \u003ca href=\"https://www.kqed.org/news/12034478/federal-workers-fired-thousands-california-wants-hire-them\">mass layoffs\u003c/a>, \u003ca href=\"https://www.kqed.org/news/12037889/trump-administration-considers-immigration-detention-bay-area-military-base-records-show\">detentions\u003c/a>, \u003ca href=\"https://www.kqed.org/news/12030273/if-trump-revokes-ukrainian-refugees-legal-status-many-in-california-fear-deportation\">deportations\u003c/a>, \u003ca href=\"https://www.kqed.org/news/12034742/california-students-visa-cancellations-sue-trump-administration\">visa cancellations\u003c/a>, trade threats, and the volatility of the stock market and retirement accounts leave many people stressed, \u003ca href=\"https://www.sfchronicle.com/news/article/Author-finds-happiness-not-misery-loves-company-9961102.php\">anxious\u003c/a> — and kissing their teeth.\u003c/p>\n\u003cfigure id=\"attachment_12039305\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12039305\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/250505-NATIONALSMILESMONTH-07-BL-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/250505-NATIONALSMILESMONTH-07-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/250505-NATIONALSMILESMONTH-07-BL-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/250505-NATIONALSMILESMONTH-07-BL-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/250505-NATIONALSMILESMONTH-07-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/250505-NATIONALSMILESMONTH-07-BL-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/250505-NATIONALSMILESMONTH-07-BL-KQED-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Dr. Jessica Ngo, a dentist at Total Health Dental Care, talks with patient Otis R. Taylor Jr. in the Berkeley offices on May 5, 2025. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>I returned to Dr. J’s office at \u003ca href=\"https://totalhealthdentalcare.com/jessica-ngo\">Total Health Dental Care\u003c/a> on Telegraph Avenue in Berkeley because I’ve been grinding my teeth. And eating too many Skittles. And I missed the care she offers — the kind of sensitivity I haven’t found elsewhere.\u003c/p>\n\u003cp>Poor oral health is closely linked to chronic diseases such as stroke, heart disease and diabetes. Proper oral hygiene can extend life expectancy. However, for people without dental insurance to reduce out-of-pocket expenses, preventative care is inaccessible.\u003c/p>\n\u003cp>“I actually had terrible teeth growing up,” Dr. J, a San Francisco native and one of five children raised by Chinese immigrants, told me. “I probably have over 20 fillings, and I have a root canal, a few crowns.”\u003c/p>\n\u003cp>Wait, what?[aside postID=news_12039102 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/072820-Doctor-Pediatrician-Kid-GETTY-CM-01-copy-1020x680.jpg']“They were working all the time,” she said of her parents. “I don’t think we had very much supervision. They didn’t double-check if we were brushing properly. They didn’t really restrict us on what we were eating, so we ate a lot of junk food and had a lot of candy.”\u003c/p>\n\u003cp>Dr. J, who is married with two young daughters, told me she doesn’t recall her family having insurance when she was a child growing up in the Ingleside neighborhood. If she did go to the dentist, it was an emergency.\u003c/p>\n\u003cp>“As a result of that, I had a lot of cavities that probably went untreated for a period of time before I saw dentists in my teenage years, and that’s when I needed all of that dental work,” she said. “I actually enjoyed going to the dentist, because it was something that wasn’t always available to me.”\u003c/p>\n\u003cp>That is why she does what she does.\u003c/p>\n\u003cp>This is why I go to see her: My mother, who once dug through the garbage for a baby tooth I wanted to put under my pillow for the tooth fairy, has always stressed the importance of a healthy mouth. Going to the dentist wasn’t always available to her.\u003c/p>\n\u003cp>I balked at braces, because I didn’t want to get teased, even though my misaligned central incisors — buck teeth — were clowned. Braces gave me a straighter smile — and made me less prone to gum disease, which slowly erodes the bone and tissue that anchor your teeth.\u003c/p>\n\u003cfigure id=\"attachment_12039309\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12039309\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/250505-NATIONALSMILESMONTH-35-BL-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/250505-NATIONALSMILESMONTH-35-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/250505-NATIONALSMILESMONTH-35-BL-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/250505-NATIONALSMILESMONTH-35-BL-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/250505-NATIONALSMILESMONTH-35-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/250505-NATIONALSMILESMONTH-35-BL-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/250505-NATIONALSMILESMONTH-35-BL-KQED-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Chusang Nhasang talks with patient Otis Taylor at the front desk of the Total Health Dental Care Berkeley offices on May 5, 2025. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>If left untreated, gum disease can lead to tooth loss and lingering bad breath. The problems can go far beyond your mouth. The bacteria behind gum disease can enter the bloodstream, traveling to organs like the heart, lungs and kidneys.\u003c/p>\n\u003cp>“Gum issues, if you’re not taking care of it, become a lot more complicated to treat as time goes on, so your mom was definitely right in that regard,” Dr. J, 36, said. “It’s rare to have that prevention or preventative care if there is a financial barrier or the patient isn’t covered, and so lower-income individuals have a harder time with that.”\u003c/p>\n\u003cp>Republicans in Congress are debating how to cut billions from Medicaid over the next decade — known as Medi-Cal in California — the safety-net program that covers health care for low-income families, children, seniors and people with disabilities. In California, roughly 15 million people rely on it.[aside postID=news_12039390 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/IMG_1018-1020x765.jpg']According to one IGS poll, \u003ca href=\"https://www.kqed.org/news/12039465/medicaid-cuts-divide-california-house-members-as-budget-deadline-looms\">more than half — 56% — of California voters\u003c/a> believe the state will be negatively impacted by proposed changes to Medi-Cal, which offers preventative and restorative dental benefits to children and adults. More than two-thirds of Medi-Cal recipients express concern about \u003ca href=\"https://www.kqed.org/news/12039102/californians-worried-about-medi-cal-congressional-republicans-consider-cuts\">their own health insurance coverage\u003c/a>.\u003c/p>\n\u003cp>And get this: The prevalence of periodontal disease is higher among Black and Mexican American adults age 30 and older, according to \u003ca href=\"https://www.nidcr.nih.gov/research/oralhealthinamerica\">Oral Health in America: Advances and Challenges\u003c/a> — a report from the National Institute of Dental and Craniofacial Research, part of the National Institutes of Health.\u003c/p>\n\u003cp>That’s why the \u003ca href=\"https://www.kqed.org/reparations\">California Reparations Task Force\u003c/a>, the first statewide body to study reparations for Black people, released a report with 115 policy recommendations, including a section on \u003ca href=\"https://oag.ca.gov/system/files/media/ch29-ca-reparations.pdf\">remedying disparities\u003c/a> in oral health care.\u003c/p>\n\u003cp>What kept me away from Dr. J’s office was insurance — Total Health didn’t take KQED’s plan. That changed this year when KQED switched providers. With age, I’ve come to value doctors I can truly connect with — where care feels human, not just clinical.\u003c/p>\n\u003cp>Dr. J’s office has been renovated with slat wood paneling and wood floors, but the energy remains the same. I crack jokes with Chusang Nhasang, the financial manager. The music is from personal playlists.\u003c/p>\n\u003cfigure id=\"attachment_12039306\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12039306\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/250505-NATIONALSMILESMONTH-25-BL-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/250505-NATIONALSMILESMONTH-25-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/250505-NATIONALSMILESMONTH-25-BL-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/250505-NATIONALSMILESMONTH-25-BL-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/250505-NATIONALSMILESMONTH-25-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/250505-NATIONALSMILESMONTH-25-BL-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/250505-NATIONALSMILESMONTH-25-BL-KQED-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Dr. Jessica Ngo, a dentist at Total Health Dental Care, holds her Orascoptic dental loupes in Berkeley on May 5, 2025. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>It’s the kind of place where dental anxiety melts away like butter on a pancake fresh off the griddle, a dental office where talk of sneaker collecting feels just as natural as a cleaning. Dental hygienists and dental assistants move around the office on lightweight performance shoes, such as On or Hoka. Dr. J said Adidas Ultraboosts are her go-to, but the last time I saw her, she was rocking the orange-accented Adidas Yeezy Boost 350 V2 Beluga Reflective.\u003c/p>\n\u003cp>“At some point, I was a major collector,” she said as she peeled off her gloves and pulled out her phone to play Jubel’s electronic dance cover of “\u003ca href=\"https://www.youtube.com/watch?v=tYwBRlgeK9Q\">Dancing in the Moonlight\u003c/a>,” a \u003ca href=\"https://www.youtube.com/watch?v=g5JqPxmYhlo\">1972 hit by King Harvest\u003c/a>. “I had shoe boxes — a line of them. I actually have a ton of shoes I’ve never opened, and so I became more practical. I don’t buy them just to store them anymore. I buy them to wear them.”\u003c/p>\n\u003cp>She’s going to give the shoes to her daughters, who, like me, love going to the dentist. Dr. J pointed out my Air Max 1 Dirty Denim. I clean my sneakers with a toothbrush.\u003c/p>\n\u003cp>Dr. J guided a pen-like intraoral scanner over my molars, its soft, mechanical hum rising as it created 3D images of my teeth.\u003c/p>\n\u003cp>“I wanted to show you — that crack is dangerous,” she said, pointing to a monitor. “We’re hoping that we put the crown over and it stops the crack, but sometimes when they’re too deep, it can still propagate. So we shall see.”\u003c/p>\n\u003cp>I floss after every snack and meal. Sometimes I walk around the newsroom handing out chocolate after lunch. I have a devastating sweet tooth.