Food and Health Access: Policy Impacts
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Medi-Cal (Medicaid)
Medi-Cal provides free or low-cost health coverage to Californians with low income. Between 2026 and 2027, federal and state policy changes will introduce new requirements for adults, older adults, and certain immigrant groups.
Adults (Aged 19–64) — New Federal Community Engagement Rules
Effective January 1, 2027, new federal law (H.R. 1) requires adults who receive Medi-Cal through the “Expansion” group (based on income) to meet a “Community Engagement” requirement to keep their health insurance.
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Who is NOT required to meet work rules?
The following groups are automatically excused from the 2027 Medi-Cal work requirements:
- Children & Young Adults: Ages 0-18 and Foster Youth up to age 26.
- Pregnant Individuals: Covers pregnancy and up to one year postpartum.
- Seniors: Adults age 65 and older.
- Medically Frail: Those with chronic physical/mental health conditions or substance use disorders that limit work ability.
80 Hour Requirement
Impacted adults must complete 80 hours per month of qualifying activities. This requirement can be met through any one or combination of the following:
- Paid work or self-employment.
- Earning at least $580 per month automatically satisfies the requirement.
- Enrolling in school or job training at least half-time.
- Volunteering at an approved site.
Six-Month Renewals
Starting in 2027, this group must renew their Medi-Cal every 6 months instead of once a year.
Reduced Retroactive Coverage
Medi-Cal will only pay for 1 month of past medical bills (previously 3 months) for new applicants in this group.
Older Adults & People With Disabilities
Effective January 1, 2026, California reinstated “Asset Limits” for those whose Medi-Cal is based on age or disability.
Who May Be Affected:
- Individuals Age 65+ who meet Medi-Cal household income limits.
- Individuals with physical, mental, or developmental disabilities.
- Nursing Care Residents.
- Those in a family whose income exceeds federal tax requirements.
Asset Limit Test
Bank accounts, cash, more than one house or vehicle count. Assets that don’t count include: the home you live in, one vehicle, household items, and some savings, like retirement accounts.
You can own up to $130,000 in countable assets for one person (and $65,000 for each additional household member, max 10 people).
If you already have Medi-Cal, this check will happen during your first renewal in 2026.
Adult Immigrant Coverage Changes
Federal and state policy shifts have introduced new restrictions and costs for non-citizens ages 19 and older.
| Effective Date | Policy Change | Who is Impacted? |
|---|---|---|
| Jan 1, 2026 | Enrollment Freeze: Undocumented adults (19+) cannot newly enroll in full-scope Medi-Cal. | Unenrolled undocumented adults (19–64) |
| July 1, 2026 | Loss of Dental: Non-emergency dental services will end for specific groups. | Adults without “Satisfactory Immigration Status” |
| Oct 1, 2026 | Status Re-classification: Federal law narrows “qualified” status definitions. | Asylees, Refugees, and Parolees |
| July 1, 2027 | Monthly Premiums: A $30 monthly fee will be required to maintain full-scope coverage. | Impacted immigrants (ages 19–59) |
How to Prepare for Medi-Cal Changes
6-Month Renewal Requirement
Starting in 2027, many adults will need to renew their Medi-Cal twice a year. Missing a renewal letter is the #1 reason people lose coverage.
Update your contact info at BenefitsCal.com today.
Check Your Mail:
Be sure to read any notifications you receive from the County. With 6-month renewals, missing one letter could end your health and food benefits.
Report Changes Quickly:
If you become pregnant, get a new job, or experience a health change, tell the County immediately because this may exempt you from work requirements.
Apply Early:
Because “Retroactive Coverage” is being cut from 3 months to 1, waiting to apply after an injury could leave you with thousands in unpaid bills.
Information Resources
California Department of Healthcare Services Medi-Cal Changes Overview
CalFresh (SNAP)
Known federally as the Supplemental Nutrition Assistance Program (SNAP), CalFresh provides monthly food benefits via an Electronic Benefits Transfer (EBT) card to help households purchase groceries and fresh food. Eligibility rules and requirements are changing for some individuals. Changes are categorized below based on who is impacted.
Immigrant Eligibility Changes April 1
Starting April 1, 2026, federal law is changing who qualifies for CalFresh. Many lawfully present immigrants who are currently eligible will lose access to benefits.
✔ Who Stays Eligible?
