California has made major strides in expanding health care access, but new federal and state policy threats risk reversing progress. To protect California health coverage disparities and Medi-Cal policy progress, state leaders must act to preserve affordable care and advance health equity.

The publication gives 5 facts about health coverage in California:

1. Nearly one-third of Californians under age 65 are covered by Medi-Cal, but federal cuts put their coverage at risk.
2. Medi-Cal Works to reduce poverty — continued investments is the way forward, not cuts.
3. California’s uninsured rate reached a new historic low in 2024, new federal law threatens progress.
4. Health inequities are largest for American Indian and Alaska Native Californians.
5. Adults are most likely to be uninsured, and federal cuts could push even more out of coverage.

Policy recommendations include avoid rushing the implementation of H.R. 1 and engage stakeholders early for an inclusive decision-making process; communicate proactively, regularly, and effectively with Medi-Cal enrollees; strengthen Medi-Cal eligibility and enrollment systems; protect immigrants in state-funded Medi-Cal from new federal requirements; and set new cost-sharing requirements at the lowest possible level.