California’s Medi‑Cal expanded coverage effective Nov. 1 to include tumor‑informed minimal residual disease (MRD) testing, whole‑genome sequencing (WGS) for rare‑disease diagnosis, and additional genome‑wide cytogenomic tests. The state bulletin lists specific CPT codes and frequency limits and applies benefits to millions of Medi‑Cal enrollees. Covered MRD testing is noted as personalized, tumor‑informed plasma assays reported as presence/absence with disease‑burden correlation when appropriate. Medi‑Cal previously led with newborn rapid WGS coverage and now broadens genomic access for cancer and rare disease diagnosis under Medicaid. The policy expands payer access to high‑sensitivity molecular diagnostics and could shift demand profiles for labs and diagnostic vendors serving the state’s large Medicaid population.