\u003c/p>\n\u003cp>“Otherwise, your teeth are beautiful,” she said, swiveling to take off her gloves. “You’re taking good care of them. The gum looks really healthy.”\u003c/p>\n\u003cp>As she peeled the plastic from her wrist, a soft, suctioned \u003cem>shffft\u003c/em> gave way to a crisp \u003cem>snap\u003c/em>.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"excerpt": "After four years, Otis R. Taylor Jr. reunited with Dr. Jessica Ngo, a San Francisco native who might have the coolest dental practice in the Bay Area. He was kept away because of insurance. ",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The three-way syringe hisses — a dry \u003cem>pssst\u003c/em> followed by the rhythmic \u003cem>chik-chik-chik\u003c/em> of the metal dental scaler on enamel, as hardened tartar is scraped from my teeth, a sound I can almost feel.\u003c/p>\n\u003cp>It had been four years since I last saw my dentist, Dr. Jessica Ngo, and a lot had happened since then.\u003c/p>\n\u003cp>Through the safety glasses I wore to shield my eyes from splashes and debris, I caught sight of her dark eyes and the mole on the skin fold below her left eye. She wore Orascoptic dental loupes — high-powered lenses designed for spotting what eludes the naked eye. I hummed along with Taylor Swift’s “Shake It Off” as I followed the stray wisps of black hair slipping from beneath the satin headgear she wore.\u003c/p>\n\u003cp>“Are you really wearing a bonnet?” I asked.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Ngo — or Dr. J, as I call her — laughed behind her surgical mask.\u003c/p>\n\u003cp>I told her I also wear a bonnet to protect my locs while sleeping. It’s a hair thing. I \u003cem>get\u003c/em> it. We laughed together.\u003c/p>\n\u003cp>Maybe you could use some more laughter these days. National Smile Month, an annual campaign to promote \u003ca href=\"https://www.dentalhealth.org/national-smile-month\">oral health\u003c/a>, began Tuesday, but in 2025, there hasn’t been much to smile about for the people I care for. The ripple effects of \u003ca href=\"https://www.kqed.org/news/12034478/federal-workers-fired-thousands-california-wants-hire-them\">mass layoffs\u003c/a>, \u003ca href=\"https://www.kqed.org/news/12037889/trump-administration-considers-immigration-detention-bay-area-military-base-records-show\">detentions\u003c/a>, \u003ca href=\"https://www.kqed.org/news/12030273/if-trump-revokes-ukrainian-refugees-legal-status-many-in-california-fear-deportation\">deportations\u003c/a>, \u003ca href=\"https://www.kqed.org/news/12034742/california-students-visa-cancellations-sue-trump-administration\">visa cancellations\u003c/a>, trade threats, and the volatility of the stock market and retirement accounts leave many people stressed, \u003ca href=\"https://www.sfchronicle.com/news/article/Author-finds-happiness-not-misery-loves-company-9961102.php\">anxious\u003c/a> — and kissing their teeth.\u003c/p>\n\u003cfigure id=\"attachment_12039305\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12039305\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/250505-NATIONALSMILESMONTH-07-BL-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/250505-NATIONALSMILESMONTH-07-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/250505-NATIONALSMILESMONTH-07-BL-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/250505-NATIONALSMILESMONTH-07-BL-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/250505-NATIONALSMILESMONTH-07-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/250505-NATIONALSMILESMONTH-07-BL-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/250505-NATIONALSMILESMONTH-07-BL-KQED-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Dr. Jessica Ngo, a dentist at Total Health Dental Care, talks with patient Otis R. Taylor Jr. in the Berkeley offices on May 5, 2025. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>I returned to Dr. J’s office at \u003ca href=\"https://totalhealthdentalcare.com/jessica-ngo\">Total Health Dental Care\u003c/a> on Telegraph Avenue in Berkeley because I’ve been grinding my teeth. And eating too many Skittles. And I missed the care she offers — the kind of sensitivity I haven’t found elsewhere.\u003c/p>\n\u003cp>Poor oral health is closely linked to chronic diseases such as stroke, heart disease and diabetes. Proper oral hygiene can extend life expectancy. However, for people without dental insurance to reduce out-of-pocket expenses, preventative care is inaccessible.\u003c/p>\n\u003cp>“I actually had terrible teeth growing up,” Dr. J, a San Francisco native and one of five children raised by Chinese immigrants, told me. “I probably have over 20 fillings, and I have a root canal, a few crowns.”\u003c/p>\n\u003cp>Wait, what?\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“They were working all the time,” she said of her parents. “I don’t think we had very much supervision. They didn’t double-check if we were brushing properly. They didn’t really restrict us on what we were eating, so we ate a lot of junk food and had a lot of candy.”\u003c/p>\n\u003cp>Dr. J, who is married with two young daughters, told me she doesn’t recall her family having insurance when she was a child growing up in the Ingleside neighborhood. If she did go to the dentist, it was an emergency.\u003c/p>\n\u003cp>“As a result of that, I had a lot of cavities that probably went untreated for a period of time before I saw dentists in my teenage years, and that’s when I needed all of that dental work,” she said. “I actually enjoyed going to the dentist, because it was something that wasn’t always available to me.”\u003c/p>\n\u003cp>That is why she does what she does.\u003c/p>\n\u003cp>This is why I go to see her: My mother, who once dug through the garbage for a baby tooth I wanted to put under my pillow for the tooth fairy, has always stressed the importance of a healthy mouth. Going to the dentist wasn’t always available to her.\u003c/p>\n\u003cp>I balked at braces, because I didn’t want to get teased, even though my misaligned central incisors — buck teeth — were clowned. Braces gave me a straighter smile — and made me less prone to gum disease, which slowly erodes the bone and tissue that anchor your teeth.\u003c/p>\n\u003cfigure id=\"attachment_12039309\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12039309\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/250505-NATIONALSMILESMONTH-35-BL-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/250505-NATIONALSMILESMONTH-35-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/250505-NATIONALSMILESMONTH-35-BL-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/250505-NATIONALSMILESMONTH-35-BL-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/250505-NATIONALSMILESMONTH-35-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/250505-NATIONALSMILESMONTH-35-BL-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/250505-NATIONALSMILESMONTH-35-BL-KQED-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Chusang Nhasang talks with patient Otis Taylor at the front desk of the Total Health Dental Care Berkeley offices on May 5, 2025. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>If left untreated, gum disease can lead to tooth loss and lingering bad breath. The problems can go far beyond your mouth. The bacteria behind gum disease can enter the bloodstream, traveling to organs like the heart, lungs and kidneys.\u003c/p>\n\u003cp>“Gum issues, if you’re not taking care of it, become a lot more complicated to treat as time goes on, so your mom was definitely right in that regard,” Dr. J, 36, said. “It’s rare to have that prevention or preventative care if there is a financial barrier or the patient isn’t covered, and so lower-income individuals have a harder time with that.”\u003c/p>\n\u003cp>Republicans in Congress are debating how to cut billions from Medicaid over the next decade — known as Medi-Cal in California — the safety-net program that covers health care for low-income families, children, seniors and people with disabilities. In California, roughly 15 million people rely on it.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>According to one IGS poll, \u003ca href=\"https://www.kqed.org/news/12039465/medicaid-cuts-divide-california-house-members-as-budget-deadline-looms\">more than half — 56% — of California voters\u003c/a> believe the state will be negatively impacted by proposed changes to Medi-Cal, which offers preventative and restorative dental benefits to children and adults. More than two-thirds of Medi-Cal recipients express concern about \u003ca href=\"https://www.kqed.org/news/12039102/californians-worried-about-medi-cal-congressional-republicans-consider-cuts\">their own health insurance coverage\u003c/a>.\u003c/p>\n\u003cp>And get this: The prevalence of periodontal disease is higher among Black and Mexican American adults age 30 and older, according to \u003ca href=\"https://www.nidcr.nih.gov/research/oralhealthinamerica\">Oral Health in America: Advances and Challenges\u003c/a> — a report from the National Institute of Dental and Craniofacial Research, part of the National Institutes of Health.\u003c/p>\n\u003cp>That’s why the \u003ca href=\"https://www.kqed.org/reparations\">California Reparations Task Force\u003c/a>, the first statewide body to study reparations for Black people, released a report with 115 policy recommendations, including a section on \u003ca href=\"https://oag.ca.gov/system/files/media/ch29-ca-reparations.pdf\">remedying disparities\u003c/a> in oral health care.\u003c/p>\n\u003cp>What kept me away from Dr. J’s office was insurance — Total Health didn’t take KQED’s plan. That changed this year when KQED switched providers. With age, I’ve come to value doctors I can truly connect with — where care feels human, not just clinical.\u003c/p>\n\u003cp>Dr. J’s office has been renovated with slat wood paneling and wood floors, but the energy remains the same. I crack jokes with Chusang Nhasang, the financial manager. The music is from personal playlists.\u003c/p>\n\u003cfigure id=\"attachment_12039306\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12039306\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/250505-NATIONALSMILESMONTH-25-BL-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/250505-NATIONALSMILESMONTH-25-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/250505-NATIONALSMILESMONTH-25-BL-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/250505-NATIONALSMILESMONTH-25-BL-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/250505-NATIONALSMILESMONTH-25-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/250505-NATIONALSMILESMONTH-25-BL-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/250505-NATIONALSMILESMONTH-25-BL-KQED-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Dr. Jessica Ngo, a dentist at Total Health Dental Care, holds her Orascoptic dental loupes in Berkeley on May 5, 2025. