California

California Medicaid and the new work rules

Medi-Cal (New Adult Group) is run by California Department of Health Care Services (DHCS). California expanded Medicaid on January 1, 2014, which is why the new federal work requirement reaches this state — and why what you do before January 1, 2027 matters.

Work rules start January 1, 2027 Medicaid expanded 13,910,180 enrolled 4,800,000 in the expansion group

Start here

From January 1, 2027, most adults have to show 80 hours a month

The requirement applies to adults aged 19 to 64 covered through Medicaid expansion — around 4,800,000 people in California. It is not only about paid work: study, job training, volunteering and a mix of them all count , and earning at least $580 a month satisfies it on its own.

DHCS says it will try to verify exemptions and compliance automatically from data it already has — employment, disability, and other program records — before asking a member to send paperwork. Members who are subject to the rule must report at least 80 hours a month of work, job training, school, or volunteering, or at least $580 in monthly earnings (averaged over six months for seasonal work), or a mix that adds up to the same total. A letter from Medi-Cal or the county is the trigger — DHCS tells members to open and respond to it right away, since not responding can end coverage even for someone who actually qualifies for an exemption.

If your hours swing from month to month, say so. The rule is written per month, which is the wrong shape for farm and fishing work, construction, tourism and seasonal retail — a good month and a dead month average out to a living, but the dead month is the one that fails. Federal law has a provision for exactly this: a seasonal worker can satisfy the requirement using their average monthly income over the previous six months instead of hours worked in the month being checked. It is at 42 CFR 435.552(a)(7), and the law defines who counts as seasonal by pointing at the tax code rather than listing jobs, so do not decide for yourself that it misses you. If your work is seasonal or your hours are irregular, tell the state that when you report, and ask for the six-month average to be used.

1,100,000 people

That is the state's own estimate of how many will lose coverage.

DHCS's own estimate, presented in a CalHHS Connect webinar (July 2026) and summarized by the California Health Care Foundation (June 2026), is that disenrollment from the work requirement starts around 43,000 people in 2026-27 and grows to as many as 1.1 million by 2029-30, out of roughly 4.8 million adults in the New Adult Group (about 2.2 million of whom DHCS expects would qualify for an exemption). An earlier Legislative Analyst's Office / Senate Budget Subcommittee estimate from March 2026 put the number closer to 1.4 million, or about 30 percent of the expansion group. DHCS has said its estimates predate the June 1, 2026 CMS interim final rule and will likely be revised — most observers expect revisions to show more disenrollment and fewer exemptions, not fewer.

Most of that is expected to be paperwork rather than people becoming ineligible. Which is the whole reason to sort out your address and your proof now rather than at the last minute.

December 2025 · already happened

CMS released initial federal guidance on implementing the work and community engagement requirement

April 2026 · already happened

DHCS issued ACWDL/MEDIL 25-30, 'Work and Community Engagement Requirements for the New Adult Group,' detailing exemptions and county procedures

June 1, 2026 · already happened

CMS published an interim final rule with additional implementation detail; public comment period ran through July 31, 2026

July 31, 2026 · already happened

California and co-plaintiff states asked a federal court to rule on a preliminary injunction to delay the January 1, 2027 start date and suspend challenged provisions of the interim final rule

August–September 2026 · already happened

DHCS ran 'Coverage Ambassador' trainings for community partners on six-month renewals, the work requirement, reduced retroactive coverage, and the immigration-status changes

January 1, 2027

Work requirement and six-month renewals for the expansion group take effect (unless a court delays it)

You do not have to prove anything if any of these describe you

Exemptions are meant to be applied by the state automatically from records it already holds, but records are imperfect. If one of these fits you and you still get asked to report hours, say so and ask them to check — don't assume the notice is right.

