With sweeping changes to Medi-Cal eligibility set to take effect in January 2027, CalOptima Health is launching a countywide initiative aimed at helping Orange County residents keep their health coverage and navigate what may be the most significant enrollment overhaul in years.
The new “Keep Your Medi-Cal, OC” campaign includes millions of dollars in new investments for community outreach, enrollment assistance, education and one-on-one navigation services. CalOptima Health announced the effort on October 19, saying the goal is to help residents understand the new rules, comply with evolving requirements and avoid losing coverage because of paperwork, reporting issues or confusion about eligibility.
Millions Invested to Help Residents Maintain Coverage
CalOptima Health’s Board of Directors recently approved $6.1 million in funding for two major new programs designed to support Medi-Cal members during the transition.
Orange County Supervisor Vicente Sarmiento, who serves as chair of the CalOptima Health Board, said the coming eligibility changes are especially challenging for individuals who already face barriers to maintaining coverage.
The first new initiative is a Community Enrollers Academy that will train and certify community organizations to assist residents with Medi-Cal enrollment and renewal efforts. The program will be administered by the Community Health Initiative of Orange County (CHIOC).
Organizations that complete the three-month training program will be eligible for grants of up to $200,000 over two years to support enrollment activities in their communities. The academy is expected to begin in April 2027, with applications opening in December.
The second initiative is a two-year pilot program focused on helping members comply with new federal work and community engagement requirements tied to Medi-Cal eligibility. CalOptima Health has designated up to $4 million for the effort.
Up to four organizations will receive annual grants of $500,000 to provide individualized assistance that may include:
- Evaluating member eligibility requirements
- Developing compliance plans
- Assisting with job applications
- Connecting individuals to education and job-training programs
- Helping gather documentation required for Medi-Cal eligibility
- Assisting with income reporting requirements
New Eligibility Rules Could Affect Thousands of Orange County Residents
The changes scheduled for January 2027 represent a major shift from recent years, when Medi-Cal enrollment expanded significantly and beneficiaries faced fewer procedural barriers to remaining enrolled.
Under the new framework described by CalOptima Health, some adults may be required to demonstrate compliance with work, volunteer, education or job-training requirements depending on their circumstances. Members may also be required to regularly report income and respond promptly to correspondence from Medi-Cal and the Orange County Social Services Agency.
The agency’s concern is that many eligible residents could lose coverage simply because they fail to understand the new requirements or miss critical notices.
As a result, the “Keep Your Medi-Cal, OC” campaign is emphasizing three key messages:
- Understand how the new eligibility rules affect your coverage.
- Respond promptly to Medi-Cal and county notices.
- Seek assistance immediately if questions arise.
Existing Community Network Already Serving Residents
The latest funding builds on a previous $7.1 million investment by CalOptima Health supporting 14 community organizations across Orange County.
Those organizations currently provide enrollment assistance, renewal support and education regarding Medi-Cal eligibility. They include:
- 2-1-1 Orange County
- Families Together OC
- Providence Mission Hospital
- Access California Services
- First 5 Orange County
- Serve the People Community Health Center
- Camino Health Center
- Give for a Smile
- Southland Integrated Services
- Community Health Initiative of Orange County
- Latino Health Access
- Vision y Compromiso
- Council on Aging Southern California
- NOCRHF Family Health Matters Community Health Clinic
CalOptima Health is encouraging community organizations and service providers to utilize a new multilingual outreach toolkit that includes flyers, posters, social media materials and other educational resources intended to reach residents before the new requirements take effect.
Additional Advertising Campaign Planned
The “Keep Your Medi-Cal, OC” effort is part of a broader $19 million commitment through CalOptima Health’s Community Reinvestment Program.
According to the agency, future outreach efforts will include:
- Billboard advertising
- Bus shelter advertising
- Digital advertising
- Social media campaigns
- Educational videos
- Expanded community outreach programs
CalOptima Health reports that approximately $5.9 million remains available for additional outreach activities that could be approved by the Board through 2028.
Chief Executive Officer Michael Hunn said community-based organizations will play a critical role in helping members understand the unprecedented changes occurring within the Medi-Cal program.
What Is Happening With Medi-Cal Statewide?
The announcement comes during a period of significant change for Medi-Cal, California’s version of Medicaid.
Over the past several years, California expanded Medi-Cal eligibility to cover low-income adults regardless of immigration status, helping push statewide enrollment well above 15 million beneficiaries. However, policymakers at both the state and federal levels have increasingly focused on program costs, eligibility verification and workforce participation requirements.
As a result, beneficiaries across California are already facing increased eligibility reviews following the end of pandemic-era continuous coverage protections. Many residents who remained automatically enrolled during the COVID-19 public health emergency have had to complete renewals and re-establish eligibility documentation.
The additional federal requirements expected in 2027 could further complicate enrollment and renewal processes for certain adults, making outreach efforts like CalOptima Health’s increasingly important for counties with large Medi-Cal populations.
Nearly 800,000 Orange County Residents Rely on CalOptima Health
CalOptima Health remains one of the largest public health plans in California. The county-organized health system serves nearly 795,000 Orange County residents, including low-income children, adults, seniors and people with disabilities.
The organization works with a provider network that includes approximately 10,000 physicians and specialists as well as 46 acute care and rehabilitation hospitals throughout the region.
With major eligibility changes on the horizon, CalOptima Health is betting that proactive education, trusted community partnerships and personalized assistance can prevent thousands of Orange County residents from losing coverage simply because they fail to navigate an increasingly complex Medi-Cal system.