Healthcare legislation doesn’t usually make front-page news, but the newly passed One Big Beautiful Bill Act (HR 1) is important for many people in our community. This federal law brings several changes to Medicaid and Medi-Cal programs that millions of Americans depend on for affordable health care. These changes may affect local patients, families, and the work of health organizations like Barton Health.

This new law will adjust who qualifies for coverage, how often people must update their information, what they may need to pay, and which services are included. It’s important that our community understands these changes.  

This article is not meant to be an all-inclusive list of changes.  It is strongly encouraged that residents contact their local Medi-Cal office or Covered California insurance plan to determine how these changes might impact them.   

Upcoming Changes to Medi-Cal/Medicaid: What You Need to Know

1. Work Requirements for Some Adults

 Adults ages 19–64 without dependent children may soon need to complete 80 hours a month of approved activities (such as working, job training, school, or volunteering) to stay covered.

 Who is exempt? There are various allowed exemptions, including pregnant women, those aged under 19, or over 64, those with certain medical conditions, or those caring for young children, among other exemptions.

People will also need to renew their eligibility every six months instead of once a year. This means more frequent paperwork, and missing a notice could lead to a temporary loss of coverage even if you still qualify.  It is important to make sure that your contact information is up to date.

2. Possible New Co-Pays

States can now charge co-pays, up to $35 per service, for some enrollees, depending on income levels and other factors. Primary care and emergency care will remain at no cost, but other visits or treatments may cost more.

3. Changes to Long-Term Care Rules

In the past, people could get financial help for nursing homes or in-home care without most of the value of their home being counted. Under the new rules, only the first $1 million of a home’s value won’t be counted. Anything above that will be included when deciding if someone qualifies for help. This means people with more expensive homes may get less financial assistance. The $1 million limit will stay the same, even in places where housing is very costly, like California.

4. Changes for Non-Citizens Using Medi-Cal

  • 2026: Adults without eligible immigration status will not be able to join full Medi-Cal for the first time, but those already enrolled can stay covered if they renew on time.
  • July 2026: Some adults will see changes to dental coverage; emergency dental care will still be available.
  • 2027: Undocumented adults ages 19–59 will need to pay a $30 monthly premium to stay enrolled.

Pregnant women will continue receiving full Medi-Cal during pregnancy and for one year after, no matter their immigration status.

Emergency Medi-Cal will remain available to anyone who qualifies by income.

Covered California and Nevada Health Link: An Important Option for Many

Not everyone qualifies for Medi-Cal or Nevada Medicaid, and many families make too much to qualify but still can’t afford regular private insurance. Covered California and Nevada Health Link both help bridge that gap. Covered California is the state of California’s online marketplace, while Nevada Health Link is Nevada’s state-run marketplace where people can compare health plans and often get financial help to lower their monthly costs.

Most households can get tax credits that reduce the price of their monthly premiums. These savings are applied right away, so your monthly bill is lower from the start.

During COVID-19, the federal government temporarily boosted this financial help, making coverage much cheaper—sometimes even as low as $0 a month for eligible families. These extra savings, called “enhanced subsidies,” are expected to decrease in the coming years.

Covered California and Nevada Health Link will still offer regular financial help, but people should be aware that the larger COVID-era discounts may not continue in 2026 and beyond. This may affect what households pay for coverage in the future.

A valuable resource:

• California residents: CoveredCa.com/important-changes/

• Nevada residents: NevadaHealthLink.com

Barton Health’s Commitment

Even though the One Big Beautiful Bill Act brings changes to Medicaid, Medi-Cal, and Covered California, Barton Health’s mission remains the same: to deliver high-quality, patient-centered care, regardless of insurance status, income, or background. Healthcare can feel overwhelming, especially as policies shift, but our focus remains on supporting patients, promoting wellness, and ensuring that everyone has access to the services they need to stay healthy. 

–Kelly Neiger, Chief Financial Officer, Barton Health

Barton Health provides free Covered California enrollment support at 530-600-1984. Medi-Cal assistance through El Dorado County is available at 530-543-5908. For information about Barton’s Financial Aid services, call 530-539-6086.