The cuts coming to Medicaid, known here as Medi-Cal, will make health care more expensive and harder to access for millions of low-income Californians, according to a new report from Georgetown University.
The Congressional Budget Office estimated the cuts of about $1 trillion will cause at least 15 million people across the U.S. to lose coverage over the next 10 years.
Edwin Park, research professor in the McCourt School of Public Policy Center for Children and Families at Georgetown University, said the “One Big Beautiful Bill Act,” passed by Republicans, slashes the amount states are reimbursed and restricts provider taxes, which help fund Medi-Cal.
“This means the states cannot add new taxes or increase current taxes to help close budget shortfalls or finance various Medicaid improvements,” Park pointed out. “States are going to have less funding for their Medicaid program. They’re going to have to make cuts across the board.”
Right now California receives more than $81 billion in Medi-Cal funding per year, which covers 66% of the cost of care. The Trump administration said the changes were necessary to partially pay for an extension of the 2017 tax cuts. The new rules impose stricter work requirements with more paperwork, which is expected to cause many people to drop off the rolls.
Park noted new cost-sharing rules mean the state will have to charge Medi-Cal patients more starting in 2028.
“There’s a huge body of research showing that cost sharing increases, even modest ones, reduce utilization among low-income people,” Park explained. “That’s why this produces savings of about $7.4 billion over 10 years.”
In 2027, states will be required to redetermine people’s eligibility for Medicaid every six months instead of once a year.
Sabrina Corlette, research professor and founder and co-director of the Center on Health Insurance Reforms at Georgetown University, said people will also have to verify their eligibility more often for CoveredCA, the state insurance marketplace.
“It requires all enrollees to return to the marketplace every year to verify the information in their application and reenroll in a health plan, even if nothing has changed,” Corlette noted. “This change is going to require people to really take active steps to maintain their coverage.”
Starting in October 2026, many lawfully present immigrants will lose access to subsidized plans on CoveredCA.