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>It’s the kind of place where dental anxiety melts away like butter on a pancake fresh off the griddle, a dental office where talk of sneaker collecting feels just as natural as a cleaning. Dental hygienists and dental assistants move around the office on lightweight performance shoes, such as On or Hoka. Dr. J said Adidas Ultraboosts are her go-to, but the last time I saw her, she was rocking the orange-accented Adidas Yeezy Boost 350 V2 Beluga Reflective.\u003c/p>\n\u003cp>“At some point, I was a major collector,” she said as she peeled off her gloves and pulled out her phone to play Jubel’s electronic dance cover of “\u003ca href=\"https://www.youtube.com/watch?v=tYwBRlgeK9Q\">Dancing in the Moonlight\u003c/a>,” a \u003ca href=\"https://www.youtube.com/watch?v=g5JqPxmYhlo\">1972 hit by King Harvest\u003c/a>. “I had shoe boxes — a line of them. I actually have a ton of shoes I’ve never opened, and so I became more practical. I don’t buy them just to store them anymore. I buy them to wear them.”\u003c/p>\n\u003cp>She’s going to give the shoes to her daughters, who, like me, love going to the dentist. Dr. J pointed out my Air Max 1 Dirty Denim. I clean my sneakers with a toothbrush.\u003c/p>\n\u003cp>Dr. J guided a pen-like intraoral scanner over my molars, its soft, mechanical hum rising as it created 3D images of my teeth.\u003c/p>\n\u003cp>“I wanted to show you — that crack is dangerous,” she said, pointing to a monitor. “We’re hoping that we put the crown over and it stops the crack, but sometimes when they’re too deep, it can still propagate. So we shall see.”\u003c/p>\n\u003cp>I floss after every snack and meal. Sometimes I walk around the newsroom handing out chocolate after lunch. I have a devastating sweet tooth.\u003c/p>\n\u003cp>“Otherwise, your teeth are beautiful,” she said, swiveling to take off her gloves. “You’re taking good care of them. The gum looks really healthy.”\u003c/p>\n\u003cp>As she peeled the plastic from her wrist, a soft, suctioned \u003cem>shffft\u003c/em> gave way to a crisp \u003cem>snap\u003c/em>.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Californians are expressing widespread worry about the future of \u003ca href=\"https://www.kqed.org/news/tag/medicaid\">Medicaid\u003c/a>, as Republicans in Congress weigh cuts to the program that covers health care for Americans with low incomes and disabilities.\u003c/p>\n\u003cp>GOP leaders are looking for budget savings to pay for the extension of tax cuts favored by President Donald Trump, but the idea of cutting Medicaid has raised alarm among some in the party — including \u003ca href=\"https://www.kqed.org/news/12032994/democrats-focus-their-message-on-gop-cuts-to-medicaid\">California Republicans\u003c/a> who represent districts with high numbers of Medicaid recipients. A \u003ca href=\"https://escholarship.org/uc/item/1nd0h87z\">pair of surveys\u003c/a> released \u003ca href=\"https://escholarship.org/uc/item/40r36594\">this week\u003c/a> by the UC Berkeley Institute of Governmental Studies found broad concern about \u003ca href=\"https://www.kqed.org/news/tag/medi-cal\">Medi-Cal\u003c/a>, the state’s Medicaid program, among California voters.\u003c/p>\n\u003cp>A full two-thirds, 67%, of registered voters who receive coverage through Medi-Cal are worried that they, or a family member, will lose insurance due to changes being pursued by the Trump administration. In a separate survey, 56% of voters polled said that the Trump administration’s proposed changes to Medi-Cal will have a “negative impact” on California.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Only tariffs ranked higher on voters’ lists of issues facing negative headwinds from Washington, said Mark DiCamillo, the poll’s director.\u003c/p>\n\u003cp>“Medi-Cal was right up there, so it’s one of the areas where most voters have concerns,” he said.\u003c/p>\n\u003cp>The program has emerged as a key inflection point in House Republicans’ budget talks this week. House Speaker Mike Johnson has been meeting privately in his office with groups of Republicans, as he works to enact the president’s legislative agenda with a slim seven-seat majority.\u003c/p>\n\u003cfigure id=\"attachment_12030841\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12030841\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/GettyImages-2201320740.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/GettyImages-2201320740.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/GettyImages-2201320740-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/GettyImages-2201320740-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/GettyImages-2201320740-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/GettyImages-2201320740-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/GettyImages-2201320740-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">A “Save Medicaid” sign is affixed to the podium for the House Democrats’ press event to oppose the Republicans’ budget on the House steps of the Capitol on Tuesday, February 25, 2024. \u003ccite>(Bill Clark/CQ-Roll Call, Inc., via Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The IGS surveys did not ask specifically about the budget plan, which sets a target of $880 billion in spending cuts over the next decade from the committee that oversees Medicaid spending. Trump has supported the budget framework, but told NBC last week that House Republicans are “not cutting [Medicaid]. They’re looking at fraud, waste and abuse.”\u003c/p>\n\u003cp>An \u003ca href=\"https://www.cbo.gov/system/files/2025-03/61235-Boyle-Pallone.pdf\">analysis\u003c/a> by the nonpartisan Congressional Budget Office shows that there is no way to reach the spending target without cutting Medicaid.\u003c/p>\n\u003cp>For most enrollees, Medi-Cal costs are shared evenly between California and the federal government. However, the federal government picks up 90% of the tab for the Medicaid expansion authorized through the Affordable Care Act, which covers Californians making up to $21,597.\u003c/p>\n\u003cp>Fiscal conservatives in the GOP caucus have floated ideas such as reducing the federal cost-share for expansion enrollees or enacting a per-enrollee cap on federal spending. Those proposals would generate significant savings in the range of $700 billion, according to the Congressional Budget Office, but also result in millions of Americans losing their health insurance.[aside postID=news_12038904 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2024/05/20240524_MobileHeadStart-34_qut-1020x680.jpg']Supporters of Medi-Cal warn that the impact of cuts will ripple beyond the patients who lose insurance. A \u003ca href=\"https://laborcenter.berkeley.edu/california-could-lose-up-to-217000-jobs-if-congress-cuts-medicaid/\">report\u003c/a> from the UC Berkeley Labor Center found that reductions to the healthcare program could result in the loss of up to 217,000 jobs.\u003c/p>\n\u003cp>In the rural Central Valley community of Visalia, Kaweah Health Center receives more than 30% of its revenue from Medi-Cal. The hospital is also the largest employer in Tulare County.\u003c/p>\n\u003cp>“When a healthcare job is lost, that healthcare worker has less money to spend in their community, at the stores they normally shop at,” said Laurel Lucia, director of the Health Care Program at the Labor Center. “That in turn could lead to job losses in those other non-healthcare industries.”\u003c/p>\n\u003cp>The potential cuts could also slow Republican momentum in California heading into the 2026 midterm elections. A \u003ca href=\"https://www.kqed.org/news/12033802/how-cuts-medicaid-republican-gains-california\">KQED analysis\u003c/a> found the congressional districts that shifted most toward Trump between 2020 and 2024 rely disproportionately on Medi-Cal. Enrollment is especially high in a pair of Central Valley swing districts held by Republican Rep. David Valadao and Democratic Rep. Adam Gray.\u003c/p>\n\u003cp>Republicans may be backing away from changes to the federal matching fund rates provided to the states.\u003c/p>\n\u003cp>New Jersey Republican Rep. Jeff Van Drew said those Medicaid changes “are dead.”\u003c/p>\n\u003cp>Instead, moderate Republicans have emphasized support for a different suite of ideas, such as restricting Medicaid access for undocumented immigrants and adults without jobs — ideas that would likely result in fewer savings, but generate less political blowback.\u003c/p>\n\u003cp>California has expanded Medi-Cal enrollment to residents without citizenship, a move that appears broadly popular in the new IGS polling. Support for providing Medi-Cal coverage for undocumented Californians stands at 61% for undocumented children, 49% for adults up to age 49, and 53% for those over age 50.\u003c/p>\n\u003cp>\u003cem>This story includes reporting from \u003c/em>\u003ca href=\"https://apnews.com/\">\u003cem>The Associated Press\u003c/em>\u003c/a>\u003cem> and KQED’s \u003c/em>\u003ca href=\"https://www.kqed.org/author/mbolanos\">\u003cem>Madi Bolaños\u003c/em>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Californians are expressing widespread worry about the future of \u003ca href=\"https://www.kqed.org/news/tag/medicaid\">Medicaid\u003c/a>, as Republicans in Congress weigh cuts to the program that covers health care for Americans with low incomes and disabilities.\u003c/p>\n\u003cp>GOP leaders are looking for budget savings to pay for the extension of tax cuts favored by President Donald Trump, but the idea of cutting Medicaid has raised alarm among some in the party — including \u003ca href=\"https://www.kqed.org/news/12032994/democrats-focus-their-message-on-gop-cuts-to-medicaid\">California Republicans\u003c/a> who represent districts with high numbers of Medicaid recipients. A \u003ca href=\"https://escholarship.org/uc/item/1nd0h87z\">pair of surveys\u003c/a> released \u003ca href=\"https://escholarship.org/uc/item/40r36594\">this week\u003c/a> by the UC Berkeley Institute of Governmental Studies found broad concern about \u003ca href=\"https://www.kqed.org/news/tag/medi-cal\">Medi-Cal\u003c/a>, the state’s Medicaid program, among California voters.\u003c/p>\n\u003cp>A full two-thirds, 67%, of registered voters who receive coverage through Medi-Cal are worried that they, or a family member, will lose insurance due to changes being pursued by the Trump administration. In a separate survey, 56% of voters polled said that the Trump administration’s proposed changes to Medi-Cal will have a “negative impact” on California.