One Big Beautiful Bill Could Disproportionately Affect Medi‑Cal Coverage for Individuals Experiencing Homelessness

The One Big Beautiful Bill Act (OBBBA), establishes work and community engagement requirements for most Medicaid beneficiaries, requiring participation in work, volunteer service, or other work-related activities for a minimum of 80 hours per month, subject to certain exceptions. California estimates that about 1 to 2 million of its 14 million Medi-Cal recipients will lose coverage, either because they will fail to meet the work requirements or due to challenges associated with navigating the administrative process to comply. Individuals experiencing homelessness may be particularly affected, given the practical difficulties associated with meeting work verification, documentation, and periodic eligibility confirmation requirements.