New federal work requirements are expected to begin for CalFresh in October 2026, and for Medi-Cal in January 2027.  If you use either of these programs, these changes could affect you.

Read below to learn where these changes come from, what they could mean for you, and what is being done to protect you.

What is H.R. 1?

House Resolution 1 (H.R. 1) is also known as the One Big Beautiful Bill.  H.R. 1 requires states to tie Medicaid eligibility for adults ages 19–64 in the Affordable Care Act (ACA) Expansion Population to “work requirements”.  This is expected to begin January 1, 2027.  People who are impacted will now have their Medi-Cal eligibility determined every 6 months instead of annually.

HR 1 requires people to complete very specific qualifying activities to qualify for CalFresh and/or Medi-Cal, unless they are exempt from work requirements.  Around 15,500 people receiving regional center services are part of the Medi-Cal ACA Expansion population that will have to meet these requirements.

H.R. 1 allows for exemptions to work requirements if an individual meets certain conditions.  A person could qualify for exemption if they are medically frail and cannot complete one or more activities of daily living.  This can include people with physical, intellectual, and/or developmental disabilities.  A last-minute change in federal rules also requires these individuals to prove they cannot work.  Many states, including California, are suing the federal government about this.

What are we doing to help?

The Departments of Developmental Services (Department), Health Care Services (DHCS), and Social Services (CDSS) are working with counties to use available data to exempt individuals receiving regional center services from work requirements in these programs.  This data will help identify people who should remain eligible for them.  The first data was provided to counties last week, and it is being tested to make sure counties can correctly identify individuals who should be automatically exempted from work requirements without having to provide additional documentation.

Next Steps:

The three Departments are collaborating on information for the community explaining what to expect, when, and what people need to know to keep CalFresh and Medi-Cal.  Communication plans will include guidance for regional centers to support individuals through the Medi-Cal and CalFresh county renewal processes.

What Else is California Doing?

California Attorney General Rob Bonta is co-leading a coalition of 24 attorneys general and two governors.  The coalition filed a lawsuit against the federal government regarding the Medicaid work requirements.  In the lawsuit, the coalition challenges the interim final rule published by the U.S. Department of Health and Human Services and Centers for Medicare & Medicaid Services (CMS) for:

  • Unlawfully shrinking Congress’s protections for medically frail Medicaid recipients.
  • Ignoring substantial evidence that work reporting requirements cause eligible individuals to lose healthcare coverage.  People are less likely to work because of barriers like overwhelming paperwork and other administrative requirements, rather than just not wanting to work.
  • Failing to consider the significant harms that states, people who receive Medicaid, healthcare providers, and state healthcare systems will experience.
  • Creating new, unconstitutional requirements after states had already begun work to comply with the One Big Beautiful Bill Act, which was based on the statute’s plain language and CMS’s prior guidance.

Where can I get more information?

 


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