Undocumented Access

Federal defendants file the record in the states' public charge suit

On October 23, 2026, the federal defendants in State of New York v. DHS filed the administrative record index, with certifications for the rule and its guidance. The states move for summary judgment by December 11, and the last brief is due March 12, 2027.

DHCS issues fee-for-service toolkit and opens 2027 authorizations November 1

On October 14, 2026, DHCS issued Version 1.0 of its Medi-Cal Fee-for-Service Provider Toolkit for the January 1, 2027 move of UIS members out of managed care. DHCS will accept treatment authorization requests for 2027 dates of service starting November 1. The toolkit lists community health worker services as available in fee-for-service, while ECM and Community Supports are not.

Court sets public charge summary judgment schedule through March 2027

An order signed October 5 and entered October 6, 2026 adjourned the October 9 conference in State of New York v. DHS and set a briefing schedule. Defendants produce the administrative record October 23. The states move for summary judgment December 11, and briefing ends March 12, 2027. The order sets no date for a ruling.

CMSP staff urge final approval of emergency-only care for undocumented adults

CMSP staff asked its Governing Board on October 5, 2026 to give final approval to cuts starting January 1, 2027, including emergency-only coverage for undocumented adults. The report says up to 124,000 residents of its 35 counties could lose Medi-Cal, and the immigrant change affects up to 8,680 people. Clinics in CMSP counties should plan for more uninsured visits.

DHCS letter tells refugees and asylees their full Medi-Cal continues

DHCS dated a member letter October 1, 2026, telling refugees, asylees, parolees and other affected immigrants they keep full-scope Medi-Cal as federal funding ends. They must update immigration information by December 1 and move to fee-for-service Medi-Cal on January 1, 2027. Counties add the letter to new applications starting October 1.

More than 281,000 lawfully present immigrants face Medicaid loss in October

More than 281,000 immigrants in nine states and D.C. were expected to lose Medicaid starting October 1, as KFF Health News reported on September 30, 2026. Florida alone counted nearly 177,000. Green card holders, people under 19 and immigrants from Cuba, Haiti and some Pacific Island countries keep their coverage.

DHCS warns managed-care-only providers lose UIS patients after December 31

DHCS posted a provider notice September 29, 2026, opening a new web page for the move of UIS members from managed care to fee-for-service. Providers that bill only through managed care cannot keep caring for UIS members after December 31, 2026. Health centers should update PAVE enrollment and review treatment authorization rules now.

Newsom signs SB 1323 requiring clinics to post immigration enforcement notices

Governor Newsom signed SB 1323 by Senator Susan Rubio on September 27, 2026. Health care provider entities must post a notice at main public entrances that immigration agents need a judicial warrant to enter nonpublic areas, and must set visitor procedures. The changes repeal on January 1, 2030.

Healthy San Francisco enrollment grows 39% since January

On September 23, 2026, Mission Local reported that enrollment in Healthy San Francisco, the city's program for uninsured residents, has grown 39% since January. A city health official tied the rise to the state's freeze on new Medi-Cal enrollment for undocumented immigrants. The city approved more than $25 million for nonprofit clinics that see these patients.

Judge strikes down federal notices that widened immigrant benefit bans

On September 21, 2026, a federal judge in Rhode Island vacated 2025 HHS, Justice, Education, Labor and HUD notices that widened which programs count as federal public benefits under PRWORA. She barred enforcing them against the 20 plaintiff states and D.C. HHS, Education, Labor and HUD may still write new rules after notice and comment.

Immigrant groups file third suit against public charge rule in New York

On September 17, 2026, Make the Road New York and three other groups sued DHS in Manhattan federal court to vacate the new public charge rule. Their complaint cites a DHS estimate of about $13 billion a year in lost benefits for some 2.1 million people. The October 9 conference was adjourned on October 5.

Public charge rule stays in effect as court sets October 9 conference

A federal judge in New York signed an order on September 16, 2026 setting an initial conference for October 9 in the 21-state suit against the new public charge rule. The states have not asked the court to block the rule while the case proceeds. The rule took effect September 18 and applies to immigrant families now.

Public Health Watch finds confusion after Medi-Cal immigrant dental cut delayed

Public Health Watch reported on September 15, 2026 that worry and confusion persist after California moved its immigrant dental cut to July 1, 2027. About 2.3 million immigrants now face that date, and by September DHCS had not formally told plans to call members. State data show over 220,000 immigrants dropped or lost coverage from January through June.

