The California Senate Democrats recently released their 2026-27 state budget proposal, called the Foundation for the Future.1 It is framed around three core priorities: responsible budgeting, maintaining vital programs, and improving California’s long-term fiscal health. After reviewing the plan, AJSOCAL is encouraged by its implications for the people we serve, particularly low-income individuals, immigrants, and AAPI communities.
Why This Budget Matters: Medi-Cal Premiums
Before turning to specific items, we want to underscore why the delay of Medi-Cal premiums warrants particular attention, as it represents one of the broadest health access protections in the plan and could affect many adults regardless of immigration status.
Ample research shows that premiums have a harmful impact on low-income enrollees. A study of Wisconsin’s Medicaid program found that introducing just a $10 monthly premium reduced enrollment by 1.4 months and made enrollees 12 percentage points less likely to remain covered for a full year.2 Further, reviews of the broader research literature by the Kaiser Family Foundation confirm this pattern: even modest premiums and cost-sharing requirements lead to reduced coverage, worse access to care, worse health outcomes, and increased financial burden on low-income enrollees.3 In fact, potential revenue gains are often offset by higher disenrollment, increased use of expensive services like emergency room care, greater costs for uninsured individuals, and higher administrative expenses. Premiums also place added pressure on safety-net providers, community health centers, and hospitals.4
This concern is especially important at a time when federal legislation could expand Medicaid cost-sharing requirements nationally, potentially pushing millions out of coverage. Against this backdrop, the Senate’s proposal to delay Medi-Cal premiums is a crucial step toward a budget that protects enrollment and keeps the door to coverage open.
1. Medi-Cal Premiums – Delayed to January 1, 2028
The proposed budget delays the implementation of monthly premiums for adults enrolled in Medi-Cal, regardless of immigration status, from July 1, 2027, to January 1, 2028 – at temporary cost of $125 million in 2027-2028. As described above, this could affect many adult Medi-Cal enrollees. Delaying premiums, even temporarily, helps avoid creating a new barrier to coverage for people who are already vulnerable.
2. In-Home Supportive Services (IHSS) – Maintained
The proposed budget keeps current support for IHSS, a program that helps pay caregivers, often family members, to assist older adults and people with disabilities so they can live safely at home. The Senate rejected proposed changes that would have reduced these services, committing $323 million to keep the program intact. As a result, families that rely on IHSS are less likely to be forced to choose between caregiving and financial survival.
3. Full-Scope Medi-Cal for Asylees, Refugees, and Other Immigrants – Maintained
The Senate budget maintains full-scope Medi-Cal for the most vulnerable Californians, including refugees, asylees, survivors of human trafficking, and other immigrants who are no longer eligible for federal funding due to federal policy changes, at a cost of $786 million in 2026-27 growing to $1.1 billion annually. With more than 80% of the refugee and asylee population at less than 200% of the Federal Poverty Level,5,6 this would help preserve critical health coverage for certain immigrants even without federal support. This directly affects many AAPI community members, including recent arrivals and families with mixed immigration statuses.
4. Dental Benefits – Protected Through January 1, 2028
Dental coverage for adults age 19 and older, regardless of immigration status, was scheduled to be eliminated starting July 1, 2026. The Senate budget delays those reductions until January 1, 2028, at a temporary cost of $446 million in 2026-27 and $349 million in 2027-28. Recognizing that dental care is often one of the first benefits people lose and one of the hardest to afford out of pocket, this delay allows more time for people to continue accessing the care they need.
5. Community Clinics – Protected Through January 1, 2028
Funding reductions to community clinics are scheduled to begin on July 1, 2026. The Senate budget proposal delays those reductions until January 1, 2028, at a temporary cost of $1.1 billion in 2026-27 and $565 million in 2027-28. Community clinics are often the primary, and sometimes the only, place where low-income and immigrant families receive care, especially in languages other than English. One in three, or 32.5%, of AAPIs in California are limited English proficient (LEP) with some populations, such as Burmese individuals exceeding LEP rates of 50%.7 Protecting these clinics helps preserve a critical point of access to health care for our communities.
What This Means for AAPI Communities
The Senate’s budget plan is a meaningful step toward protecting health access in California, especially at a time when federal policy is moving in the opposite direction. It preserves key Medi-Cal programs and delays new financial barriers to affordable, accessible, and continuous care for the communities we serve.
When Medi-Cal coverage is preserved, enrollment navigators, like those in our Health Access Program (HAP), have programs in place to connect people to. When clinics stay funded, the providers our community members rely on can continue serving them in a culturally and linguistically appropriate way. When premiums are delayed, the families we serve are less likely to lose coverage before they have a fair opportunity to understand their options.
AJSOCAL urges the serious consideration and ultimate adoption of these recommendations. The Senate’s proposed budget will benefit AAPI communities, who are disproportionately impacted by gaps in access, affordability, and culturally responsive care and many other low-income, vulnerable communities. We look forward to working in partnership with state leaders to continue championing policies that support healthy, dignified, and thriving communities across California.
If you have questions or want to learn more about your Medi-Cal and health coverage options, please reach out to us. Our services are open to individuals of all races and ethnicities, and we provide assistance in multiple languages.
[1] Senate Democrats, Foundation for the Future: 2026–27 State Budget Plan (2026), https://sbud.senate.ca.gov/system/files/2026-04/foundation-for-the-future-budget-plan-final-2026.pdf.
[2] Laura Dague, The Effect of Medicaid Premiums on Enrollment: A Regression Discontinuity Approach, 37J. Health Econ. 1 (2014), https://doi.org/10.1016/j.jhealeco.2014.05.001
[3] Madeline Guth, Maria Ammula & Elizabeth Hinton, Understanding the Impact of Medicaid Premiums & Cost-Sharing: Updated Evidence from the Literature and Section 1115 Waivers (Kaiser Family Foundation 2021), https://www.kff.org/medicaid/understanding-the-impact-of-medicaid-premiums-cost-sharing-updated-evidence-from-the-literature-and-section-1115-waivers/
[4] Samantha Artiga, Petry Ubri & Julia Zur, The Effects of Premiums and Cost Sharing on Low-Income Populations: Updated Review of Research Findings (KFF 2017), https://www.kff.org/medicaid/the-effects-of-premiums-and-cost-sharing-on-low-income-populations-updated-review-of-research-findings/
[5] Randy Capps, Leighton Ku, Michael Fix, Chris Furgiuele, Scott McNiven, Jeff Passel, Dan Perez-Lopez, Rajeev Ramchand, How Are Immigrants Faring After Welfare Reform? Preliminary Evidence from Los Angeles and New York City (Office of the Assistant Secretary for Planning and Evaluation of the U.S. Department of Health and Human Services 2002), https://aspe.hhs.gov/reports/how-are-immigrants-faring-after-welfare-reform
[6] Emory Wolf, Covered California Policy and Action Items (Covered California 2026), https://board.coveredca.com/meetings/2026/April%2016,%202026/2026.04.16_Policy_and_Action.pdf
[7] 2025 Fact Sheet: Asian Americans, Native Hawaiians and Pacific Islanders in California (AAPI Data 2025), https://aapidata.com/wp-content/uploads/2025/05/CA-AANHPI-Factsheet-2025.pdf
