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California Dept. of Health Care Services (DHCS)
Since 2007· Agency
Law or rule (2026)Set by statute, regulation or the agency; numbers change yearly.
The California department that runs Medi-Cal, the state's Medicaid program, with federal oversight and funding through CMS.
See it on the Personal Finance & Estate map →How it works
Formed in 2007 when California split its old Department of Health Services, DHCS runs Medi-Cal for about 15 million people, over a third of the state, through managed-care plans and county eligibility offices. It sets eligibility rules, including the asset test reinstated in 2026 for older and disabled applicants, pays for nursing homes and in-home care, and runs estate recovery after a member dies. Medi-Cal's budget nears $200 billion a year, more than half from federal funds.
Why it matters for you
Medi-Cal is California's main payer for long-term care, so DHCS rules on assets, transfers and estate recovery shape how families plan for aging parents. Ask an elder-law attorney before moving assets.
Rules, limits and sources (2026)
DHCS publishes monthly enrollment and budget data; Medi-Cal rules sit in the Welfare and Institutions Code and federal Medicaid law, Title XIX of the Social Security Act.
Watch out for
Whether the reinstated asset test saves as much as projected, or mostly adds paperwork and pushes families toward planning workarounds, is debated.
Connections (2)
▸California Dept. of Health Care Services (DHCS) runs Medi-Cal with funding via Centers for Medicare & Medicaid Services (CMS)Law or rule (2026)
How they connect
Medicaid is a federal-state partnership: CMS sets minimum rules, approves California's state plan and waivers, and pays a share of costs, about half for most enrollees and 90% for adults added by the ACA expansion. DHCS designs the details, contracts with managed-care plans and counties, and answers to CMS audits.
When it applies
Medi-Cal began in 1966 under the 1965 Medicaid law; DHCS took over in 2007, and CMS approved the CalAIM waivers reshaping Medi-Cal in 2021.
The rule
California's Medicaid state plan, Section 1115 waivers and federal matching rates are public on CMS and DHCS websites.
Watch out for
How the 2025 federal law's work requirements, due to start by 2027, and tighter limits on provider taxes will shift costs onto California is still being estimated.
▸Medi-Cal (California's Medicaid) is run by California Dept. of Health Care Services (DHCS)Law or rule (2026)
How they connect
DHCS runs Medi-Cal statewide: it sets eligibility rules, contracts with managed-care plans, pays providers and handles estate recovery. County social services offices take applications and renewals, so families usually deal with the county first. DHCS also runs long-term care programs for seniors, including nursing-home coverage and home-based waivers.
When it applies
Medi-Cal began in 1966; DHCS was formed in 2007 when the old Department of Health Services split in two.
The rule
The Welfare and Institutions Code (Sec. 14000 and following) governs Medi-Cal; DHCS publishes enrollment, which topped 15 million in 2024.
Watch out for
2025–26 budget pressures, from the reinstated asset test to an enrollment freeze for some undocumented adults, leave future eligibility rules in flux.