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Only tariffs ranked higher on voters’ lists of issues facing negative headwinds from Washington, said Mark DiCamillo, the poll’s director.\u003c/p>\n\u003cp>“Medi-Cal was right up there, so it’s one of the areas where most voters have concerns,” he said.\u003c/p>\n\u003cp>The program has emerged as a key inflection point in House Republicans’ budget talks this week. House Speaker Mike Johnson has been meeting privately in his office with groups of Republicans, as he works to enact the president’s legislative agenda with a slim seven-seat majority.\u003c/p>\n\u003cfigure id=\"attachment_12030841\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12030841\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/GettyImages-2201320740.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/GettyImages-2201320740.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/GettyImages-2201320740-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/GettyImages-2201320740-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/GettyImages-2201320740-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/GettyImages-2201320740-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/GettyImages-2201320740-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">A “Save Medicaid” sign is affixed to the podium for the House Democrats’ press event to oppose the Republicans’ budget on the House steps of the Capitol on Tuesday, February 25, 2024. \u003ccite>(Bill Clark/CQ-Roll Call, Inc., via Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The IGS surveys did not ask specifically about the budget plan, which sets a target of $880 billion in spending cuts over the next decade from the committee that oversees Medicaid spending. Trump has supported the budget framework, but told NBC last week that House Republicans are “not cutting [Medicaid]. They’re looking at fraud, waste and abuse.”\u003c/p>\n\u003cp>An \u003ca href=\"https://www.cbo.gov/system/files/2025-03/61235-Boyle-Pallone.pdf\">analysis\u003c/a> by the nonpartisan Congressional Budget Office shows that there is no way to reach the spending target without cutting Medicaid.\u003c/p>\n\u003cp>For most enrollees, Medi-Cal costs are shared evenly between California and the federal government. However, the federal government picks up 90% of the tab for the Medicaid expansion authorized through the Affordable Care Act, which covers Californians making up to $21,597.\u003c/p>\n\u003cp>Fiscal conservatives in the GOP caucus have floated ideas such as reducing the federal cost-share for expansion enrollees or enacting a per-enrollee cap on federal spending. Those proposals would generate significant savings in the range of $700 billion, according to the Congressional Budget Office, but also result in millions of Americans losing their health insurance.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Supporters of Medi-Cal warn that the impact of cuts will ripple beyond the patients who lose insurance. A \u003ca href=\"https://laborcenter.berkeley.edu/california-could-lose-up-to-217000-jobs-if-congress-cuts-medicaid/\">report\u003c/a> from the UC Berkeley Labor Center found that reductions to the healthcare program could result in the loss of up to 217,000 jobs.\u003c/p>\n\u003cp>In the rural Central Valley community of Visalia, Kaweah Health Center receives more than 30% of its revenue from Medi-Cal. The hospital is also the largest employer in Tulare County.\u003c/p>\n\u003cp>“When a healthcare job is lost, that healthcare worker has less money to spend in their community, at the stores they normally shop at,” said Laurel Lucia, director of the Health Care Program at the Labor Center. “That in turn could lead to job losses in those other non-healthcare industries.”\u003c/p>\n\u003cp>The potential cuts could also slow Republican momentum in California heading into the 2026 midterm elections. A \u003ca href=\"https://www.kqed.org/news/12033802/how-cuts-medicaid-republican-gains-california\">KQED analysis\u003c/a> found the congressional districts that shifted most toward Trump between 2020 and 2024 rely disproportionately on Medi-Cal. Enrollment is especially high in a pair of Central Valley swing districts held by Republican Rep. David Valadao and Democratic Rep. Adam Gray.\u003c/p>\n\u003cp>Republicans may be backing away from changes to the federal matching fund rates provided to the states.\u003c/p>\n\u003cp>New Jersey Republican Rep. Jeff Van Drew said those Medicaid changes “are dead.”\u003c/p>\n\u003cp>Instead, moderate Republicans have emphasized support for a different suite of ideas, such as restricting Medicaid access for undocumented immigrants and adults without jobs — ideas that would likely result in fewer savings, but generate less political blowback.\u003c/p>\n\u003cp>California has expanded Medi-Cal enrollment to residents without citizenship, a move that appears broadly popular in the new IGS polling. Support for providing Medi-Cal coverage for undocumented Californians stands at 61% for undocumented children, 49% for adults up to age 49, and 53% for those over age 50.\u003c/p>\n\u003cp>\u003cem>This story includes reporting from \u003c/em>\u003ca href=\"https://apnews.com/\">\u003cem>The Associated Press\u003c/em>\u003c/a>\u003cem> and KQED’s \u003c/em>\u003ca href=\"https://www.kqed.org/author/mbolanos\">\u003cem>Madi Bolaños\u003c/em>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"title": "Insurance Denials Can Devastate Mental Health Patients. California Is Considering How to Fix That",
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"content": "\u003cp>\u003cem>This story was originally published by \u003ca href=\"https://calmatters.org/\">CalMatters\u003c/a>. \u003ca href=\"https://calmatters.org/subscribe-to-calmatters/\">Sign up\u003c/a> for their newsletters.\u003c/em>\u003c/p>\n\u003cp>Frustrated Californians have long complained that they can’t get their health plans to cover desperately needed mental health treatment.\u003c/p>\n\u003cp>These days, state lawmakers appear to be hearing them — and trying to act.\u003c/p>\n\u003cp>One bill introduced this session would require health plans to cough up more \u003ca href=\"https://calmatters.digitaldemocracy.org/bills/ca_202520260sb363\">data on coverage denials \u003c/a>— and penalize those that wrongfully deny claims most often.\u003c/p>\n\u003cp>Another would require plans to \u003ca href=\"https://calmatters.digitaldemocracy.org/bills/ca_202520260ab669\">wait at least 28 days\u003c/a> after approving a patient to go into a substance use treatment center before they reassess whether the patient can remain there.\u003c/p>\n\u003cp>A third would prohibit health plans from requiring \u003ca href=\"https://calmatters.digitaldemocracy.org/bills/ca_202520260ab384\">prior authorization\u003c/a> for mental health and substance use treatment before and during a patient’s stay in a hospital.\u003c/p>\n\u003cp>The list goes on.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Four years after state leaders passed \u003ca href=\"https://calmatters.org/health/2020/08/california-leader-mental-health/\">landmark legislation\u003c/a> to improve mental health and substance use coverage, polls portray a public still deeply unhappy with what they’re getting. One such poll of Californians last year found that more than 80% of respondents wanted the governor and legislature \u003ca href=\"https://www.chcf.org/publication/2024-chcf-california-health-policy-survey/#related-links-and-downloads\">to increase access to mental health treatment\u003c/a>.\u003c/p>\n\u003cp>“Everybody’s been denied some form of care,” said John Drebinger, a senior advocate with the Steinberg Institute, a mental health advocacy organization. “Nobody likes this. If you haven’t been, you know somebody who has.”\u003c/p>\n\u003cp>At a February oversight hearing of the Senate budget and fiscal review committee, \u003ca href=\"https://calmatters.digitaldemocracy.org/legislators/scott-wiener-100936\">Scott Wiener\u003c/a>, the Democratic San Francisco state senator who authored the 2020 coverage law, called the process by which consumers can \u003ca href=\"https://www.dmhc.ca.gov/FileaComplaint.aspx\">appeal denials \u003c/a>to the state’s Department of Managed Health Care “burdensome, opaque and time-consuming.”\u003c/p>\n\u003cp>In light of federal efforts to fire workers and remove data from government websites, he said, “it’s more important than ever for California to lead.”\u003c/p>\n\u003cp>It’s still early enough in the process that any of the proposed legislation could be stymied by a variety of factors, including federal fiscal uncertainty, health plan opposition and disagreement among advocates about the best approach.[aside postID=news_12018653 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2024/12/AnthemBlueCrossGetty-1020x680.jpg']Last year, a handful of bills designed to hold health plans accountable ended up dying late in the legislative process. Supporters blamed \u003ca href=\"https://calmatters.org/digital-democracy/2024/08/newsom-healthcare-costs-inflated-estimates/\">inflated cost estimates \u003c/a>for their demise.\u003c/p>\n\u003cp>But some of those same lawmakers and advocates say the tenor of the conversation has changed in the months since 26-year-old Luigi Mangione shot and killed Brian Thompson, the chief executive officer of UnitedHealthcare, last December. That killing prompted an outpouring of public frustration and has become a cultural flashpoint.\u003c/p>\n\u003cp>At the February oversight hearing, Mary Watanabe, director of the Department of Managed Health Care, seemed open to requiring plans to provide more information about coverage denials.\u003c/p>\n\u003cp>“We really are seeking to understand the barriers that consumers experience navigating the behavioral health system,” she said.\u003c/p>\n\u003cp>Mary Ellen Grant, spokeswoman for the California Association of Health Plans, said in an email that it was premature to offer comment, given that the industry association has not yet taken a formal position on individual bills. She provided a fact sheet about the importance of prior authorization for “making health care safer, higher quality and more affordable.”\u003c/p>\n\u003cp>Here are some of the top bills attempting to tackle this issue:\u003c/p>\n\u003ch2>More transparency about denials\u003c/h2>\n\u003cp>Wiener would like to see \u003ca href=\"https://calmatters.digitaldemocracy.org/bills/ca_202520260sb363\">much greater transparency\u003c/a> from commercial health plans. His Senate Bill 363 would require plans to report granular data to the state about how often they deny treatment. This bill applies to denials of all types of medical care, not just mental health.