California’s next governor will face destabilizing surge in uninsured

September 9, 2026 - 03:11

If the current polls hold and Xavier Becerra wins the governor's race this November, he will step into office during what could be the sharpest drop in health coverage the state has seen in years. The problem is not a sudden policy failure but a slow-building wave that is about to crash. For the first time since the Affordable Care Act expanded Medi-Cal, the state is set to see a major reversal in its uninsured rate.

The main driver is the end of a federal rule that kept millions of people enrolled in Medi-Cal without annual checks during the public health emergency. That rule expired last year, and since then, California has been reviewing eligibility for every person on the program. The result has been a massive purge. Hundreds of thousands of people have already lost coverage, often not because they no longer qualify, but because they missed a renewal letter or could not navigate the paperwork. Many of them are children, working parents, or people with chronic conditions who simply fell through the cracks.

Becerra, who built his national reputation as a defender of the Affordable Care Act while serving as U.S. Health and Human Services Secretary, will have to act fast. The state budget is tight, and the federal government is not offering the same emergency flexibilities it did during the pandemic. Without quick fixes, the uninsured rate could climb by over a million people by next year. That would strain emergency rooms, push more families into debt, and widen the health gap between rich and poor communities.

The next governor will also have to deal with rising costs for private insurance and a shortage of doctors in rural areas. Becerra has said he wants to expand coverage, but he will need to find new revenue and simplify the renewal process to stop the bleeding. Voters may have chosen him for his record, but the real test will be whether he can keep people from losing their health care before they even see a doctor.