The Brief

You’ve likely heard about AI powering driverless cars, writing term papers and creating unsettling deep fakes.

Can that same technology also prevent people from becoming homeless?

That’s what Los Angeles County is trying to find out. Officials there are using AI technology to predict who in the county is most likely to lose their housing — and then stepping in to help those people with their rent, utility bills, car payments and more.

It’s still an experimental strategy. But the program has served more than 700 clients since 2021, and 86% have retained their housing. It comes at a time when more than 180,000 Californians have no place to call home, and people are ending up on the streets faster than government agencies and nonprofits can get them into housing. Officials all over the state are turning to methods aimed at preventing homelessness before it happens.

L.A. County’s algorithm analyzes data from residents’ emergency room visits, jail stays, use of food assistance and more, and has sparked interest from Silicon Valley to San Diego. Final data on the program — which has roughly $26 million in federal COVID funds and is expected to end in 2026 — aren’t yet out. If it’s successful, it could have major implications for helping cities and counties spend their limited resources more efficiently.

“If we know who people are who unfortunately are going to have that experience, and they’re already county clients, it’s a real opportunity to do something early on in their lives to prevent that from happening,” said Dana Vanderford, associate director of homelessness prevention for L.A. County’s Department of Health Services.

Dana Vanderford, Associate Director of Homelessness Prevention at Housing for Health at Los Angeles County Department of Health Services, in Los Angeles on Feb. 29, 2024.

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Jules Hotz for CalMatters

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How does artificial intelligence predict homelessness?

The idea started in 2019, when UCLA’s California Policy Lab began experimenting to see if it could use machine learning, combined with L.A. County data, to predict homelessness. Then, the county paired that with money to intervene before people ended up on the street – the program is predominantly funded with $26 million in COVID-era funds from the federal American Rescue Plan.

The UCLA researchers start with a list of 90,000 people who recently used services from the county’s Health Services or Mental Health departments. Using 580 factors, the computer ranks those people from 1 to 90,000 based on their risk of becoming homeless. The people deemed to be highest-risk tend to show up in emergency rooms and jails at high rates, and have high usage of services such as CalFresh food benefits. But the model takes many more data points into consideration.

For example, if people receive services in many different geographic areas, it could mean they’re couch surfing — bouncing from one precarious living situation to the next.

“You sort of let the computer learn what it finds to be predictive over time,” said Janey Rountree, executive director of the California Policy Lab at UCLA.

To train the algorithm, the researchers showed it a list of people who became homeless along with the services they used prior to losing their housing. Then, they had the algorithm practice “predicting” homelessness using old data, and checked to see if it was accurate. When they were satisfied, they started using it for real predictions.

How well does it work? Among the 90,000 people the researchers started with, 7% became homeless in 18 months. Among the 10,000 people the algorithm deemed to be highest risk, 24% became homeless.

If they were targeting fewer people (say 1,000 instead of 10,000), it would be even more accurate, Rountree said. But social workers aren’t able to get in touch with many of the people on the list, and others don’t agree to participate in the aid program, so they have to cast a broader net.

Is a computer really better at guessing who will become homeless than human social workers trained in this work? Rountree says yes — 3.5 times better, to be exact.

The problem with humans, she said, is that they’re biased toward the people they know.

“It’s just human nature to want to help the people that you’re in contact with,” she said. “They all seem housing-unstable and at high risk. You want to help those individuals or those families in front of you. But not all of them are going to become homeless and be on the street or use shelter if they don’t get assistance.”

Caseworkers also often prioritize people with lower needs, Rountree said. Someone who recently lost their job but otherwise is stable gets preference over someone facing ongoing struggles with their mental health or addiction, because the stable person is easier to help. But the stable person may not be the one who needs the help the most.

There’s also a belief that people with higher needs won’t spend the money they’re given wisely, Rountree said. But AI doesn’t have that bias, so it ensures the money goes to who needs it most.

