Looming in 2026: Oakland health advocates prepare community for Medi-Cal freeze

Second in a three-part series about Oakland agencies preparing for major federal funding cuts.

Oakland health advocates are preparing for changes to California’s Medi-Cal insurance program that will affect immigrant communities. 

Starting Jan. 1, the state’s insurance program for low-income people will stop accepting new applications from any person who holds an “unsatisfactory immigration status,” meaning they are either undocumented, have a student or work visa, or are going through an immigration proceeding. It would also affect people with less than five years as a legal permanent resident. 

Alameda County officials have determined that about 58,000 people in the county have “unsatisfactory immigration status” and will be affected.

According to an Alameda County ad hoc committee formed at the start of the second Trump administration, upcoming enrollment changes are estimated to push roughly 130,000 county residents off Medi-Cal coverage over the next couple of years.

“This is just showing how broken the system is, that we’re not going to be able to provide health insurance for everyone under this administration,” Alameda County Supervisor Nikki Fortunato Bas said.  

The changes come as the Trump administration targets undocumented people across the country. Ongoing raids make many undocumented Californians afraid to seek medical care. Local officials and health care advocates said they’ve been swamped as they tackle a growing list of cuts to services available to immigrants.

The California Budget & Policy Center, a research nonprofit, estimates California may lose $30 billion in federal Medicaid and Medi-Cal funding due to the spending bill that President Donald Trump signed into law in July. Alameda County expects to lose $100 million by 2030. 

No one should have to go without health care, Bas said. The ad hoc committee — known as Alameda County Together for All is ramping up outreach and communication to enroll and re-enroll as many people as possible before the changes take effect.

To reach people who need help, ACT for All has allocated $2.5 million for a communication outreach effort, while Alameda County Health and the county Social Services Agency assemble a communications plan, Bas said.

“I wish we had done this much sooner, but it’s never too late,” Bas said. “The outreach is going to be starting imminently.”

Who needs to apply?

Undocumented Medi-Cal enrollees who currently have coverage will continue to have it, but they must complete their renewal packets within 90 days, or they won’t be able to reapply to the program. 

Undocumented residents can still apply for restricted or emergency Medi-Cal, such as pregnancy-related services or life-saving services, said Dinh Ly, director of member services at the Asian Health Center. 

The Unity Council, an Oakland nonprofit providing career, housing, financial and other services, is preparing for the consequences facing immigrants in Fruitvale. 

“We serve so many people annually, especially the communities that are being hit first and worst right now with this administration,” said Caheri Gutierrez, director of fund development and communications. “But our message has been steady and strong, and it’s ‘Be prepared, not scared.’”

The Coalition of Concerned Medical Professionals in Oakland has seen a surge in demand for the health care it provides for residents who can’t pay and is planning for more people needing its services. 

“Phones are ringing off the hook, and people are coming from hours away to get care because there’s nowhere else,” said Olivia Rodriguez, a nurse and volunteer organizer for the coalition, which is comprised of volunteer health professionals.

Several organizations, including La Clinica de La Raza and Asian Health Services, will host events across the city in the coming weeks to raise awareness of the cuts and ensure that those who can re-enroll do so in time. 

Next: Trump’s push to shift housing policy leaves Alameda County providers in limbo

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Looming in 2026: Cuts in federal funds deal blow to Oakland’s deficit-laden budget