\u003c/p>\n\u003cp>The state also has its own appeals process for consumers, known as \u003ca href=\"https://calmatters.org/health/mental-health/2024/10/mental-health-insurance-appeal/\">independent medical review\u003c/a>. Wiener’s bill would also penalize plans if the state overturns their coverage denials more than half the time.\u003c/p>\n\u003cp>Wiener acknowledges that health plans have proven “worthy opponents” to some of his other bills. But he calls the push for greater accountability “long overdue.” Since he introduced the legislation, he said, he’s been struck by how many people have stopped him on the streets of San Francisco to share their personal nightmares about being denied coverage.\u003c/p>\n\u003cp>“This is touching a nerve,” he said.\u003c/p>\n\u003ch2>Protecting the first 28 days\u003c/h2>\n\u003cp>\u003ca href=\"https://calmatters.digitaldemocracy.org/bills/ca_202520260ab669\">Assembly Bill 669 \u003c/a>would keep plans from reviewing a patient’s eligibility for continuing substance use treatment until at least 28 days after they’ve been approved.[aside postID=news_12028048 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2025/02/GettyImages-1434072256-copy-1020x680.jpg']\u003ca href=\"https://calmatters.digitaldemocracy.org/legislators/matt-haney-165453\">Matt Haney,\u003c/a> a Democratic state Assembly member from San Francisco who authored the bill, says his interest in the bill was inspired by the\u003ca href=\"https://calmatters.org/health/mental-health/2024/10/mental-health-parity-addiction-treatment/\"> story of Ryan Matlock\u003c/a>. Matlock, a young man whose story was featured in CalMatters last fall, died of a fentanyl overdose not long after his health plan decided to stop covering his residential treatment. The plan initially decided Matlock did not need to remain at the treatment facility after he had spent just three days there. Matlock’s mother, Christine Dougherty, is testifying on behalf of the legislation.\u003c/p>\n\u003cp>Haney says 12 other states already have similar laws in place.\u003c/p>\n\u003cp>“It’s infuriating and mind-boggling that an insurer can deny someone care that they say they need and their physician says they need but it’s denied by the insurer’s employed ‘doctor’ who never even spoke to the patient,” he said. “That is dangerous and it’s wrong and it is not how medical decisions that can have such life or death consequences should be determined.”\u003c/p>\n\u003cp>Among the organizations sponsoring the bill are the California Consortium of Addiction Programs and Professionals, the California Behavioral Health Association, the Addiction Treatment Advocacy Coalition, and A New PATH (Parents for Addiction Treatment & Healing).\u003c/p>\n\u003ch2>No prior authorization for inpatient mental health\u003c/h2>\n\u003cp>The sweeping Mental Health Protection Act, AB 384, would prevent health plans from\u003ca href=\"https://calmatters.digitaldemocracy.org/bills/ca_202520260ab384\"> requiring prior authorization\u003c/a> for inpatient care for mental health and substance use treatment. It would also prevent plans from requiring prior authorization for any medical care deemed necessary during the inpatient stay.\u003c/p>\n\u003cp>\u003ca href=\"https://calmatters.digitaldemocracy.org/legislators/damon-connolly-165425\">Damon Connolly\u003c/a>, a Democratic state Assembly member from San Rafael, says he modeled the bill off of similar, successful legislation in Illinois.\u003c/p>\n\u003cp>“Too often prior authorization is creating delays in a situation where every second counts,” he said.\u003c/p>\n\u003cp>The California State Association of Psychiatrists and the California Behavioral Health Association are co-sponsoring the bill.\u003c/p>\n\u003ch2>Defines ‘medically necessary’ care\u003c/h2>\n\u003cp>Health plans are required to cover medically necessary health and mental health care. But what constitutes medical necessity? A bill by Democratic Fresno state Assemblymember \u003ca href=\"https://calmatters.digitaldemocracy.org/legislators/joaquin-arambula-17377\">Joaquin Arambula\u003c/a>, AB 980, would \u003ca href=\"https://calmatters.digitaldemocracy.org/bills/ca_202520260ab980\">define “medically necessary”\u003c/a> to mean legally prescribed medical care that is reasonable and fits with standards set by the medical community. The bill also details the harms that plans may be held liable for if such care is not provided.\u003c/p>\n\u003ch2>Behavioral health visits after a wildfire\u003c/h2>\n\u003cp>With wildfires wiping out entire neighborhoods in the state, it is clear some people in devastated communities will need behavioral health treatment. A bill by Democratic state Assemblymembers \u003ca href=\"https://calmatters.digitaldemocracy.org/legislators/john-harabedian-187422\">John Harabedian\u003c/a> from Pasadena and\u003ca href=\"https://calmatters.digitaldemocracy.org/legislators/robert-rivas-165041\"> Robert Rivas\u003c/a> from Salinas, AB 1032 would require health insurers to reimburse enrollees from a disaster zone for up to \u003ca href=\"https://calmatters.digitaldemocracy.org/bills/ca_202520260ab1032\">12 visits with a licensed behavioral health provider \u003c/a>during the year after a wildfire event.\u003c/p>\n\u003cp>\u003cem>This article was \u003ca href=\"https://calmatters.org/health/mental-health/2025/03/mental-health-insurance-legislation/\">originally published on CalMatters\u003c/a> and was republished under the \u003ca href=\"https://creativecommons.org/licenses/by-nc-nd/4.0/\">Creative Commons Attribution-NonCommercial-NoDerivatives\u003c/a> license.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>This story was originally published by \u003ca href=\"https://calmatters.org/\">CalMatters\u003c/a>. \u003ca href=\"https://calmatters.org/subscribe-to-calmatters/\">Sign up\u003c/a> for their newsletters.\u003c/em>\u003c/p>\n\u003cp>Frustrated Californians have long complained that they can’t get their health plans to cover desperately needed mental health treatment.\u003c/p>\n\u003cp>These days, state lawmakers appear to be hearing them — and trying to act.\u003c/p>\n\u003cp>One bill introduced this session would require health plans to cough up more \u003ca href=\"https://calmatters.digitaldemocracy.org/bills/ca_202520260sb363\">data on coverage denials \u003c/a>— and penalize those that wrongfully deny claims most often.\u003c/p>\n\u003cp>Another would require plans to \u003ca href=\"https://calmatters.digitaldemocracy.org/bills/ca_202520260ab669\">wait at least 28 days\u003c/a> after approving a patient to go into a substance use treatment center before they reassess whether the patient can remain there.\u003c/p>\n\u003cp>A third would prohibit health plans from requiring \u003ca href=\"https://calmatters.digitaldemocracy.org/bills/ca_202520260ab384\">prior authorization\u003c/a> for mental health and substance use treatment before and during a patient’s stay in a hospital.\u003c/p>\n\u003cp>The list goes on.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Four years after state leaders passed \u003ca href=\"https://calmatters.org/health/2020/08/california-leader-mental-health/\">landmark legislation\u003c/a> to improve mental health and substance use coverage, polls portray a public still deeply unhappy with what they’re getting. One such poll of Californians last year found that more than 80% of respondents wanted the governor and legislature \u003ca href=\"https://www.chcf.org/publication/2024-chcf-california-health-policy-survey/#related-links-and-downloads\">to increase access to mental health treatment\u003c/a>.\u003c/p>\n\u003cp>“Everybody’s been denied some form of care,” said John Drebinger, a senior advocate with the Steinberg Institute, a mental health advocacy organization. “Nobody likes this. If you haven’t been, you know somebody who has.”\u003c/p>\n\u003cp>At a February oversight hearing of the Senate budget and fiscal review committee, \u003ca href=\"https://calmatters.digitaldemocracy.org/legislators/scott-wiener-100936\">Scott Wiener\u003c/a>, the Democratic San Francisco state senator who authored the 2020 coverage law, called the process by which consumers can \u003ca href=\"https://www.dmhc.ca.gov/FileaComplaint.aspx\">appeal denials \u003c/a>to the state’s Department of Managed Health Care “burdensome, opaque and time-consuming.”\u003c/p>\n\u003cp>In light of federal efforts to fire workers and remove data from government websites, he said, “it’s more important than ever for California to lead.”\u003c/p>\n\u003cp>It’s still early enough in the process that any of the proposed legislation could be stymied by a variety of factors, including federal fiscal uncertainty, health plan opposition and disagreement among advocates about the best approach.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Last year, a handful of bills designed to hold health plans accountable ended up dying late in the legislative process. Supporters blamed \u003ca href=\"https://calmatters.org/digital-democracy/2024/08/newsom-healthcare-costs-inflated-estimates/\">inflated cost estimates \u003c/a>for their demise.\u003c/p>\n\u003cp>But some of those same lawmakers and advocates say the tenor of the conversation has changed in the months since 26-year-old Luigi Mangione shot and killed Brian Thompson, the chief executive officer of UnitedHealthcare, last December. That killing prompted an outpouring of public frustration and has become a cultural flashpoint.\u003c/p>\n\u003cp>At the February oversight hearing, Mary Watanabe, director of the Department of Managed Health Care, seemed open to requiring plans to provide more information about coverage denials.\u003c/p>\n\u003cp>“We really are seeking to understand the barriers that consumers experience navigating the behavioral health system,” she said.\u003c/p>\n\u003cp>Mary Ellen Grant, spokeswoman for the California Association of Health Plans, said in an email that it was premature to offer comment, given that the industry association has not yet taken a formal position on individual bills. She provided a fact sheet about the importance of prior authorization for “making health care safer, higher quality and more affordable.”\u003c/p>\n\u003cp>Here are some of the top bills attempting to tackle this issue:\u003c/p>\n\u003ch2>More transparency about denials\u003c/h2>\n\u003cp>Wiener would like to see \u003ca href=\"https://calmatters.digitaldemocracy.org/bills/ca_202520260sb363\">much greater transparency\u003c/a> from commercial health plans. His Senate Bill 363 would require plans to report granular data to the state about how often they deny treatment. This bill applies to denials of all types of medical care, not just mental health.