The results are apparent. People the algorithm targets are much more likely to have been incarcerated, sought substance use treatment, had mental health issues or been hospitalized than the people who seek aid through L.A. County’s other homelessness prevention programs, Rountee said. In that way, this program fills a hole in LA County’s net of services, she said.

L.A. County’s other, more traditional programs geared to prevent homelessness rely on people reaching out to request help or on case workers referring clients.

Interestingly, they aren’t duplicating efforts. There’s almost no overlap between the people targeted by the AI algorithm and those served by traditional prevention programs, Vanderford said.

“We know there’s a significant population of folks who if somebody doesn’t reach out to them to offer assistance, they might lose their housing right out from under them without reaching out for assistance themselves,” she said.

Then, a human steps in

Four times a year, the Policy Lab researchers send L.A. County a list of residents the AI program has deemed most likely to become homeless. The county then mails those people letters, telling them they’ve been selected to participate in the program. After that, a social worker cold-calls them to tell them the good news.

Frequently, the person at the other end of the line is convinced it’s a scam. After all, how often does someone legitimate call out of the blue offering free money?

When that happens, case worker Genice Brown usually will ask if she can email them — a move she hopes lends a bit more credence to her pitch. Once she convinces them the program is real, nine out of 10 people agree to sign up, she said.

Genice Brown, a medical case worker with the Housing Stabilization and Homelessness Prevention Unit, in Los Angeles on Feb. 29, 2024.

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Jules Hotz for CalMatters

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Individuals enrolled in the program receive a base sum of either $4,000 or $6,000 (the amount is randomly assigned so researchers can assess the impacts of different amounts of money). Families start at $6,000 or $8,000, with larger families receiving more.

Brown can use that money for whatever her clients need most. Usually rent comes first, but it also can cover other bills. In addition, she helps connect her clients to doctors, dentists and mental health services. If they’re looking for work, Brown gets them gift cards for interview outfits, helps them with their resumes and role-plays interview questions.

She works with each client for three or four months.

‘I just really needed the help’

For 38-year-old Sandricka Henderson, help came just in time.

Diagnosed with lupus at the start of the COVID-19 pandemic, Henderson could no longer work her physically-demanding warehouse job. Disability benefits gave her barely more than $1,000 a month — just a quarter of what she made while she was working. With an 8-year-old son to support, Henderson found she was at least $400 behind on her bills every month.

Just before Christmas last year, Henderson received a call from a woman offering free money. Henderson was sure it was a scam, and braced for the woman to ask for her Social Security number.

But the social worker (who turned out to be Genice Brown) didn’t, and Henderson eventually realized the program was real. The first thing Brown gave her was a $100 giftcard to a local grocery store — a blessing, Henderson said, because she had nothing in her refrigerator.

Shortly after, Henderson’s landlord sent her a letter warning she had 10 days to pay her rent or be evicted. About a week later, Brown sent the rent money and helped Henderson avoid catastrophe. She also helped Henderson catch up on her car payment.

Now, Henderson no longer feels like she’s teetering on the edge of homelessness. She has some money in her savings account, and her rent is prepaid for several months.

“I just really needed the help,” Henderson said. Because she’s used to working hard and taking care of herself, she added, she never would have reached out and asked for it.

“It really did change my whole circumstances,” she said. “My son had a Christmas that I didn’t think I was going to be able to give him.”

The future of AI in homelessness services

Throughout California, new people are becoming homeless faster than aid workers can find existing homeless residents housing. In Santa Clara County, for example, for every one homeless household that moved into housing last year, another 1.7 became newly homeless, according to Destination: Home, a Santa Clara County-based organization focused on ending homelessness.

The L.A. County team has met with government agencies from all over the country who are interested in its AI model, including Santa Clara and San Diego counties, Vanderford said.

San Diego County is working on a plan for homelessness prevention, Tim McClain, spokesman for the county’s Health and Human Services Agency, said in an email to CalMatters. He wouldn’t provide any additional updates.

