Big changes are coming for California caregivers in 2026.
From higher wages and new eligibility rules to updates in Medi-Cal and federal Medicaid requirements, this year brings a mix of opportunities and adjustments that could affect how you care for a loved one—or how you receive care yourself.
Here’s a break down the most important updates in plain language so you can understand exactly what they mean for you and your family.
Stronger Paid Family Leave Benefits
California’s Paid Family Leave (PFL) program isn’t seeing major overhauls in 2026, but recent improvements may make it more valuable for caregivers than ever.
Wage replacement rates remain higher thanks to prior updates—up to 90% of wages for lower-income workers and about 70% for higher earners. The maximum weekly benefit increases to approximately $1,765 in 2026, giving caregivers stronger financial support when they need time away from work.
A key new protection takes effect January 1, 2026: expanded job restoration rights. Employers with 25 or more workers must now reinstate employees returning from PFL—even if they didn’t formally apply for state benefits.
What this means:
Caregivers have more income protection—and stronger job security—when stepping away from work to care for loved ones.
Financial & Wage Changes
IHSS Wages Are Going Up
One of the most noticeable changes in 2026 is higher pay for In-Home Supportive Services (IHSS) providers.
Many California counties have negotiated wage increases that take effect January 1, 2026. For example, in Los Angeles County, IHSS wages are rising by $1.14 per hour, bringing the base rate to $19.64. Across the state, IHSS pay is moving toward a $20-per-hour floor.
What this means for families:
Higher wages can help attract and retain reliable in-home caregivers—something many families desperately need. Better pay often leads to more stability, less turnover, and stronger relationships between caregivers and care recipients.
If you hire private caregivers outside of IHSS, you may also notice wages increasing in the broader home care market as pay standards continue to rise.
Medi-Cal Asset Limits Are Coming Back
This change is especially important for older adults and people who rely on Medi-Cal.
In 2024, California eliminated asset limits for many Medi-Cal programs. But starting January 1, 2026, asset limits are being reinstated for certain non-expansion Medi-Cal programs:
- $130,000 for individuals
- $195,000 for couples
What this means for families:
Some people who qualified for Medi-Cal over the last two years may need to re-evaluate their eligibility. Savings, investments, or other countable assets could once again affect access to benefits.
If you or a loved one rely on Medi-Cal to pay for long-term care or medical services, it may be wise to talk with a benefits counselor or legal professional to plan ahead.
New Flexibility with Health Savings Accounts (HSAs)
Beginning in 2026, Bronze and catastrophic health plans through Covered California will count as high-deductible health plans. That means enrollees can use Health Savings Accounts (HSAs) to pay for direct primary care fees.
Why this matters:
For caregivers managing ongoing medical expenses, HSAs can be a helpful, tax-advantaged way to cover out-of-pocket costs. It’s one more tool families can use to stretch healthcare dollars a little further.
Expanded Rights for Family Caregivers
The Family Preparedness Act Brings More Flexibility
One of the most caregiver-friendly changes this year is the expansion of the Family Preparedness Act (AB 495).
Starting January 1, 2026, California is broadening who counts as a “relative” for caregiver authorization affidavits. The definition now includes adults within the fifth degree of kinship—such as great-aunts, great-uncles, and cousins.
What this means in real life:
More extended family members can now legally authorize medical care and school enrollment for a minor who is living with them.
This is a big win for grandparents, aunts, uncles, and other relatives who step in to care for children when parents are unavailable. It reduces paperwork hurdles and better reflects the way caregiving actually happens in many families.
Eligibility & Service Updates
CARE Act Eligibility Is Expanding
California’s CARE Act program, which helps connect people with serious mental health needs to treatment and services, is expanding in 2026.
Beginning January 1, individuals with bipolar I disorder with psychotic features will now be eligible to participate.
What this means for caregivers:
More families caring for loved ones with complex mental health conditions may be able to access structured support, treatment plans, and court-supervised assistance. For caregivers in crisis situations, this expansion could open important new doors.
Changes Affecting Immigration Status and Enrollment
Another significant update in 2026 involves Medi-Cal and IHSS enrollment rules.
Beginning January 1, new applicants aged 19 and older with “unsatisfactory immigration status” will face an enrollment freeze for full-scope Medi-Cal and IHSS services. Importantly, current enrollees are not affected.
What this means:
Families who may be impacted should pay close attention to application timing and seek guidance from trusted community organizations or legal aid providers.
Federal Change: Medicaid Work Requirements
In addition to California-specific updates, a major federal change is also on the horizon.
A new federal law introduces Medicaid “community engagement” (work) requirements for adults ages 19 to 64 who receive Medicaid through expansion programs.
Under these rules, many beneficiaries will need to complete at least 80 hours per month of work, training, or other qualifying activities to keep coverage. States have until January 1, 2027, to put these requirements into place.
Here’s the part caregivers need to know most: Family caregivers are exempt from these work requirements. If you are caring for a child under age 13, or a person with a disability of any age, you should not be required to meet the 80-hour monthly work threshold to keep your Medicaid coverage.
But there’s a catch: While caregivers are protected, they will still need to verify that they qualify for the exemption.
That means paperwork, documentation, and possibly new forms to complete when enrolling or renewing Medicaid benefits.
What this means for caregivers:
It will be important to keep clear records that show your caregiving role—such as IHSS paperwork, medical documents, or other proof that you provide regular care to a qualifying individual.
More detailed guidance from California agencies is expected as the federal rules are rolled out.
What Caregivers Should Do Now
With so many changes ahead, a little preparation can go a long way. Here are a few practical steps you can take:
- Check IHSS wage updates in your county so you know what to expect
- Review Medi-Cal eligibility in light of the returning asset limits
- If you rely on Medicaid, make sure you understand the caregiver exemption and gather any needed documentation
- Pay attention to notices from Medi-Cal or your health plan
- Reach out for benefits counseling if you’re unsure how these changes affect your family
Staying informed now can help prevent surprises later.
The Bottom Line
Caregiving is challenging enough without having to keep up with shifting laws and policies.
While 2026 brings a lot of changes, many of them are designed to strengthen the caregiving system—through better pay, clearer rules, and expanded support for families.
The key is knowing what’s coming and understanding how it applies to your unique situation.
And remember: you don’t have to figure it all out alone. Trusted California Caregiver Resource Centers are here to help you navigate these updates every step of the way.
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