Children, ages 0 through 18

Adults 65 and older

Pregnant people, during pregnancy and for one year after

Parents or caretaker relatives of a child age 0 through 13

People with disabilities

People with serious physical or mental health conditions, or substance use problems

People released from jail or prison in the last 90 days

People enrolled in Medicare Part A or Part B

American Indians or Alaska Natives

People under age 26 who were in foster care on their 18th birthday

Income limits

What you can earn and still qualify

Monthly income, before tax, for the whole household. These are the state's own published figures, which is what its caseworkers actually apply. If you are close to a line, apply anyway — some income does not count, and only the agency can run the calculation for your situation.

Adults 19 to 64138% of the poverty line

1 person: $1,836
2 people: $2,490
3 people: $3,143
4 people: $3,795
5 people: $4,450
6 people: $5,102

Parents and caretakers138% of the poverty line

1 person: $1,836
2 people: $2,490
3 people: $3,143
4 people: $3,795
5 people: $4,450
6 people: $5,102

Pregnant213% of the poverty line

1 person: $2,833
2 people: $3,843
3 people: $4,851
4 people: $5,858
5 people: $6,868
6 people: $7,875

Source: DHCS All County Welfare Directors Letter (ACWDL) 26-01, 'Medi-Cal Monthly Income Eligibility Thresholds,' dated January 21, 2026, effective January 1, 2026 for MAGI-based programs. A note on precision: DHCS's own public-facing 'Eligibility by Federal Poverty Level' webpage (dhcs. We publish the state figure.

January 1, 2027

Two other changes land on the same day

Renewals get more frequent, and back-dated coverage gets shorter.

Renewals every six months Starting January 1, 2027, New Adult Group members must renew their eligibility every six months instead of once a year, roughly doubling how often expansion enrollees need to confirm their information with the county.

Back-dated coverage is changing on January 1 California has an expansion group, so the split applies in full here: New Adult Group (ACA expansion) enrollees get one month of retroactive coverage once this takes effect, while children, parents, pregnant people, older adults, and people who are aged, blind, or disabled get two months — both down from three. Apply as soon as you think you'll need care rather than waiting for a bill to arrive. If you have unpaid medical bills, applying sooner covers more of them.

P.L. 119-21 §71112, amending 42 U.S.C. §1396a(a)(34). Applies to applications submitted on or after January 1, 2027.

Do this now

Update your address and phone number first. Everything about the new rules arrives by mail, and a stale address is the most common reason people lose coverage they are still entitled to. Then check whether an exemption applies to you.

Apply, renew or update details BenefitsCal.com Free, and open all year The state's own work-rules page Read California's guidance Updated as rules are finalized Talk to a person 1-800-541-5555 Mon–Fri, business hours; automated system outside those hours

About the phone numbers: A separate TTY number, 711 (California Relay Service), also works for any Medi-Cal line and is more commonly advertised to the public than 1-866-784-2595, which appears specifically on DHCS's internal contacts page.

Deaf, hard of hearing or speech-impaired: 1-866-784-2595.

EnglishSpanishArabicArmenianChineseFarsiHmongJapaneseKhmerKoreanLaoMienPunjabiRussianTagalogVietnamese

Medi-Cal materials are required in more languages than almost any other state program because California sets a low bar for what counts as a required 'threshold' language — once a dialect is spoken by roughly 3,000 Medi-Cal members statewide, or concentrated among at least 1,000 members in a single ZIP code (or 1,500 across neighboring ZIP codes), health plans and counties must translate written notices into it and offer a live interpreter. That standard has produced well over a dozen required languages beyond English, including Spanish, Chinese, Vietnamese, Korean, Tagalog, Armenian, Russian, Farsi, Hmong, Arabic, Khmer, Lao, Mien, and Punjabi. If a county notice or health plan handbook does not arrive in your language, you can ask your county eligibility worker or your plan's member services line to resend it in one of these languages or to connect you with a free interpreter — interpreter services are required at every Medi-Cal appointment and every call to the county office, and you should never have to pay for one or bring your own.

If a letter arrives

Most people who lose coverage lose it over paperwork, not eligibility

Nationally, most people who lose Medicaid lose it over paperwork rather than because they stopped qualifying. From January 1, 2027 that matters more, not less.