Santa Clara County met with the California Policy Lab earlier this year, and hopes to schedule another informational meeting soon, said Consuelo Hernandez, director of the county’s Office of Supportive Housing. The county has its own homelessness prevention program, which relies on humans triaging clients. If artificial intelligence can do that work more efficiently, it’s worth exploring, Hernandez said.

But at the end of the day, what they really want is more money to help the people that already fill their queues.

“Without having additional resources,” Hernandez said, “what is the true benefit of knowing there are more people out there who are in need?”

If you found out your neighbor had a past criminal conviction, your knee-jerk reaction might be that you’d want them relocated.

But what if that person committed a burglary in their late teens, served years in state prison, turned their life around, and now mentors at-risk youth?

Do the details matter? Researchers found that they do.

A new poll by Goodwin Simon Strategic Research examines California voters’ attitudes toward due process for immigrants with criminal convictions during the Trump administration’s nationwide crackdown on unauthorized immigration. The survey also examined support for how tax dollars are spent and Californians’ views on the state’s sanctuary policies.

It found bipartisan support for ensuring that immigrants facing deportation receive due process, including ones with criminal records.

“This survey shows that there’s clear concern about the current administration’s approach to immigration enforcement,” said Sara Knight, a research director at Goodwin Simon Strategic Research. “I’m not surprised by the results, but I am heartened to see how strong the support for due process is and the growing frustration with treating people inhumanely in our immigration system.”

President Donald Trump campaigned on the promise of mass deportations that targeted criminals, among other things, and he has made good on that. Immigration and Customs Enforcement agents have arrested more than 160,608 noncitizens nationwide with criminal convictions or pending charges, since his inauguration.

The Trump administration has sought to expand the use of “expedited removal,” which allows immigration officers to remove certain non-citizens, like those convicted of crimes, from the United States without a hearing before an immigration judge.

Researchers say this latest poll by Goodwin Simon Strategic Research, released to CalMatters this week, also reflects waning support, even among a small majority of Republicans for the harshest immigration enforcement practices. It showed 84% of Democrats, 61% of independents, and 54% of Republicans agreed that “even if someone does have a record, they deserve due process and the chance to have their case heard by a judge before being deported.”

The poll was commissioned by the Immigrant Legal Resource Center and the National Day Laborer Organizing Network, both pro-immigrant organizations. Goodwin Simon Strategic Research describes itself on its website as an “independent opinion research firm.” Researchers wrote the survey questions and polled more than 1,200 self-identified voters. Knight said the partisan divide among those polled mirrored the party-affiliation split in the electorate. The margin of error was 3 points.

Some other recent polls echo similar conclusions released in recent weeks, including one released last week by UC Berkeley’s Possibility Lab that found one-third of Latino voters who supported Trump now regret their choice. Another public opinion poll by the nonpartisan research firm Public Policy Institute of California found 71% of Californians surveyed said they disapproved of the job ICE is doing. And, a CNN exit poll after the Proposition 50 redistricting election on Nov. 4 found that about three-quarters of California voters said they’re dissatisfied with or angry about the way things are going in the U.S., and 6 in 10 said the Trump administration’s actions on immigration enforcement have gone too far.

Tricia McLaughlin, an assistant secretary at the Department of Homeland Security, pointed to other recent national polls to argue the public supports Trump’s immigration policies.

“President Trump and (Homeland Security) Secretary (Kristi) Noem are delivering on the American people’s mandate to deport illegal aliens, and the latest polls show that support for the America First agenda has not wavered — including a New York Times poll that nearly 8 in 10 Americans support deporting illegal aliens with criminal records,” McLaughlin said in a written statement.

“The American people, the law, and common sense are on our side, and we will not stop until law and order is restored after Biden’s open border chaos flooded our country with the worst of the worst criminal illegal aliens,” she continued.

