OC Medical Providers Worry as CalOptima Enrollment Plummets

Nearly 27,000 patients have opted out of the healthcare program in the last two months, raising concerns about maintaining services.

Feb. 28, 2026 at 3:36am

Got story updates? Submit your updates here. ›

Orange County health leaders say the area's Medicaid program, CalOptima, has seen a sharp decline in enrollment in recent months, with nearly 27,000 patients opting out. Providers are worried this will make it difficult to keep clinics and services running, as the program provides crucial funding and reimbursements. Some patients cite immigration enforcement fears as the reason for disenrolling, while new state rules around asset limits and monthly fees have also contributed to the drop.

Why it matters

The decline in CalOptima enrollment could have serious consequences for low-income patients in Orange County, leading to disruptions in care, more emergency room visits, and higher costs for taxpayers. It also highlights the chilling effect that immigration enforcement activities and policy changes can have on access to essential healthcare services.

The details

Clinics like Families Together of Orange County Community Health Center in Tustin are already feeling the strain, with each provider seeing around 20 patients per day. The center relies heavily on Medicaid reimbursements and may have to cut back on additional services like transportation and a food pantry if the enrollment decline continues. Orange County Supervisor Vicente Sarmiento, who sits on CalOptima's board, says immigration fears are a major factor behind the reduced use of community health services.

  • In the last two months, nearly 27,000 CalOptima patients have opted out of the healthcare program.
  • In July, the Trump administration gave ICE agents access to the personal data of 79 million people enrolled in Medicaid.

The players

Families Together of Orange County Community Health Center

A community health center in Tustin that relies on Medicaid reimbursements and is already stretched thin due to the CalOptima enrollment decline.

Vicente Sarmiento

An Orange County Supervisor and member of the CalOptima board, who cites immigration fears as a major factor behind the reduced use of community health services.

CalOptima

The Medicaid program in Orange County that has seen a sharp decline in enrollment in recent months.

Got photos? Submit your photos here. ›

What they’re saying

“We want to make sure our patients have continuity of care, but that will cost us. We will have to look at the extra wrap-around services we provide.”

— Cassandra Rossel, Communications director at Families Together of Orange County Community Health Center

“Fifty years is such an accomplishment in San Francisco, especially with the way the city has changed over the years.”

— Gordon Edgar, Grocery employee

What’s next

Orange County health leaders and CalOptima officials will need to work to address the enrollment decline and ensure continued access to essential healthcare services for low-income residents.

The takeaway

The drop in CalOptima enrollment highlights the complex intersection of healthcare, immigration policy, and community trust. Addressing this issue will require a multi-faceted approach to support vulnerable populations and maintain a robust safety net for those in need.