Full Breakdown
Health Net to End Assisted-Living Benefit for Medi-Cal Members, Raising Eviction Fears
8/18/2026, 2:09:32 AM
Core Event: Termination of Assisted-Living Coverage
Health Net, one of the largest Medi-Cal insurers, announced it will cease offering the optional assisted-living benefit to its members at the end of the year. The benefit currently covers most of the 24-hour service costs for board-and-care homes and memory-care facilities, allowing residents to pay only room-and-board fees.
Background & Context: Medi-Cal, CalAIM, and the Assisted-Living Benefit
The assisted-living benefit is part of California’s CalAIM initiative, designed to stabilize high-cost Medi-Cal users by covering long-term residential care that would otherwise drive repeated emergency-room visits. Health Net operates Medi-Cal plans in ten counties, including Los Angeles and Fresno.
Data & Statistics: Scope and Costs
- Approximately 3,500 Medi-Cal patients rely on Health Net’s assisted-living coverage.
- Facilities charge $5,000 to $7,000 per month, compared with $10,000+ for nursing homes.
- The average assisted-living cost for families in this story is roughly $6,000 per month.
Official Statements & Responses
The Department of Health Care Services (DHCS) said Medi-Cal members are entitled to services until the end of the year when “clinically appropriate,” and that members may appeal or file grievances if they believe protections are insufficient. DHCS asserted its patient-notification requirements are adequate, stating “Medi-Cal members have strong protections.”
Criticism & Opposition
Advocates argue the termination will create a “disaster.” Pauline Shatara, deputy director of California Advocates for Nursing Home Reform, warned the loss of coverage could force residents into emergency rooms or onto the streets. Hagar Dickman, director of long-term services and supports for Justice In Aging, said, “Their position is it’s less costly to offer no services than some services.”
On-the-Ground Reports
Matt Johnstone learned of the change when a board-and-care facility called to inform him that Health Net was eliminating the benefit for his 89-year-old father, who has dementia. Johnstone said his family cannot afford the $6,000-monthly fee and fears his father could become homeless.
Conflicting Reports & Gaps
Providers disagree on when members will receive formal termination notices. Some expect notices by the end of September, others anticipate delivery in early December, raising concerns that notices could arrive after evictions have begun. Health Net claims members will have access to alternative care, yet advocates note a lack of concrete transition plans and limited state consumer protections beyond a 30-day notice requirement.
Verbatim Quotes
- “He’s declining, and I just don’t know what’s going to happen if the program ends,” — Matt Johnstone
- “This is going to be a disaster,” — Pauline Shatara
- “Their position is it’s less costly to offer no services than some services,” — Hagar Dickman
What’s Next
State regulators will monitor Health Net’s compliance with the requirement to maintain services through the end of the year and ensure members receive any clinically appropriate extensions. Families are advised to pursue appeals or grievances through DHCS if they encounter gaps in care.
