Shirley Lewis, a Jawonio Day Services participant, was among the Medicare recipients, healthcare workers, and caregivers who gathered with U.S. Senate Minority Leader Chuck Schumer at Helen Hayes Hospital in Haverstraw, N.Y. April 17, 2025. Schumer spoke about how cuts to Medicaid will affectrecipients as Republicans in Congress vote to enact cuts to the program as well as to other social safety net programs.
California – California has seen nearly 900,000 residents removed from its Medicaid rolls over the past two years as part of a national process known as the “Medicaid unwinding,” following the end of pandemic-era protections. While the state has fared better than others in limiting disenrollment, the drop underscores growing concern about access to health care for low-income families, especially amid recent federal policy changes.
According to data from the nonpartisan Kaiser Family Foundation (KFF), the number of Californians enrolled in Medicaid—known locally as Medi-Cal—fell from 14.29 million in March 2023 to 13.39 million in March 2025. This change came after the expiration of a federal rule that had required states to maintain continuous coverage for enrollees during the COVID-19 public health emergency.
During the pandemic, Medicaid enrollment surged as millions lost jobs or income, and states were barred from removing most beneficiaries, even if their eligibility changed. But once the public health emergency ended, states resumed eligibility checks. How they approached the process, however, has varied widely.
California, like New York, took a slower, more deliberate approach to reviewing eligibility, resulting in a relatively modest 6.3% decline in coverage—compared to double-digit drops in states like Texas and Florida. Health policy experts note that this slower pace likely reduced erroneous disenrollments of eligible recipients. By contrast, states that rushed the process often removed people for failing to respond to paperwork or administrative requests, not because they were ineligible.
Michael Sparer, chair of the Department of Health Policy and Management at Columbia University, described the unwinding as a policy challenge with long-term consequences. “There is clear evidence that many beneficiaries who were still eligible lost coverage simply because they did not timely navigate the administrative hurdles,” Sparer said.
California’s Medicaid enrollment in 2025 remains 16% higher than pre-pandemic levels, but new federal policies could complicate the outlook. President Donald Trump’s recently passed One Big Beautiful Bill includes Medicaid funding cuts, a crackdown on “waste, fraud and abuse,” and the reintroduction of work requirements. These changes, critics argue, could create additional barriers for vulnerable populations.
As the unwinding continues, more reductions in enrollment are expected, not only in California but across the country. With millions already stripped of coverage, public health experts warn of rising uninsured rates, worse health outcomes, and increased strain on emergency systems. They emphasize that those losing Medicaid should be offered alternative coverage options, such as subsidized ACA marketplace plans, to prevent further erosion of access to care.