From prison to ICE

In the more recent Goodwin Simon Strategic Research poll, 61% of voters surveyed said they want California’s prison system to stop directly handing immigrants over to Immigration and Customs Enforcement for deportation.

The state’s sanctuary law does not apply to immigrants who have been convicted of serious crimes. State prisons have transferred to ICE more than 9,500 people with criminal records since Gov. Gavin Newsom took office in 2019, according to data released to CalMatters. So far in 2025, ICE has picked up 1,217 inmates directly from the California Department of Corrections and Rehabilitation, the data shows.

The corrections department also provides ICE with information that helps the agency locate, arrest, and deport people who are not directly transferred. CalMatters obtained and reviewed more than 27,000 pages of emails between state prison employees and ICE. The emails show prison employees regularly communicate with ICE about individuals in state custody, including U.S. citizens. They often share personal details about their families, visitors, and phone calls. Often, these family members have no criminal records and are U.S. citizens

Newsom, U.S. Senator Alex Padilla, and Speaker Robert Rivas have all denounced ICE’s broader deportation efforts. But all three have also indicated some level of support for having federal immigration officials remove noncitizens with prior convictions for violent crimes from the community.

The governor has stated he would veto legislation that seeks to restrict the state prison system’s ability to coordinate with federal immigration authorities for the deportation of felons.

‘We may be deporting the wrong people’

Goodwin Simon researchers found that voters’ opinions change when they find out more details about the personal circumstances of a noncitizen with a past criminal conviction, even for violent crime. Pollsters gave two narratives to voters.

One was about a man who was brought to the United States from Mexico as a child. He got into a fight in his early 20s that left someone injured. The man was sentenced to seven years in state prison, where he turned his life around by taking college classes and helping other inmates get their high school diplomas. When he got out of prison, he was deported to Mexico before an immigration judge could decide on his case.

The other narrative was about a person closely connected to a man whose family fled genocide in Cambodia when he was a baby. In the U.S., the man was the lookout for a robbery when he was a teenager and served 30 years in state prison. Upon his release, prison officials turned him over to ICE.

“We may be deporting the wrong people. Although this last person did commit a crime, he has served his time and is now a valuable member of society, so it would be hard to say for sure if a person ever committed a crime deserves to be sent back. That is why the due process is important,” one Republican voter from Sacramento responded to the poll. She shifted her opinion from the view that people with past criminal convictions should be automatically deported to favoring a judge reviewing each individual case after hearing the narratives.

After voters reviewed both pro- and anti-messaging and the two stories, support for having an immigration judge review individual cases before deportation increased from 84% to 90% among Democrats; from 61% to 74% among independents, but it dropped from 54% to 51% among Republicans. Central Coast voters and Republican women voters increased support for due process by 9 points after hearing the stories.

The European Union has announced a fine of $140 million against Elon Musk's X, the social media platform formerly known as Twitter, for several failures to comply with rules governing large digital platforms. A European Commission spokesperson said the fine against X's holding company was due to the platform's misleading use of a blue check mark to identify verified users, a poorly functioning advertising repository, and a failure to provide effective data access for researchers.

Europe's preference had not been to fine X, said the spokesperson, Thomas Regnier, as he drew a contrast with the Chinese-owned platform TikTok. Regnier announced Friday that TikTok had separately offered concessions that would allow it to avoid such penalties.

"If you engage constructively with the Commission, we settle cases," Regnier said at a press conference in Brussels. "If you do not, we take action."

The possibility that X would face financial penalties in Europe had drawn significant political fire, not only from Musk but also from others in Washington, D.C., over the past two years since the European Commission began its investigation.

"Rumors swirling that the EU commission will fine X hundreds of millions of dollars for not engaging in censorship," Vice President J.D. Vance wrote on X on Thursday. "The EU should be supporting free speech, not attacking American companies over garbage."

In July 2024, in a set of preliminary findings, the European Commission formally accused X — which serves more than 100 million users within the EU — of several violations. These included its failure to meet transparency mandates, obstructing researchers' access to data and misleading users by converting the blue verification badge into a paid subscription feature.

