Design Highlights
- California’s 2025–26 budget reinstates an asset test for Medi-Cal, impacting seniors and disabled adults starting January 1, 2026.
- Asset thresholds are set at $130,000 for individuals and $195,000 for couples, limiting access for those with modest savings.
- A freeze on full-scope Medi-Cal enrollment for undocumented adults aged 19 and older begins January 1, 2026, preventing new applicants.
- New prior authorization requirements for hospice services are introduced, tightening eligibility checks and imposing cost-sharing measures.
- Advocates warn these changes may significantly restrict access to care for vulnerable populations, despite projected savings for the state.
In a bold move that’s sure to raise eyebrows, California’s 2025–26 budget is tightening the screws on Medi-Cal access for seniors and disabled adults. Yes, you heard that right. The state is angling to save a whopping $4.7 billion through a series of policy changes that many are calling a slap in the face for those who can least afford it. This budget isn’t just a minor tweak; it’s a significant shift in the way Medi-Cal operates for some of California’s most vulnerable populations.
The heart of these changes includes reinstating an asset test for seniors and disabled adults—goodbye, previous no-asset-test approach. Starting January 1, 2026, those applying for Medi-Cal will have to prove they have less than $130,000 in assets for individuals and $195,000 for couples. This is a far cry from the $2,000 and $3,000 limits that were initially proposed—thank goodness for small mercies, right? Still, advocates warn that this will block access for many who have just enough savings to get by. So much for being prepared for emergencies. Additionally, the budget maintains prior investments, including Medi-Cal expansion to all income-eligible adults regardless of immigration status effective January 2024. Furthermore, this budget reflects significant General Fund shortfall adjustments, indicating broader fiscal challenges.
Now, let’s talk about income. To qualify for Medi-Cal, seniors and disabled adults must still meet income rules below 138% of the federal poverty level. But don’t worry, they won’t be kicked off the program if they already qualify. This budget is more about tightening eligibility checks and imposing cost-sharing than actually removing coverage. A bit of a silver lining, perhaps, but still a cloudy day for those in need. Experts increasingly recommend that seniors consider long-term care insurance as a financial safeguard against rising care costs that government programs may no longer fully absorb.
And if you thought that was it, hold onto your hats: the budget is also freezing full-scope Medi-Cal enrollment for undocumented adults aged 19 and older starting January 1, 2026. Existing enrollees can breathe a sigh of relief, but new applicants? Tough luck. Estimated savings from this freeze are projected to hit $77.9 million in the coming year, ballooning to $3.3 billion by 2028–29. Who knew budget cuts could sound so efficient?
Let’s not forget about hospice services either. New prior authorization requirements are coming into play. Because, of course, steering the healthcare system wasn’t complicated enough already.
In short, this budget isn’t just a budget; it’s a game changer for many. A game that seems rigged against those who need it most. The question remains: who will be left standing when the dust settles?