\u003c/p>\n\u003cp>The state also has its own appeals process for consumers, known as \u003ca href=\"https://calmatters.org/health/mental-health/2024/10/mental-health-insurance-appeal/\">independent medical review\u003c/a>. Wiener’s bill would also penalize plans if the state overturns their coverage denials more than half the time.\u003c/p>\n\u003cp>Wiener acknowledges that health plans have proven “worthy opponents” to some of his other bills. But he calls the push for greater accountability “long overdue.” Since he introduced the legislation, he said, he’s been struck by how many people have stopped him on the streets of San Francisco to share their personal nightmares about being denied coverage.\u003c/p>\n\u003cp>“This is touching a nerve,” he said.\u003c/p>\n\u003ch2>Protecting the first 28 days\u003c/h2>\n\u003cp>\u003ca href=\"https://calmatters.digitaldemocracy.org/bills/ca_202520260ab669\">Assembly Bill 669 \u003c/a>would keep plans from reviewing a patient’s eligibility for continuing substance use treatment until at least 28 days after they’ve been approved.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003ca href=\"https://calmatters.digitaldemocracy.org/legislators/matt-haney-165453\">Matt Haney,\u003c/a> a Democratic state Assembly member from San Francisco who authored the bill, says his interest in the bill was inspired by the\u003ca href=\"https://calmatters.org/health/mental-health/2024/10/mental-health-parity-addiction-treatment/\"> story of Ryan Matlock\u003c/a>. Matlock, a young man whose story was featured in CalMatters last fall, died of a fentanyl overdose not long after his health plan decided to stop covering his residential treatment. The plan initially decided Matlock did not need to remain at the treatment facility after he had spent just three days there. Matlock’s mother, Christine Dougherty, is testifying on behalf of the legislation.\u003c/p>\n\u003cp>Haney says 12 other states already have similar laws in place.\u003c/p>\n\u003cp>“It’s infuriating and mind-boggling that an insurer can deny someone care that they say they need and their physician says they need but it’s denied by the insurer’s employed ‘doctor’ who never even spoke to the patient,” he said. “That is dangerous and it’s wrong and it is not how medical decisions that can have such life or death consequences should be determined.”\u003c/p>\n\u003cp>Among the organizations sponsoring the bill are the California Consortium of Addiction Programs and Professionals, the California Behavioral Health Association, the Addiction Treatment Advocacy Coalition, and A New PATH (Parents for Addiction Treatment & Healing).\u003c/p>\n\u003ch2>No prior authorization for inpatient mental health\u003c/h2>\n\u003cp>The sweeping Mental Health Protection Act, AB 384, would prevent health plans from\u003ca href=\"https://calmatters.digitaldemocracy.org/bills/ca_202520260ab384\"> requiring prior authorization\u003c/a> for inpatient care for mental health and substance use treatment. It would also prevent plans from requiring prior authorization for any medical care deemed necessary during the inpatient stay.\u003c/p>\n\u003cp>\u003ca href=\"https://calmatters.digitaldemocracy.org/legislators/damon-connolly-165425\">Damon Connolly\u003c/a>, a Democratic state Assembly member from San Rafael, says he modeled the bill off of similar, successful legislation in Illinois.\u003c/p>\n\u003cp>“Too often prior authorization is creating delays in a situation where every second counts,” he said.\u003c/p>\n\u003cp>The California State Association of Psychiatrists and the California Behavioral Health Association are co-sponsoring the bill.\u003c/p>\n\u003ch2>Defines ‘medically necessary’ care\u003c/h2>\n\u003cp>Health plans are required to cover medically necessary health and mental health care. But what constitutes medical necessity? A bill by Democratic Fresno state Assemblymember \u003ca href=\"https://calmatters.digitaldemocracy.org/legislators/joaquin-arambula-17377\">Joaquin Arambula\u003c/a>, AB 980, would \u003ca href=\"https://calmatters.digitaldemocracy.org/bills/ca_202520260ab980\">define “medically necessary”\u003c/a> to mean legally prescribed medical care that is reasonable and fits with standards set by the medical community. The bill also details the harms that plans may be held liable for if such care is not provided.\u003c/p>\n\u003ch2>Behavioral health visits after a wildfire\u003c/h2>\n\u003cp>With wildfires wiping out entire neighborhoods in the state, it is clear some people in devastated communities will need behavioral health treatment. A bill by Democratic state Assemblymembers \u003ca href=\"https://calmatters.digitaldemocracy.org/legislators/john-harabedian-187422\">John Harabedian\u003c/a> from Pasadena and\u003ca href=\"https://calmatters.digitaldemocracy.org/legislators/robert-rivas-165041\"> Robert Rivas\u003c/a> from Salinas, AB 1032 would require health insurers to reimburse enrollees from a disaster zone for up to \u003ca href=\"https://calmatters.digitaldemocracy.org/bills/ca_202520260ab1032\">12 visits with a licensed behavioral health provider \u003c/a>during the year after a wildfire event.\u003c/p>\n\u003cp>\u003cem>This article was \u003ca href=\"https://calmatters.org/health/mental-health/2025/03/mental-health-insurance-legislation/\">originally published on CalMatters\u003c/a> and was republished under the \u003ca href=\"https://creativecommons.org/licenses/by-nc-nd/4.0/\">Creative Commons Attribution-NonCommercial-NoDerivatives\u003c/a> license.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"title": "Providing Health Care for Immigrants Is Costing California More Than Expected. Is Coverage at Risk?",
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"content": "\u003cp>The California health care program that covers almost 15 million people is costing more money than Gov. Gavin Newsom projected, creating a \u003ca href=\"https://calmatters.org/tag/california-budget/\">new budget problem\u003c/a> in a lean year.\u003c/p>\n\u003cp>Now his administration is borrowing $3.4 billion from the state’s general fund to cover the unexpected cost increase. It’s unclear when the administration plans to restore the money.\u003c/p>\n\u003cp>The administration acknowledged that more people are enrolled in the program than the state anticipated, and that the state is spending $2.7 billion more than it planned on coverage expansions for immigrants without legal status.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Roughly 1.6 million immigrants without legal status are enrolled in \u003ca href=\"https://calmatters.org/tag/medi-cal/\">Medi-Cal\u003c/a>, according to state data. The program is a lifeline to people who traditionally have not had access to health insurance, and California is one of six states that \u003ca href=\"https://www.kff.org/racial-equity-and-health-policy/press-release/more-states-are-providing-fully-state-funded-health-coverage-to-some-individuals-regardless-of-immigration-status/\">offer coverage to immigrant adults \u003c/a>regardless of whether they are in the country legally.\u003c/p>\n\u003cp>Senate Minority Leader Brian Jones said Newsom has overpromised and under-delivered on health care at a time when all Californians are struggling to afford the cost of living in the state.\u003c/p>\n\u003cp>“Democrats and the governor are picking priorities, and they’re prioritizing people that have come into our country illegally over people who immigrated here legally, people that are citizens,” Jones said.\u003c/p>\n\u003cp>The state’s Medi-Cal expansion for undocumented immigrants costs about $8.5 billion from the state general fund annually, according to \u003ca href=\"https://calmatters.digitaldemocracy.org/hearings/258448\">a recent budget hearing\u003c/a>.\u003c/p>\n\u003cp>“If we weren’t spending eight-and-a-half billion dollars on illegal immigrants, we wouldn’t need to borrow $3.4 billion to cover the difference,” Jones said.\u003c/p>\n\u003cp>H.D. Palmer, a spokesperson for the state’s finance department, acknowledged that the rise in spending is partially attributable to higher-than-projected costs associated with larger enrollment numbers for California’s undocumented population. In January,\u003cstrong> \u003c/strong>the \u003ca href=\"https://www.dhcs.ca.gov/Documents/Budget-Highlights/DHCS-FY-2025-26-Governors-Budget-Highlights.pdf\">Department of Health Care Services (PDF)\u003c/a>, which oversees Medi-Cal, estimated California is spending $2.7 billion beyond what it budgeted due to the cost of covering care and prescriptions for newly enrolled immigrants.\u003c/p>\n\u003cp>But immigrants aren’t the only population that is using Medi-Cal more than the state expected.\u003c/p>\n\u003cp>California’s Medi-Cal population in general ballooned during the COVID-19 pandemic when the federal government temporarily suspended income eligibility checks to keep people insured during the national emergency. Before the pandemic about 13 million people used Medi-Cal. That number peaked at 15.6 million in 2023 when \u003ca href=\"https://www.chcf.org/collection/medi-cal-end-public-health-emergency/#:~:text=The%20requirement%20ended%20on%20March,Californians%20may%20leave%20the%20program.\">eligibility checks resumed\u003c/a>. Today 14.9 million people are enrolled, according to \u003ca href=\"https://lao.ca.gov/Publications/Report/5010\">state data\u003c/a>.[aside postID=news_12022068 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2024/11/GettyImages-536950177-1020x680.jpg']The Legislative Analyst’s Office has also noted \u003ca href=\"https://lao.ca.gov/reports/2025/5010/Understanding-Recent-Increases-Medi-Cal-Senior-Caseload-030525.pdf\">a 40% growth over the last four years (PDF)\u003c/a> in the number of seniors enrolled in Medi-Cal. While seniors make up only about 10% of the program’s enrollees, they account for a large part of the program’s spending because benefits such as long-term care are among the most expensive.\u003c/p>\n\u003cp>Medi-Cal spends about $15,000 a year per senior. That compares to the $8,000 a year the program spends on average on other enrollees.\u003c/p>\n\u003cp>Newsom’s office said these issues are neither new nor unique to California. Medi-Cal is California’s version of Medicaid, the federal-state program that provides health coverage nationwide to low-income households.\u003c/p>\n\u003cp>“Rising Medicaid costs are a national challenge, affecting both red and blue states alike,” Elana Ross, a spokesperson for the governor’s office, said in an email.