Musk has long stated his intention to legally challenge any EU sanctions, rather than make concessions to resolve the investigation.

Nonetheless, the company could have faced far higher financial penalties, with European authorities able under new legislation — known as the Digital Services Act — to fine offenders 6% of their worldwide annual revenue, which in this case could have included several other of Musk's companies, including SpaceX.

The fine announcement follows months of accusations from activists and trade experts that authorities in Brussels were deliberately easing up on enforcement to appease U.S. President Donald Trump. Musk was a prominent supporter of Trump's campaign and spent several months this past spring serving as an administration adviser and the public face of the Department of Government Efficiency initiative.

The willingness to take on Musk's business empire could serve as a critical test of the EU's determination, especially in light of Trump's previous threats of tariffs over the bloc's fines against U.S. technology giants.

The confrontation highlights a growing division over the concept of digital sovereignty, which has transformed long-standing allies into competitors as Europe strives to establish itself as the global authority for digital regulation, and the Trump administration pushes back against perceived curbs on U.S. companies' profits and freedom of expression.

So, experts warn, this direct punitive action against Musk's businesses carries the risk of U.S. retaliation, even though the EU remains heavily dependent on American technology for a range of sectors.

The United States is already leveraging some of these concerns about free speech as grounds for denying U.S. visas to certain individuals.

The Trump administration also has consistently argued that the EU unfairly targets U.S. technology companies with severe financial penalties and burdensome regulations, equating these measures to tariffs that justify trade retaliation. Just last week, U.S. Commerce Secretary Howard Lutnick stated that the EU must revise its digital regulations to secure a deal aimed at reducing steel and aluminum tariffs.

The Commission denied again Friday any connection between the trade negotiations with the U.S. and the implementation of its technology rulebooks, any targeting of American firms or any kind of infringement on freedom of expression.

"Our digital legislation has nothing to do with censorship," said Commission spokesperson Regnier. "We adopt the final decision, not targeting anyone, not targeting any company, not targeting any jurisdictions based on their color or their country of origin."

Despite the Trump administration's pressure, the EU has proceeded with the enforcement of its digital antitrust rules, recently imposing fines of $584 million on Apple Inc. and $233 million on Meta Platforms Inc.

It also has issued substantial penalties against other corporations, including over $8 billion total in fines against Alphabet Inc.'s Google over several years and a separate directive for Apple to repay €13 billion in back taxes to Ireland for providing unfair state aid.

Other potentially more serious concerns about X's management of illegal content, election-related misinformation and the utilization of Community Notes have not yet progressed to the preliminary stage in a separate investigation by the European Commission.

It’s only been a month since the federal government shutdown caused the 5.5 million Californians who use CalFresh — the state’s version of the Supplemental Nutrition Assistance Program — to see their payments delayed.

And although payments of SNAP (formerly referred to as food stamps) have restarted, another holiday season is around the corner, putting extra strain on folks who are food insecure in the Bay Area.

One positive development: The CalFresh Fruit and Vegetable EBT Program — a state program offering SNAP recipients up to $60 of free produce each month — has restarted as of November.

The program, which first launched in 2023, is dependent on state-allocated annual funds that are spent until they’re used up, and the 2024 cycle ran out for CalFresh users back in January of this year.

But this year, the program has received an injection of $36 million, which is projected to last until summer 2026.

In previous years, the CalFresh Fruit and Vegetable EBT Program has made “a real, real difference to so many families,” before its funds were used up, said Assemblymember Alex Lee (D-San José), who chairs the state Legislature’s Human Services Committee with oversight of CalFresh policy.

But despite that, he said, “still only a small percentage of all CalFresh-eligible families are using it.”

While only six stores in the Bay Area are participating in the program right now — almost all of them in the South Bay — anyone receiving CalFresh benefits can automatically receive $60 worth of fresh produce each month if they’re able to reach one of these locations.

