NEWS: Sen. Schiff Demands Health Net Restore Coverage for Thousands in CA Depending on Assisted Living Care, Warns of Health Implications

Washington, D.C. - Today, U.S. Senator Adam Schiff (D-Calif.) is urging Health Net, one of the largest Medicaid plans in California, to reverse its termination of assisted living coverage for 3,000 Californians, jeopardizing access to housing and essential care services.

"The sudden loss of assisted living benefits could have potentially devastating repercussions for enrollees and their family members. I urge Health Net to reconsider this coverage termination," Senator Schiff said to Interim CEO at Health Net Eric Schmacker in a new letter.

The Senator emphasized that millions of Californians are already facing significant uncertainty about accessing medical care in the aftermath of the largest Medicaid cut in U.S. history by this Republican-led Congress. Additionally, Schiff warned that forcing thousands to pay out of pocket for assisted living services will be a heavy burden on these patients and their family members.

"Very few families have the capacity to provide full-time care, imposing undue financial, physical, and emotional strain on loved ones. Sadly, others have no family or support systems to rely on at all. With such limited alternatives, the risk of sudden coverage loss could be catastrophic," the Senator wrote.

"I am deeply concerned that Health Net's coverage termination of Medi-Cal assisted living benefits will compound the damage caused by the cuts to Medicaid programs across the country. While California's health care safety net faces extraordinary strain, we must work together to mitigate coverage loss and help Medi-Cal beneficiaries access the care and support they need," the Senator concluded.

The full text of the letter can be found here and below.

Dear Mr. Schmacker,

I write to you today with deep concerns regarding Health Net's decision to terminate Medi-Cal coverage of Assisted Living Facility Transitions (ALFT) and Personal Care Homemaker Services (PCHS) Community Support benefits, impacting approximately 3,000 Californians enrolled in Health Net plans. The sudden loss of assisted living benefits could have potentially devastating repercussions for enrollees and their family members. I urge Health Net to reconsider this coverage termination and ensure each of these enrollees maintain access to assisted living care.

Assisted living benefits provide an important alternative to institutional care. In California, thousands of Medi-Cal enrollees rely on these benefits to manage basic day-to-day needs, such as meal preparation, medication management, bathing, dressing, and mobility. Losing plan coverage of such vital services leaves very few alternatives for access to care. For a vast majority of these Medi-Cal enrollees, paying for assisted living services out-of-pocket - which can cost as much as $7,000 each month - is not feasible. But enrollees are not the only ones affected by this coverage termination - without access to professional support, family members are often left to fill the caregiver role. At the same time, very few families have the capacity to provide full-time care, imposing undue financial, physical, and emotional strain on loved ones. Sadly, others have no family or support systems to rely on at all. With such limited alternatives, the risk of sudden coverage loss could be catastrophic.

I am particularly concerned that Health Net's decision to terminate assisted living coverage comes at a time when Californians are already facing significant uncertainty about accessing care. Last year, the Trump administration and Congressional Republicans enacted the largest cut to health care in American history, with many of these devastating cuts set to take effect on January 1, 2027. I am deeply concerned that Health Net's coverage termination of Medi-Cal assisted living benefits will compound the damage caused by the cuts to Medicaid programs across the country. While California's health care safety net faces extraordinary strain, we must work together to mitigate coverage loss and help Medi-Cal beneficiaries access the care and support they need.

I urge Health Net to reconsider the decision to terminate coverage of Assisted Living Facility Transitions and Personal Care Homemaker Services Community Support benefits and work with DHCS to ensure continuity of care for these Medi-Cal enrollees. Thank you for your attention to this important matter.

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