DHCS and DSS propose multiple Medi‑Cal and IHSS reductions to close $12B shortfall; lawmakers and advocates warn of health and equity harm

Overview Department of Health Care Services and the Department of Social Services presented a wide package of May‑Revision budget solutions aimed at trimming general fund exposure in Medi‑Cal and long‑term supports. Administration staff described a $12 billion general fund shortfall and said the health and human services budget — which makes up about one‑fifth of the general fund — must bear a portion of the adjustment.

Key DHCS proposals presented - UIS enrollment freeze: an enrollment freeze for full‑scope state‑only Medi‑Cal adults with "unsatisfactory immigration status" effective Jan. 1, 2026, producing scored multi‑year savings in the May Revision. DHCS estimated cumulative, long‑run savings but acknowledged disenrollment impacts would accumulate over multiple years. - $100/month premiums: a proposal to levy a $100 monthly premium for adult beneficiaries in the optional expansion with unsatisfactory immigration status, starting Jan. 1, 2027; the administration's estimate assumed a phased disenrollment effect (DOF and LAO asked for further modeling). DHCS estimated a modest near‑term fiscal effect that grows in later years. - Elimination of…