Keep reading for how the CalFresh Fruit and Vegetable EBT Program works, where it’s available and how to redeem your money in-store.

And if you don’t need this information yourself right now, consider sharing it with someone else who might: “One in five Californians suffer from food insecurity,” Lee said. “So statistically speaking, you are, or you know someone who is struggling with food.”

Can anyone on CalFresh use the CalFresh Fruit and Vegetable EBT Program?

Yes: If you receive any CalFresh (SNAP) benefits, you have automatic access to the CalFresh Fruit and Vegetable EBT Program at participating stores (see below).

You don’t need to apply for anything, as your EBT card itself is your proof of eligibility.

Can I use the CalFresh Fruit and Vegetable EBT Program in any store that accepts EBT?

No: You’ll need to visit one of the specific stores participating in the program.

In the Bay Area, almost all of these stores are in Santa Clara County:

• Santa Fe Foods, 860 White Road, San José
• Arteaga’s Food Center, 204 Willow St., San José
• Arteaga’s Food Center, 1003 Lincoln Ave., San José
• Arteaga’s Food Center, 2620 Alum Rock Ave., San José
• Arteaga’s Food Center, 6906 Automall Pkwy., Gilroy

In Alameda County, you can use the program at:

• Santa Fe Foods, 7356 Thornton Ave., Newark

There are also participating stores in Monterey and Salinas counties, and several in the Los Angeles area. See a full list of grocery stores participating in the CalFresh Fruit and Vegetable EBT Program.

How do I use the CalFresh Fruit and Vegetable EBT Program in the store?

First, make sure you’re in one of the stores participating in the program — mistakes can happen — and that you’ve brought your EBT card with you.

Next, do your shopping as normal, and pick up fresh fruits and vegetables as part of your trip. You don’t have to separate the produce or pay for it in a different transaction.

At the register, tell the cashier you’d like to use your EBT card to pay for your shopping, like you usually would. When it comes to the fresh fruits and vegetables in your cart, you’ll initially see the costs of those particular items come off your EBT funds — but then those funds will be immediately returned, making that produce effectively free at the register.

Another way of seeing it: If your cart amounts to $15 of EBT-eligible food, including $5 of produce, you’ll initially see $15 debited from your card on the screen — but then you’ll see the instant rebate of $5 for your produce, meaning your final receipt will only be $10.

“People don’t have to enroll and do anything different; they don’t have to keep track of some paper coupon or some other card,” said Eli Zigas, executive director of Fullwell: the Bay Area nonprofit advocacy organization partnering with the state to administer the program this year.

“It’s all built into the EBT card at the participating locations,” he said.

And while you can get these instant rebates for up to $60 worth of produce each month, remember: You don’t have to “spend” that $60 up in one transaction. Your EBT will automatically keep track of your produce purchases and just stop issuing the instant rebates once you’ve hit that $60 cap for the month.

Does the amount of produce I can buy using the CalFresh Fruit and Vegetable EBT Program depend on how much I’m receiving in CalFresh benefits?

No: Every CalFresh household can get up to $60 of free fresh fruits and vegetables with their EBT card, regardless of the amount of benefits they receive. It’s a flat amount for all SNAP users in the state.

My EBT balance is at $0 right now. Can I still use the CalFresh Fruit and Vegetable EBT Program?

No: To get the instant rebate on money spent on fresh fruit and vegetables, you’ll first need to actually spend those funds using your EBT card — even though you’ll immediately get the money back onto that card.

If you don’t have any money on your EBT card available, you’ll have to wait until your CalFresh funds are reloaded next month to be able to use the program again. But remember that if your EBT funds are running low, you can still spend a smaller amount — or whatever’s available on your card — on fresh fruit and vegetables and receive the money back instantly, until you’ve maxed out that $60-per-month cap.

Is there a deadline to use the CalFresh Fruit and Vegetable EBT Program?