\u003c/p>\n\u003ch2>Democrats pledge to protect immigrant health care\u003c/h2>\n\u003cp>Sen. Roger Niello, a long-time critic of the state’s closed-door budgeting process, which is typically hashed out between Democratic leaders and the governor, acknowledged that other factors like senior enrollment and high drug costs could be contributing to the high expenses. He said Republicans are worried about increasing spending on immigrant health care.\u003c/p>\n\u003cp>The Republican from Roseville criticized the lack of transparency from Newsom’s finance department.\u003c/p>\n\u003cp>“The completely opaque nature of the request, which says nothing about any of that, is entirely inappropriate,” Niello said.\u003c/p>\n\u003cfigure id=\"attachment_12031546\" class=\"wp-caption aligncenter\" style=\"max-width: 1568px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12031546\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/031327_Niello-MediCal_FG_CM_05-copy.jpg\" alt=\"\" width=\"1568\" height=\"1045\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/031327_Niello-MediCal_FG_CM_05-copy.jpg 1568w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/031327_Niello-MediCal_FG_CM_05-copy-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/031327_Niello-MediCal_FG_CM_05-copy-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/031327_Niello-MediCal_FG_CM_05-copy-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/031327_Niello-MediCal_FG_CM_05-copy-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1568px) 100vw, 1568px\">\u003cfigcaption class=\"wp-caption-text\">State Sen. Roger Niello holds a news conference in the rotunda of the state Capitol in Sacramento on March 13, 2025. Niello requested more transparency from Gov. Newsom as to why the state needs $3.5 billion to keep Medi-Cal solvent. \u003ccite>(Fred Greaves for CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Democratic lawmakers said they need more information about what exactly is behind the unexpected spending increases, but pushed back on the idea that the state would need to roll back coverage for its undocumented population.\u003c/p>\n\u003cp>“Immigrant workers and families, who pay billions in taxes, deserve access to care, and I am proud to protect California’s progress expanding Medi-Cal,” Assembly Speaker Robert Rivas said in a statement. “There are tough choices ahead, and Assembly Democrats will closely examine any proposal from the governor. But let’s be clear: We will not roll over and leave our immigrants behind.”[aside postID=news_12029294 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/072820-Doctor-Pediatrician-Kid-GETTY-CM-01-copy-1020x680.jpg']Immigrants lacking permanent status contribute approximately \u003ca href=\"https://calbudgetcenter.org/news/new-study-undocumented-immigrants-contribute-8-5-billion-in-california-taxes-a-year/\">$8.5 billion in state and local taxes a year\u003c/a>, according to an analysis by the California Budget and Policy Center, a nonprofit research group. That’s about the same amount it’s costing the state to give them Medi-Cal.\u003c/p>\n\u003cp>State lawmakers first allowed undocumented children to enroll in Medi-Cal in 2016 under Gov. Jerry Brown. Since then Newsom has approved adding young adults up to age 25 in 2020 and older adults and seniors in 2022. Adults ages 26–49 were the final group added in 2024. Throughout those years, even \u003ca href=\"https://calmatters.org/health/2024/01/undocumented-health-care-politics/\">some Republican lawmakers supported covering this population.\u003c/a>\u003c/p>\n\u003cp>“The Republicans need to take a better and keen-eyed look at the timeline associated with those expansions,” said Assemblymember Mia Bonta, an Oakland Democrat who leads the Health Committee. “For them to just try to play the blame game and put it all at the feet of California values to ensure that we have universal health coverage for all with this particular age group being included is just specious.”\u003c/p>\n\u003ch2>Billions more in potential Medicaid cuts\u003c/h2>\n\u003cp>Assemblymember Dawn Addis, who chairs a budget subcommittee on health, said she will be questioning Newsom officials closely about the spending increase in an upcoming hearing.\u003c/p>\n\u003cp>“We really need to understand the details of what the Department of Finance is saying, what the executive is seeing, and how they’re calculating this information,” Addis, a Democrat from San Luis Obispo, said.\u003c/p>\n\u003cp>Addis emphasized that the biggest threat to Medi-Cal right now is coming from the federal government.\u003c/p>\n\u003cp>House Republicans recently voted to advance a proposal that could result in cuts of \u003ca href=\"https://calmatters.org/health/2025/02/medicaid-medi-cal-trump-cuts/\">$880 billion to a group of programs\u003c/a>, largely Medicaid, over the next 10 years. The California Budget and Policy Center has estimated that the proposals currently at play in Congress could translate into annual losses of $10 billion to $20 billion a year for the state.\u003c/p>\n\u003cp>“The reason why it’s so important for us to fight back against cuts at the federal level to Medicaid is because there is no easy or painless solution to fill that budget hole,” said Amanda McAllister-Wallner, interim executive director of Health Access California.\u003c/p>\n\u003cp>Health Access California along with the California Immigrant Policy Center spearheaded the campaign nearly a decade ago to insure all immigrants in the state.\u003c/p>\n\u003cp>McAllister-Wallner said it was unfair and unreasonable to pin the state budget shortfall on the immigrant expansions. Over the same time period, the state has added benefits, such as \u003ca href=\"https://www.chcf.org/wp-content/uploads/2023/08/MediCalExplainedNewServicesGlance20202023.pdf\">doula services and family therapy (PDF)\u003c/a>, and invested heavily in reforming the system through a multibillion-dollar initiative called CalAIM.\u003c/p>\n\u003cp>“Those changes that we’ve made in Medi-Cal made the program stronger (and) have made the state healthier,” McAllister-Wallner said.\u003c/p>\n\u003cp>\u003cem>CalMatters reporter Alexei Koseff contributed to this story.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The California health care program that covers almost 15 million people is costing more money than Gov. Gavin Newsom projected, creating a \u003ca href=\"https://calmatters.org/tag/california-budget/\">new budget problem\u003c/a> in a lean year.\u003c/p>\n\u003cp>Now his administration is borrowing $3.4 billion from the state’s general fund to cover the unexpected cost increase. It’s unclear when the administration plans to restore the money.\u003c/p>\n\u003cp>The administration acknowledged that more people are enrolled in the program than the state anticipated, and that the state is spending $2.7 billion more than it planned on coverage expansions for immigrants without legal status.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Roughly 1.6 million immigrants without legal status are enrolled in \u003ca href=\"https://calmatters.org/tag/medi-cal/\">Medi-Cal\u003c/a>, according to state data. The program is a lifeline to people who traditionally have not had access to health insurance, and California is one of six states that \u003ca href=\"https://www.kff.org/racial-equity-and-health-policy/press-release/more-states-are-providing-fully-state-funded-health-coverage-to-some-individuals-regardless-of-immigration-status/\">offer coverage to immigrant adults \u003c/a>regardless of whether they are in the country legally.\u003c/p>\n\u003cp>Senate Minority Leader Brian Jones said Newsom has overpromised and under-delivered on health care at a time when all Californians are struggling to afford the cost of living in the state.\u003c/p>\n\u003cp>“Democrats and the governor are picking priorities, and they’re prioritizing people that have come into our country illegally over people who immigrated here legally, people that are citizens,” Jones said.\u003c/p>\n\u003cp>The state’s Medi-Cal expansion for undocumented immigrants costs about $8.5 billion from the state general fund annually, according to \u003ca href=\"https://calmatters.digitaldemocracy.org/hearings/258448\">a recent budget hearing\u003c/a>.\u003c/p>\n\u003cp>“If we weren’t spending eight-and-a-half billion dollars on illegal immigrants, we wouldn’t need to borrow $3.4 billion to cover the difference,” Jones said.\u003c/p>\n\u003cp>H.D. Palmer, a spokesperson for the state’s finance department, acknowledged that the rise in spending is partially attributable to higher-than-projected costs associated with larger enrollment numbers for California’s undocumented population. In January,\u003cstrong> \u003c/strong>the \u003ca href=\"https://www.dhcs.ca.gov/Documents/Budget-Highlights/DHCS-FY-2025-26-Governors-Budget-Highlights.pdf\">Department of Health Care Services (PDF)\u003c/a>, which oversees Medi-Cal, estimated California is spending $2.7 billion beyond what it budgeted due to the cost of covering care and prescriptions for newly enrolled immigrants.\u003c/p>\n\u003cp>But immigrants aren’t the only population that is using Medi-Cal more than the state expected.\u003c/p>\n\u003cp>California’s Medi-Cal population in general ballooned during the COVID-19 pandemic when the federal government temporarily suspended income eligibility checks to keep people insured during the national emergency. Before the pandemic about 13 million people used Medi-Cal. That number peaked at 15.6 million in 2023 when \u003ca href=\"https://www.chcf.org/collection/medi-cal-end-public-health-emergency/#:~:text=The%20requirement%20ended%20on%20March,Californians%20may%20leave%20the%20program.\">eligibility checks resumed\u003c/a>. Today 14.9 million people are enrolled, according to \u003ca href=\"https://lao.ca.gov/Publications/Report/5010\">state data\u003c/a>.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The Legislative Analyst’s Office has also noted \u003ca href=\"https://lao.ca.gov/reports/2025/5010/Understanding-Recent-Increases-Medi-Cal-Senior-Caseload-030525.pdf\">a 40% growth over the last four years (PDF)\u003c/a> in the number of seniors enrolled in Medi-Cal. While seniors make up only about 10% of the program’s enrollees, they account for a large part of the program’s spending because benefits such as long-term care are among the most expensive.\u003c/p>\n\u003cp>Medi-Cal spends about $15,000 a year per senior. That compares to the $8,000 a year the program spends on average on other enrollees.\u003c/p>\n\u003cp>Newsom’s office said these issues are neither new nor unique to California. Medi-Cal is California’s version of Medicaid, the federal-state program that provides health coverage nationwide to low-income households.\u003c/p>\n\u003cp>“Rising Medicaid costs are a national challenge, affecting both red and blue states alike,” Elana Ross, a spokesperson for the governor’s office, said in an email.