- U.S. Citizens & Non-citizen Nationals
- Green Card Holders (LPRs)
- Cuban or Haitian Entrants
- COFA Residents (Palau, Micronesia, Marshall Islands)
⚠ Who is At Risk?
- Refugees and Asylees
- Humanitarian Parolees (Afghan/Ukrainian)
- Survivors (T-Visa/Domestic Violence)
- Withholding of Removal status
- Conditional Entrants
When do these changes happen?
- New Applicants: If you apply on or after April 1, 2026, the new rules apply immediately.
- Current Recipients: You will keep your benefits until your next scheduled Recertification (Renewal) on or after April 1, 2026.
Able Bodied Adults Without Dependents (ABAWD) Reinstated & Expanded Requirements
Effective June 1, 2026, federal “community engagement” (work) rules will return to California. These rules apply to individuals categorized as ABAWDs (Able-Bodied Adults Without Dependents). If you are an ABAWD, you are limited to only 3 months of benefits in a 3-year period unless you meet the work requirement or qualify for an exemption.
Who is considered an ABAWD?
You are generally considered an ABAWD if you meet ALL of the following:
- You are between the ages of 18 and 64.
- You do not have a disability that prevents you from working.
- You do not have a dependent child under age 14 living in your home.
How to Keep Your Benefits Past 3 Months
If the 3-month time limit applies to you, you must do one of the following to stay eligible:
- ✅ Work 20+ hours a week (paid or self-employment).
- ✅ Participate in Job Training for 20 hours a week.
- ✅ Volunteer 20+ hours a week
- ✅ Report an Exemption if your situation has changed (e.g., health issue, pregnancy, or homelessness).
You may be excused from the ABAWD work requirement if you are:
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- Under age 18 or over age 64
- A parent or responsible for a dependent child under the age of 14
- You are excused from the general CalFresh work requirements
- Unable to work at least 20 hours per week or a total of 80 hours or more per month because of a physical or mental health issue.
- Unable to work because you are struggling with drug or alcohol addiction or a victim of domestic violence or experiencing chronic homelessness. The condition must be tied to a physical or mental health issue.
- Pregnant (any stage of pregnancy).
- Identify as an Indian, Urban Indian or California Indian under the Indian Health Care Improvement Act (IHCIA).
- Participating in an Office of Refugee Resettlement (ORR) training program for at least half-time.
- Living in an area where the ABAWD work requirement is waived.
⚠️ New Groups Now Subject to Work Rules
Starting June 1, 2026, the following people must now meet work requirements unless they have a health issue:
- Adults aged 55 to 64.
- Veterans and Former Foster Youth.
- Individuals experiencing homelessness.
- Parents whose youngest child in the home is 14 or older.
How to Prepare for CalFresh Changes
Complete your renewals on time:
If you miss a deadline, you will have to re-apply under the new, stricter April 1 rules.
Keep your contact info current:
Ensure San Diego County HHSA has your correct address and phone number so you don’t miss “Notice of Action” letters.
Make a Plan for New Requirements:
Start looking for volunteer, training sites, or education opportunities now if you are not currently working 20 hours a week.
Prepare for “Pro-rated” Benefits:
If an adult in the home becomes ineligible, the household’s total monthly amount will likely drop, but the eligible members (like children) can still receive their portion.
Find Other Food Assistance:
If you are part of an affected immigrant group, you may still be eligible for state-funded programs like the California Food Assistance Program (CFAP).
Report Changes Quickly:
If you become pregnant, get a new job, or experience a health change, tell the County immediately.
Renew:
Submit your reports as soon as they arrive to avoid a gap in food assistance.
Get Proof for a Health Exemption
If you have a physical or mental health condition that prevents you from working, your doctor or a licensed social worker can sign Form CF 887.
Information Resources
California Department of Social Services (CDSS) Federal Changes FAQs
CDSS CalFresh Work and Community Engagement Requirements Overview
USDA Food and Nutrition Service (FNS) Eligibility FAQs
San Diego County Health & Human Services Agency (HHSA) Federal Changes FAQs
Legal Aid Society of San Diego (LASSD) Public Assistance Help
⚠️ Important Cross-Program Note
While work hours and requirements are often aligned, Medi-Cal and CalFresh have different exemption rules. Being excused from one program does not automatically mean you are excused from the other. Always verify your specific status for both programs to ensure you do not lose coverage.