California Department of Health Care Services (DHCS) · Notice of action

NOTICE OF ELIGIBILITY DETERMINATION

Case number: ███████
Date of this notice: 1January 12, 2027

Our records do not show that you met the community engagement requirement for the reporting period.

2If you believe this is incorrect, or if an exemption applies to you, contact us on or before February 11, 2027.

3Coverage for other members of your household is not affected by this notice.

The clock starts on this date. Not the day it reached you. Assume you have less time than it feels like.

"Our records do not show" is not the same as "you did not".The state is matching against databases that are often out of date. If you worked those hours, or an exemption fits you, say so — call 1-800-541-5555.

Your children's coverage is separate. The work requirement does not apply to them. A notice about you does not end their coverage.

You can ask for a fair hearing. It's free, you don't need a lawyer, and asking can keep your coverage running while it's reviewed.

Know your state

What the federal data says about coverage here

Public federal data describes how each state runs its program. Almost all of it is written for policy analysts. Here is what those numbers mean if you are the person enrolled.

How care is delivered

Managed care

Coverage here runs through private health plans rather than the state paying providers directly. You pick a plan, and your plan decides your network.

Check your doctor is in the plan before you choose it.

Common questions

Questions people ask about this

Do the new Medicaid work rules apply to me in California?

They apply to adults aged 19 to 64 who are covered through Medicaid expansion — about 4,800,000 people in California. Children, people over 65, and most people covered on grounds of disability or pregnancy are not in that group. There is also a long list of exemptions.

How many hours a month do I have to work?

80 hours a month. Work is not the only way to meet it — study, job training, volunteering and a combination of these count too, and earning at least $580 a month also satisfies it.

Who is exempt from the work requirement in California?

Exemptions include: Children, ages 0 through 18; Adults 65 and older; Pregnant people, during pregnancy and for one year after; Parents or caretaker relatives of a child age 0 through 13; People with disabilities; People with serious physical or mental health conditions, or substance use problems; People released from jail or prison in the last 90 days; People enrolled in Medicare Part A or Part B.

When do the California work rules start?

January 1, 2027. Starting January 1, 2027, New Adult Group members must renew their eligibility every six months instead of once a year, roughly doubling how often expansion enrollees need to confirm their information with the county. Keeping your address and phone number current with the state is the single most important thing to do before then, because everything arrives by mail.

What is the income limit for California Medicaid?

For adults 19 to 64, about $1,836 a month for one person and $5,102 for a household of 6.

How do I apply for Medi-Cal (New Adult Group)?

Online at BenefitsCal.com, or by phone on 1-800-541-5555. It is free and there is no open-enrollment window — you can apply at any time of year.

How often do I have to renew California Medicaid?

Adults covered through Medicaid expansion move from a yearly renewal to one every six months starting with renewals due on or after January 1, 2027. Children, people over 65 and most people covered on grounds of disability stay on yearly renewals. Keep your address and phone number current so the renewal notice reaches you, and answer it before the date on the letter — most people who lose coverage lose it over paperwork.

Other states

Guides for neighboring states

The rules change completely at the state line. If you moved recently, or you're helping family somewhere else, start with their state rather than this one.

ArizonaThe new work rules NevadaThe new work rules OregonThe new work rules

See all 50 states and Washington, D.C. on the map →

If you lost full-scope Medi-Cal on October 1, 2026 because of a change in how the state classifies immigration status — for example, you are a refugee or asylee without a green card yet, or you have a pending humanitarian parole, trafficking, or domestic violence case — California is still covering you at state expense through June 30, 2027.

Use this window to resolve any pending immigration paperwork or ask your county eligibility worker whether you now qualify under a different category, because after June 30, 2027 coverage drops to emergency and pregnancy-related care only unless your status changes.

Updating your address takes two minutes and protects everything else. Do that first, then check the exemption list above.

Go to BenefitsCal.com →