The $36 million approved in the most recent state budget by the California legislature and Gov. Gavin Newsom for the CalFresh Fruit and Vegetable EBT Program “is three and a half times more money than this program has ever had previously for an annual cycle,” Zigas said.

In previous years, Lee said, the funding would last for different periods “because the program was so wildly successful and oversubscribed that it would run out for a while.”

So what about 2026? “We estimate, based on previous usage, that the program will have funds to run through the summer,” Zigas said.

But after summer arrives, Zigas said, “it’s all going to depend on what the usage is, and whether there’s renewed funding.” So while you still have many months to try the program, you shouldn’t wait too long — not least because each month that passes will bring another $60 for you to spend on produce.

In the wake of the SNAP delays caused by the government shutdown, “I think people have seen recently more than ever before how important CalFresh is and how much people are struggling to put food on the table,” Zigas said. “We would love to see this program not only operate continuously all year long without interruption, but also expand — because it’s a limited number of grocery stores right now offering this program, and it could be so much bigger.”

Is the CalFresh Fruit and Vegetable EBT Program the same as Market Match, and can I use both?

Market Match is a statewide program that distributes funds to farmers’ markets across California, allowing people using CalFresh to “match” an amount of their choosing from their EBT card at the market with tokens to spend at that location — essentially doubling their funds.

Market Match is a separate state program from the CalFresh Fruit and Vegetable EBT Program, but people on CalFresh can use both programs.

Learn more about the Market Match program, and watch KQED’s video on how to use your EBT card at your local market.

Why does the CalFresh Fruit and Vegetable EBT Program focus on fresh produce specifically?

The program’s focus on fresh fruit and vegetables “is recognizing that CalFresh benefits, as good as they are, are often insufficient for people to afford the food that they want for their families,” Zigas said.

This is especially true of fresh fruits and vegetables, he said, “which are harder to justify buying when you have less income because they’re not shelf stable, and you don’t know if your kids are necessarily going to like them.

“People would like to buy fresh fruits and vegetables, and often just don’t feel like they can make that choice — or afford it,” he said.

There isn’t a ton of research into the effectiveness of making people prove they have jobs in order to access social services. But what evidence there is points in one direction: Placing work requirements on programs like Medicaid does almost nothing to increase employment or hours worked, while actively hurting people in need.

With roughly 15 million Californians relying on Medi-Cal, the state’s version of Medicaid, for their health coverage, the Golden State is staring that grim truth in the face.

A significant part of Congress’ so-called Big Beautiful Bill’s takedown of Medicaid funding revolves around forcing people to show that they’re working 80 hours each month before they can receive benefits. And with about a year left until that requirement takes effect, California policymakers are scrambling to mitigate its most toxic effects — even if they are legally required to implement the broader law.

“At the end of the day, there’s not a full workaround,” said Hannah Orbach-Mandel, a policy analyst at the nonpartisan California Budget & Policy Center. “But I do believe there are some ways that California can try to be a little creative about how the law is implemented, and people are looking into that now.”

Those possibilities include using California’s relatively high minimum wage ($16.90 an hour in 2026) to propose substituting income earned for hours worked under the new Medicaid rules, along with ways to streamline what is likely to be a nightmarish bureaucratic task of recording and verifying the information the federal government is demanding.

The stakes are certainly high enough. According to Gov. Gavin Newsom’s administration, as many as 3 million Californians could be thrown off Medi-Cal based on the work requirement alone — a significant portion of the many millions of Americans across the country who face a similar fate. While the actual numbers will rise or fall depending upon how the requirements are implemented, the resulting strain on California’s health care system from fewer patients and more unreimbursed care could buckle it.

The work requirement derives from a generations-old Republican talking point that most people on public assistance could be working, but are either too lazy or unmotivated to do so. Research has disproven that theory repeatedly.