\u003c/p>\n\u003ch2>Democrats pledge to protect immigrant health care\u003c/h2>\n\u003cp>Sen. Roger Niello, a long-time critic of the state’s closed-door budgeting process, which is typically hashed out between Democratic leaders and the governor, acknowledged that other factors like senior enrollment and high drug costs could be contributing to the high expenses. He said Republicans are worried about increasing spending on immigrant health care.\u003c/p>\n\u003cp>The Republican from Roseville criticized the lack of transparency from Newsom’s finance department.\u003c/p>\n\u003cp>“The completely opaque nature of the request, which says nothing about any of that, is entirely inappropriate,” Niello said.\u003c/p>\n\u003cfigure id=\"attachment_12031546\" class=\"wp-caption aligncenter\" style=\"max-width: 1568px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12031546\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/031327_Niello-MediCal_FG_CM_05-copy.jpg\" alt=\"\" width=\"1568\" height=\"1045\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/031327_Niello-MediCal_FG_CM_05-copy.jpg 1568w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/031327_Niello-MediCal_FG_CM_05-copy-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/031327_Niello-MediCal_FG_CM_05-copy-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/031327_Niello-MediCal_FG_CM_05-copy-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/031327_Niello-MediCal_FG_CM_05-copy-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1568px) 100vw, 1568px\">\u003cfigcaption class=\"wp-caption-text\">State Sen. Roger Niello holds a news conference in the rotunda of the state Capitol in Sacramento on March 13, 2025. Niello requested more transparency from Gov. Newsom as to why the state needs $3.5 billion to keep Medi-Cal solvent. \u003ccite>(Fred Greaves for CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Democratic lawmakers said they need more information about what exactly is behind the unexpected spending increases, but pushed back on the idea that the state would need to roll back coverage for its undocumented population.\u003c/p>\n\u003cp>“Immigrant workers and families, who pay billions in taxes, deserve access to care, and I am proud to protect California’s progress expanding Medi-Cal,” Assembly Speaker Robert Rivas said in a statement. “There are tough choices ahead, and Assembly Democrats will closely examine any proposal from the governor. But let’s be clear: We will not roll over and leave our immigrants behind.”\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Immigrants lacking permanent status contribute approximately \u003ca href=\"https://calbudgetcenter.org/news/new-study-undocumented-immigrants-contribute-8-5-billion-in-california-taxes-a-year/\">$8.5 billion in state and local taxes a year\u003c/a>, according to an analysis by the California Budget and Policy Center, a nonprofit research group. That’s about the same amount it’s costing the state to give them Medi-Cal.\u003c/p>\n\u003cp>State lawmakers first allowed undocumented children to enroll in Medi-Cal in 2016 under Gov. Jerry Brown. Since then Newsom has approved adding young adults up to age 25 in 2020 and older adults and seniors in 2022. Adults ages 26–49 were the final group added in 2024. Throughout those years, even \u003ca href=\"https://calmatters.org/health/2024/01/undocumented-health-care-politics/\">some Republican lawmakers supported covering this population.\u003c/a>\u003c/p>\n\u003cp>“The Republicans need to take a better and keen-eyed look at the timeline associated with those expansions,” said Assemblymember Mia Bonta, an Oakland Democrat who leads the Health Committee. “For them to just try to play the blame game and put it all at the feet of California values to ensure that we have universal health coverage for all with this particular age group being included is just specious.”\u003c/p>\n\u003ch2>Billions more in potential Medicaid cuts\u003c/h2>\n\u003cp>Assemblymember Dawn Addis, who chairs a budget subcommittee on health, said she will be questioning Newsom officials closely about the spending increase in an upcoming hearing.\u003c/p>\n\u003cp>“We really need to understand the details of what the Department of Finance is saying, what the executive is seeing, and how they’re calculating this information,” Addis, a Democrat from San Luis Obispo, said.\u003c/p>\n\u003cp>Addis emphasized that the biggest threat to Medi-Cal right now is coming from the federal government.\u003c/p>\n\u003cp>House Republicans recently voted to advance a proposal that could result in cuts of \u003ca href=\"https://calmatters.org/health/2025/02/medicaid-medi-cal-trump-cuts/\">$880 billion to a group of programs\u003c/a>, largely Medicaid, over the next 10 years. The California Budget and Policy Center has estimated that the proposals currently at play in Congress could translate into annual losses of $10 billion to $20 billion a year for the state.\u003c/p>\n\u003cp>“The reason why it’s so important for us to fight back against cuts at the federal level to Medicaid is because there is no easy or painless solution to fill that budget hole,” said Amanda McAllister-Wallner, interim executive director of Health Access California.\u003c/p>\n\u003cp>Health Access California along with the California Immigrant Policy Center spearheaded the campaign nearly a decade ago to insure all immigrants in the state.\u003c/p>\n\u003cp>McAllister-Wallner said it was unfair and unreasonable to pin the state budget shortfall on the immigrant expansions. Over the same time period, the state has added benefits, such as \u003ca href=\"https://www.chcf.org/wp-content/uploads/2023/08/MediCalExplainedNewServicesGlance20202023.pdf\">doula services and family therapy (PDF)\u003c/a>, and invested heavily in reforming the system through a multibillion-dollar initiative called CalAIM.\u003c/p>\n\u003cp>“Those changes that we’ve made in Medi-Cal made the program stronger (and) have made the state healthier,” McAllister-Wallner said.\u003c/p>\n\u003cp>\u003cem>CalMatters reporter Alexei Koseff contributed to this story.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
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"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
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"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
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"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
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"politicalbreakdown": {
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"title": "Political Breakdown",
"tagline": "Politics from a personal perspective",
"info": "Political Breakdown is a new series that explores the political intersection of California and the nation. Each week hosts Scott Shafer and Marisa Lagos are joined with a new special guest to unpack politics -- with personality — and offer an insider’s glimpse at how politics happens.",
"airtime": "THU 6:30pm-7pm",
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"possible": {
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"title": "Possible",
"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
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"pri-the-world": {
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"info": "Each weekday, host Marco Werman and his team of producers bring you the world's most interesting stories in an hour of radio that reminds us just how small our planet really is.",
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"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-World-Podcast-Tile-360x360-1.jpg",
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},
"radiolab": {
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"info": "A two-time Peabody Award-winner, Radiolab is an investigation told through sounds and stories, and centered around one big idea. In the Radiolab world, information sounds like music and science and culture collide. Hosted by Jad Abumrad and Robert Krulwich, the show is designed for listeners who demand skepticism, but appreciate wonder. WNYC Studios is the producer of other leading podcasts including Freakonomics Radio, Death, Sex & Money, On the Media and many more.",
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},
"reveal": {
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"title": "Reveal",
"info": "Created by The Center for Investigative Reporting and PRX, Reveal is public radios first one-hour weekly radio show and podcast dedicated to investigative reporting. Credible, fact based and without a partisan agenda, Reveal combines the power and artistry of driveway moment storytelling with data-rich reporting on critically important issues. The result is stories that inform and inspire, arming our listeners with information to right injustices, hold the powerful accountable and improve lives.Reveal is hosted by Al Letson and showcases the award-winning work of CIR and newsrooms large and small across the nation. In a radio and podcast market crowded with choices, Reveal focuses on important and often surprising stories that illuminate the world for our listeners.",
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"officialWebsiteLink": "https://www.revealnews.org/episodes/",
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},
"rightnowish": {
"id": "rightnowish",
"title": "Rightnowish",
"tagline": "Art is where you find it",
"info": "Rightnowish digs into life in the Bay Area right now… ish. Journalist Pendarvis Harshaw takes us to galleries painted on the sides of liquor stores in West Oakland. We'll dance in warehouses in the Bayview, make smoothies with kids in South Berkeley, and listen to classical music in a 1984 Cutlass Supreme in Richmond. Every week, Pen talks to movers and shakers about how the Bay Area shapes what they create, and how they shape the place we call home.",
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"order": 16
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},
"science-friday": {
"id": "science-friday",
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"info": "Science Friday is a weekly science talk show, broadcast live over public radio stations nationwide. Each week, the show focuses on science topics that are in the news and tries to bring an educated, balanced discussion to bear on the scientific issues at hand. Panels of expert guests join host Ira Flatow, a veteran science journalist, to discuss science and to take questions from listeners during the call-in portion of the program.",
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