In January 2025, California Governor Gavin Newsom proposed changes to the state’s Medi-Cal program, California’s Medicaid system, that would affect undocumented adults currently eligible for coverage.
Under the proposal, beginning January 1, 2026:
The stated goal of the proposal is to address budget shortfalls while preserving Medi-Cal’s long-term sustainability.
Medi-Cal is California’s Medicaid program. It provides free or low-cost health coverage to low-income individuals and families, including:
It’s jointly funded by the federal government and the state of California, but it’s administered by the California Department of Health Care Services (DHCS).
In short: Medi-Cal = California’s version of Medicaid, tailored to provide healthcare access to millions of residents who otherwise could not afford coverage.
California is one of the few states that expanded Medicaid to include undocumented adults. Currently, over 700,000 undocumented immigrants are estimated to be enrolled in Medi-Cal, according to the California Department of Health Care Services (DHCS).
If the proposal is enacted:
For undocumented adults, the proposed $100 monthly premium may pose a financial barrier. Many work in low-wage industries without access to employer-based insurance. Critics argue this could discourage care-seeking, leading to delayed treatment and higher long-term healthcare costs.
Clinics, hospitals, and community health centers that serve large immigrant populations may face a rise in uncompensated care. Providers must prepare for shifts in reimbursement patterns, patient volume, and increased reliance on charity care programs.
Administrators face the logistical challenge of managing premiums for undocumented adults who remain covered. This includes billing, tracking payments, and processing lapses in coverage if premiums go unpaid.
State leaders emphasize that the proposal aims to balance fiscal responsibility with compassionate coverage. Medi-Cal represents one of the largest expenses in California’s state budget, and policymakers are under pressure to contain costs without dismantling access for children or critical services.
For healthcare providers, these changes could significantly affect the billing cycle and claims process:
Bridge Billing Services works with healthcare providers nationwide, including those serving high-need populations in California. As Medi-Cal evolves, we provide certified billing support to ensure providers remain financially stable while continuing to deliver essential care.
We confirm patient eligibility at every visit, helping providers determine if patients remain enrolled in Medi-Cal, have lapsed coverage, or fall under new premium rules.
Our medical billing specialists streamline claim submission and reduce administrative errors, ensuring that providers maximize reimbursements even in a shifting policy landscape.
If Medi-Cal claims are denied due to premium lapses or eligibility issues, our medical billing team manages appeals and provides documentation support to recover revenue.
We strengthen the revenue cycle by reducing claim denials, improving payment timelines, and offering insights into billing trends, helping providers forecast financial impacts of coverage changes.
Clear patient communication is essential in avoiding disputes. We assist with transparent billing solutions that explain charges, coverage responsibilities, and payment options.
The proposed Medi-Cal changes reflect the complex balance between providing care for vulnerable populations and maintaining California’s fiscal health. While patients may face new financial barriers, providers and billing teams must prepare to handle evolving insurance and claims requirements.
By outsourcing billing tasks to a trusted partner like Bridge Billing Services, healthcare organizations can remain compliant, protect cash flow, and continue to prioritize patient care even during uncertain policy shifts.
Medi-Cal is California’s Medicaid program that provides free or low-cost health coverage to low-income individuals and families. It covers services such as doctor visits, hospital stays, prescription drugs, mental health care, and more.
2. How will the proposed 2026 Medi-Cal changes affect undocumented immigrants?
If the proposal takes effect on January 1, 2026, new undocumented adults will not be able to enroll in Medi-Cal. Those already enrolled may continue coverage but will need to pay a $100 monthly premium. Coverage for children, pregnant women, and critical services will remain unchanged.
3. Will emergency services still be covered for undocumented immigrants?
Yes. Under federal law, undocumented immigrants remain eligible for restricted-scope Medi-Cal, which covers emergency services, pregnancy-related care, and some long-term services, even if they cannot access full-scope benefits.
4. How will these changes affect healthcare providers?
Providers may see more uninsured patients, face billing and claims complications, and need to track Medi-Cal eligibility more carefully. This could increase administrative workload and affect cash flow if claims are denied or patients lose coverage.
5. How can Bridge Billing Services help providers during these changes?
Bridge Billing Services offers certified billing solutions to help healthcare providers adapt. Our team specializes in insurance verification, denial management, claims processing, and revenue cycle optimization. By outsourcing billing, providers can reduce errors, protect revenue, and focus more on patient care—even as Medi-Cal policies evolve.
The 2026 Medi-Cal changes for undocumented immigrants highlight how policy decisions directly impact the billing process, revenue cycle management, and overall provider operations. Preparing now allows providers to reduce financial risk while continuing to serve their communities.
📞 Contact Bridge Billing Services today to learn how our certified billing experts can help your practice navigate Medi-Cal changes, reduce administrative overhead, and ensure efficient billing solutions.