As federal policy destabilizes Medi-Cal and home care nationwide, Governor Newsom’s proposed 2026–27 budget will determine whether California protects care or allows it to be dismantled. Rather than stabilizing these programs and backfilling cuts triggered by H.R. 1, the Governor’s budget proposal creates new barriers to Medi-Cal access and weakens California’s largest home care program, In-Home Supportive Services (IHSS).
Home Care Program Weakened:
Governor Newsom’s proposed budget includes over $33.4 billion for IHSS serving more than 875,000 Californians, yet it simultaneously sets in motion policies that will destabilize the program. Beginning in 2027–28, the state will stop paying for increases in IHSS hours, shifting costs to counties and creating a system where people’s access to care depends on where they live. The budget also ends state-funded IHSS during the Medi-Cal waiting period, meaning people who qualify for care could be left without support when they need it most.
Medi-Cal Access Worsened:
Justice in Aging predicts that 4 million Californians would lose their healthcare coverage as a result of new barriers to eligibility in H.R. 1 and of those, 3.4 million would be cut off Medi-Cal. The Governor’s proposed budget doesn’t appear to make up for that lost care, nor does it address the out of pocket expenses that Californians will face under H.R. 1.
H.R. 1, starting in 2027 forces many Californians into more frequent Medi-Cal redeterminations and new work-reporting requirements which will cause many to disenroll from their plans, slip through the cracks, and go without the necessary care they need to survive.
H.R.1 also denies Medicaid to previously covered immigrants who are here lawfully but are not green card holders, increases administrative costs, and cuts to federal matching funds -pushing eligible people off coverage and into crisis.
The Governor’s budget adds new barriers to Medi-Cal access for immigrant families. It continues an l enrollment freeze for undocumented Californians, eliminates dental coverage as of July 1, 2026 and establishes a $30/month premium in 2027. The Governor’s budget proposes imposing work requirements on immigrant populations despite not being required by H.R. 1 and denies full-scope Medi-Cal coverage to immigrant populations being pushed off Federal Medicaid.
Advocates Respond
“Shifting costs to the counties will be devastating to IHSS recipients and providers alike, let alone the administration which is already understaffed. Family members in particular will be forced to work without pay in order to keep their loved ones at home. Jobs will be lost, homes will be lost, and the poverty rate in California will explode.” – Hannah Karpilow – Outgoing Chair of Alameda County IHSS Advisory Committee, and SEIU 2015 Member
“Community living is living, period. As an IHSS and Home and Community-based Waiver recipient, I am able to work, raise my child, and love in the privacy of my home. I have no apologies for protecting this right. Besides, community-based living saves the state money. California, practice good fiscal sense.” – Michai Freeman – Systems Change Advocate at The Center for Independent Living and IHSS Recipient
A Call to Action
As federal attacks on health care accelerate, California must not retreat. We call on the Governor and Legislature to reject IHSS cuts and cost-shifts, protect Medi-Cal access, and identify new revenue streams from corporations and wealthy individuals to fully fund LTSS for all. Care is how we all survive, and the budget must reflect that truth.
About LTSS4All Coalition
The LTSS4All Grassroots Coalition is a statewide coalition made up of grassroots organizations & leaders uniting the many frontline communities who have a direct stake in creating a just Long-term Services and Supports System (LTSS). We are people with disabilities and chronic health conditions, older adults, family caregivers, and professional homecare providers.
Our members include: Hand in Hand: The Domestic Employers Network, CA Alliance of Retired Americans, Caring Across Generations, CA Council of the Blind, California Foundation for Independent Living Centers, CA Domestic Workers Coalition, Filipino Advocates for Justice, Gray Panthers chapters across the state, Immigrants with Disabilities, Pilipino Workers Center, Senior and Disability Action, and many more, with policy and advocacy partners including Disability Rights California, Disability Rights Education and Defense Fund, Justice in Aging, California Pan-Ethnic Health Network, and the California Immigrant Policy Center.