As of 2023, nearly two-thirds of all adults aged 19-64 on Medicaid were working full-time or part-time, according to the health policy research site KFF, formerly the Kaiser Family Foundation. Among the remainder who weren’t working, the vast majority fell into one of three categories: sick or disabled, caregiving for another person or attending school. All of those groups receive exemptions to the work requirement in the new law.

It’s no surprise, then, that the Congressional Budget Office has already said implementing work requirements for Medicaid recipients won’t move the needle on employment. During debate on a 2023 Medicaid bill, the CBO concluded that “the employment status of, and hours worked by, Medicaid recipients would be unchanged” by work requirements.

A couple of states have tried such restrictions themselves, with disastrous consequences. In the first seven months after Arkansas implemented work requirements in 2018, for example, roughly 18,000 people lost their Medicaid coverage — most of them, state officials said, not because they didn’t qualify, but because they either didn’t understand the new rules or couldn’t navigate the maze of administrative details and gave up, losing their health care access in the process.

Meanwhile, there was no notable improvement to the state’s employment numbers or to its total number of hours worked, a finding that has been confirmed by more recent research. The Arkansas requirements were halted in 2019 by a federal judge who ruled the program did not meet the objectives of the Medicaid program.

Nevertheless, Republicans enshrined such requirements nationally in H.R. 1 this year, and they are set to go into effect Jan. 1, 2027. They also further mandated that Medicaid recipients repeat the qualification process twice each year. The budget reconciliation bill says that those in the Medicaid expansion group between the age of 19 and 64 must show that they’re either working, going to school, in job training or doing community service at least 80 hours a month in order to stay eligible.

Those rules will chase people off Medicaid, which could increase death rates and lead to severe financial trouble. Many of those people, Orbach-Mandel says, will still fully qualify to receive benefits, but they either won’t know it or will get lost in red tape.

In California, 3 million people suddenly losing their health coverage means they’ll likely have no health insurance and no access to regular care, and will instead wait to see a doctor until they need to go to the emergency room — the one place where they know they cannot be denied care even if they can’t pay.

It all adds up to a massive new strain on an already overburdened health care system.

“That burden ends up falling on a lot of hospitals, like safety-net facilities,” Orbach-Mandel said. Many of those hospitals are already struggling to survive financially. The combination of fewer Medi-Cal patients and higher unreimbursed emergency room costs could drive them to discontinue certain services or face possible closure, as hospitals in Willows and Inyo County recently have discussed.

The Medicaid takedown is an almost perfectly Trumpian gambit: It helps to finance massive tax cuts for the nation’s richest individuals at the expense of some of the most vulnerable Americans, many of whom voted for Donald Trump. Republicans championed the work requirements mostly as a way to kick people off Medicaid.

That they will do — an estimated 6.3 million nationally, though some estimates run many multiples higher than that. California’s total may run higher or lower than the Newsom administration’s 3 million estimate as well, in part because there is no guidance yet on how the requirements are to be administered or monitored.

Orbach-Mandel said the state is ultimately responsible for gathering and producing the relevant documentation. Much of that work will be farmed out to California’s cash-strapped counties that could be saddled with building out the verification process.

Clarifying how that process should work is one way the state could ease some of the administrative effects of the new requirements. In terms of keeping more people eligible for Medi-Cal, the state’s minimum wage may come into play.

Orbach-Mandel said that one idea being tossed around is using the statewide minimum wage in a calculation of what California workers’ output is actually worth. Since that wage is higher than most other states and way above the national minimum of $7.25 per hour, California might argue that its Medicaid enrollees can prove a certain amount of earnings, rather than have to document the 80-hour work requirement.

Since federal implementation guidelines are still lacking, no one is certain what the final rules will be. It’s also possible that Congress ultimately postpones the start of the program, especially given Trump’s miserable approval numbers — and the fact that his approach to health care is the lowest-rated component of those.

Put simply, Trump’s coattails aren’t what they used to be. The Medicaid work requirements are looming, yes — but for many of the president’s longtime Republican loyalists in Congress, the 2026 midterms are going to happen first.

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