Los Angeles County Supervisor Janice Hahn stood alongside healthcare providers and community organizations in Lynwood this month to launch a coalition with a blunt mission: help more than 1 million county residents navigate at least one of several Medi-Cal changes as sweeping federal eligibility changes take hold starting January 1, 2027. The new campaign, called Keep L.A. Covered, is racing to reach enrollees before new paperwork rules and twice-yearly renewal checks push eligible families off the rolls.
The Lynwood launch, reported by Los Cerritos Community News, brought together a coalition designed to prevent low-income residents from losing coverage as the federal changes roll out through 2028. At the center of the effort is a network of trained “Coverage Champions” — pastors, promotoras, educators, and business owners — who will distribute multilingual renewal materials through clinics, churches, and schools, according to the same report.
Medi-Cal, California's version of Medicaid, covers nearly 4 million L.A. County residents and represents 41% of the county's population, according to LAist. Medicaid broadly provides free or low-cost coverage to low-income people, and losing it does not make healthcare needs disappear — it shifts financial responsibility elsewhere, often onto county emergency rooms and clinics.
What's Changing and Why January Matters
The rules trace back to the One Big Beautiful Bill, formally H.R. 1, which President Trump signed in July 2025. The law reduced federal Medicaid funding and added a requirement that benefit recipients work, attend school, volunteer, or pursue job training, per LAist's reporting. The new requirements and six-month renewal rules apply to adults ages 19 to 64 covered through Medi-Cal's Affordable Care Act expansion, according to county officials cited by LAist.
The six-month renewal rules apply to adults ages 19 to 64 covered through Medi-Cal's Affordable Care Act expansion, according to county officials cited by LAist. Expansion adults will face eligibility redeterminations every six months. Enrollees ages 19 to 64 must demonstrate at least 80 hours monthly of work, volunteering, education, job training, or qualifying income to retain coverage, per LAist. The Centers for Medicare & Medicaid Services issued the rule implementing the work requirement in June 2026, and California and other states sued to challenge the changes that same month — a federal judge denied the states' request to pause the rules in July, according to LAist.
Pregnant women, older adults, people with disabilities, and parents of children 13 and younger are largely exempt from the new requirements, LAist reports. Still, details of the 80-hour requirement remain unsettled, and the federal government is still writing details on qualifying work, volunteering, and education, according to L.A. Care Health Plan CEO Martha Santana-Chin, as relayed by LAist.
The Real Risk Is Missed Mail, Not Lost Eligibility
Campaign leaders say the greater danger isn't that people stop qualifying — it's that renewal notices arrive at old addresses or go unanswered, according to LAist's reporting on campaign organizers. Santana-Chin has emphasized that the coalition's core focus is ensuring low-income families do not lose coverage over a missed notice or administrative confusion rather than actual eligibility changes, per Los Cerritos Community News. California is currently mailing letters about the Medi-Cal changes, according to Santana-Chin.
Medi-Cal enrollees are urged to update their address and phone number with a county Medi-Cal office and to respond promptly to notices arriving in yellow or white envelopes, LAist reports. Community health centers and trained volunteers can help enrollees understand notices in person and in multiple languages. Under the process, Medi-Cal must send a noncompliance notice when it cannot verify compliance, and enrollees then have 30 days to prove compliance or an exemption — after which an application may be denied or an enrollee disenrolled if they fail to do so, according to LAist.
People experiencing homelessness face heightened risk from these paperwork and mailing-address barriers. Most homeless Californians are eligible for or already enrolled in Medi-Cal, according to the California Health Care Foundation, cited by LAist, and the 2026 Los Angeles Homeless Services Authority count estimated more than 73,000 people experiencing homelessness in L.A. County. Homeless enrollees may qualify for medical exemptions from work-related requirements, but such claims require clinical documentation and regular healthcare-system contact — and federal guidance does not allow states to exempt people from work rules solely because they are unhoused.
State Legislators and Local Leaders Push Back
California State Senator Lena Gonzalez and Assemblymember Jose Luis Solache have backed the Keep L.A. Covered initiative and called for action in Sacramento alongside the local outreach campaign, according to Los Cerritos Community News. L.A. Care Health Plan and its partners launched the broader Keep L.A. Covered effort to train pastors, teachers, and health workers on how to guide neighbors through renewal notices, and Maternal Child Health Access will host the first Keep L.A. Covered training on October 27, per LAist. People and organizations can sign up at keeplacovered.org.
The stakes extend well beyond Los Angeles. The Centers for Medicare and Medicaid Services projects the requirement will reduce nationwide Medicaid enrollment by more than 3 million people, with about 15% of enrollees expected to lose coverage — roughly 9% for failing to meet the work requirement itself and about 6% due to paperwork or administrative barriers, according to LAist's reporting on the federal agency's own projections. The actual effect depends heavily on how individual states implement the rules, according to the federal agency report cited by LAist. The Congressional Budget Office has estimated the requirement would leave 5.3 million more people uninsured by 2034, and separate CBO estimates reported by CalMatters project Public Law 119-21 will cut federal Medicaid funding by nearly $1 trillion over ten years. Federal officials, including CMS Administrator Mehmet Oz, have defended the rule as a way to promote skills and independence through work, education, job training, or community service, per LAist.
California Counties Are Already Bracing for Impact
One projection put total coverage losses at up to 3.4 million people. That statewide risk has already prompted local action: Sacramento County has projected up to $58 million in new local healthcare costs as 15,000 residents lose coverage, according to prior Hoodline reporting.
Under California Welfare and Institutions Code Section 17000, counties are legally obligated to act as healthcare providers of last resort for low-income, uninsured residents — meaning a drop in Medi-Cal enrollment doesn't reduce healthcare demand so much as shift its cost onto county budgets and emergency rooms. That dynamic is what's driving coalitions like Keep L.A. Covered to treat the January 2027 deadline as a firm target for shoring up outreach before the paperwork wave hits.
