Federal changes to health care programs in 2026 are expected to impact thousands of Stanislaus County residents, with many likely to face higher insurance premiums and stricter requirements for Medi-Cal coverage.
A report from the state Legislative Analyst’s Office (LAO) indicates that while most low-income Medi-Cal recipients will not see immediate changes to their eligibility or benefits, up to a million Californians could lose coverage due to the federal adjustments. Hospitals, particularly those in rural areas of the San Joaquin Valley, anticipate reduced payments for treating Medi-Cal patients and an increased load of uncompensated care.
“Maintaining the state’s health coverage expansions in the midst of fiscal constraints and the evolving policy landscape will be challenging,” the LAO stated. “More Californians will likely lack coverage, be uninsured or face out-of-pocket costs. This will erode the state’s efforts to expand the share of Californians with health coverage.”
The upcoming federal budget bill will also end enhanced premium tax credits for Covered California enrollees, which is expected to cause significant increases in monthly rates for some participants. Stanislaus County currently has about 28,000 people enrolled in Covered California. Critics of the Affordable Care Act argue that these subsidies benefit insurance companies and advocate for restructuring.
There remains a possibility that Congress could extend these subsidies into next year, but time is running short before January when changes would take effect.
Covered California estimates that 92% of its enrollees will continue receiving some financial assistance in 2026. Nearly half may still find plans costing $10 or less per month, though as many as 400,000 Californians could drop their coverage because of rising costs.
For those who do not have employer-sponsored insurance or qualify for Medicare or Medi-Cal, Covered California remains an option. The deadline for enrollment or plan changes is December 15 for coverage starting January 1.
To help residents navigate these changes, Central Valley Doctors Health System is offering appointments with certified counselors so patients can maintain their insurance and access to care. Jay Krishnaswamy, CEO of Central Valley Doctors Health System—which includes Doctors Medical Center—said: “Our goal is to help community members who need coverage choose a Covered California plan that meets their needs and price range.”
The new legislation also freezes enrollment in full-scope Medi-Cal for undocumented adults aged 19 and older; current enrollees can remain if they renew on time. California had previously expanded eligibility by age group between 2020 and 2024 and continues accepting children and pregnant women regardless of immigration status.
Another change reinstates asset evaluations during Medi-Cal applications or renewals for older adults and disabled individuals. The limit is set at $130,000 per person plus $65,000 per additional household member; primary residences and one vehicle are excluded from calculations.
Additional program modifications include work requirements for Medi-Cal recipients and more frequent eligibility checks—measures anticipated to increase administrative challenges. Starting October 2028, adults who qualified under ACA expansion will face a $35 copayment for certain medical visits unless treated at specific community clinics.
Local nonprofit organizations are urging county officials to coordinate planning efforts in response to potential difficulties arising from these policy shifts—including higher premiums and reduced rental aid. During a November meeting with county supervisors, representatives cited recent disruptions caused by CalFresh benefit suspensions as indicative of future risks facing vulnerable populations.
Andrew Timbie, CEO of Sierra Vista Child & Family Services, highlighted that nearly half of county residents rely on Medi-Cal while about one-fifth are foreign-born: “Our nonprofit sector is being buried,” Timbie said. “We are asking the county to work with our nonprofit groups so we’re not crushed under the weight of what’s coming in 2026.”
Keristofer Seryani, president and CEO of United Way Stanislaus County, reported a surge in calls seeking food assistance following recent emergencies: “Nonprofits will continue to rise to the occasion but cannot and should not be expected to absorb these challenges alone,” Seryani said. “We have the infrastructure, the data and the relationships. We simply need the county at the table with us investing and planning and ensuring that when the next crisis arises we are not responding out of urgency but out of preparation.”
Residents seeking free help with Covered California issues through Central Valley Doctors Health System can call 209-260-0287 for support from certified counselors.
The Sacramento Bee contributed reporting.
