“The whole concept of Medi-Cal is that it’s a safety net program,” said Dietz. “Freezing people out and preventing new enrollment means that it can’t serve that function. And if people can’t navigate the bureaucratic hurdles of redetermination, they won’t be able to get back in.”

Fresno County could feel more of a pinch if lawmakers in Washington approve cuts to Medicaid to make room for tax cuts President Donald Trump is trying to usher in.