21 states sue over public charge rule, citing lost health center revenue

On September 14, 2026, 21 states, Pennsylvania's governor and D.C. sued the Department of Homeland Security in federal court in Manhattan over the new public charge rule. The states say the rule, effective September 18, will lead families to drop programs they still qualify for, costing health centers revenue. These are allegations, and the court has not ruled.

DHCS guide ends ECM and Community Supports for UIS members January 1

DHCS released version 2.0 of its UIS transition policy guide on September 1, 2026. About 2.7 million members are expected in fee-for-service on January 1, 2027, when ECM and Community Supports end for UIS members. DHCS will accept fee-for-service treatment authorization requests for 2027 dates of service starting October 1, 2026.

DHCS says affected immigrants keep full-scope Medi-Cal through June 30, 2027

DHCS says federal law narrows federally funded full-scope Medicaid for certain immigration categories starting October 1, 2026. Affected adults keep state-funded full-scope Medi-Cal through June 30, 2027, and starting July 1, 2027 they are limited to emergency and pregnancy-related services. Eligibility staff should check the member's official notice and the county eligibility system.

County Medical Services Program proposes cuts in 35 small counties for 2027

On August 6, 2026, the board of the County Medical Services Program, which covers uninsured low-income adults in 35 small counties, proposed cuts starting January 1, 2027. It would lower the income limit from 300% to 200% of the federal poverty level and limit undocumented immigrants to emergency-only coverage again. The next public hearing is October 5 in Sacramento.

CalHHS warns federal public-charge rule will scare immigrant families away from care

In a July 16, 2026 joint statement, California health and human services leaders warned that the federal public-charge rule will create confusion and discourage eligible families from seeking services. The rule takes effect roughly mid-September 2026, 60 days after it was published in the Federal Register. The leaders pointed families to community health workers and regional hubs for help.

DHCS puts H.R. 1 Medi-Cal eligibility changes on one page

DHCS updated its Medi-Cal eligibility page on July 1 to gather the H.R. 1 changes in one place. Six-month checks for adults 19 to 64 and work requirements start January 1, 2027, and a narrower definition of qualified noncitizens starts October 1, 2026. Cost-sharing rules begin October 1, 2028, and community clinic services are exempt.

DHCS keeps full Medi-Cal dental through June 30, 2027, then narrows it

DHCS says full Medi-Cal dental continues through June 30, 2027, and it mailed updated notices in July 2026. After that, adults age 19+ without federally funded full-scope Medi-Cal generally keep only emergency dental, while those under 19, pregnant or postpartum, or qualifying foster youth under 26 keep full dental. Check benefits in the Medi-Cal Provider Portal at each visit.

Some adult Medi-Cal members move to emergency-only dental July 1, 2027

Starting July 1, 2027, DHCS says adults 19 and older who do not qualify for federally funded full-scope Medi-Cal move to emergency-only dental. Full dental continues through June 30, 2027, and emergency care still covers severe pain, swelling, infection, bleeding and trauma. People under 19, pregnant or postpartum members, and qualifying foster youth under 26 keep full dental.

In 39 interviews, undocumented adults trusted clinics but often lacked information

In January 2026, CHCF had Culture IQ Group interview 39 undocumented adults on full-scope Medi-Cal in Greater Los Angeles, the Central Valley, Monterey and the Bay Area. Participants often had little or no accurate information about coming changes and named clinicians, local clinics and official Medi-Cal messages as trusted sources. The small study cannot estimate statewide rates.

More states cut immigrant health coverage, and California's freeze fits the pattern

Minnesota ended MinnesotaCare for undocumented adults on January 1, 2026, affecting about 57,000 people, KFF and Stateline report. Illinois, Washington state, DC and Colorado also ended, froze or capped programs, and California froze new Medi-Cal enrollment for undocumented adults in January 2026. Patients who lose coverage return as self-pay sliding-fee visits, so health centers with large immigrant panels lose revenue.

Monterey County revives Esperanza Care for up to 500 undocumented adults

Monterey County supervisors voted in late May 2026 to relaunch Esperanza Care on July 1 for up to 500 undocumented adults losing Medi-Cal, Monterey County Now reported. The county pays about $500K to $1M a year. Community Health Centers of the Central Coast and Clínica de Salud del Valle de Salinas remain the safety net for everyone else.

Over 86,000 undocumented people left or were denied Medi-Cal, analysis finds

KVPR republished a Public Health Watch analysis that found more than 86,000 people without legal status left or were denied Medi-Cal in January and February 2026. It reported a rate six times that of other enrollees, and the data do not show why. DHCS says eligible members with full-scope Medi-Cal can keep it by renewing on time.