California’s budget crisis will hit about 380,000 seniors and disabled people in the state’s Medi-Cal program today when they will be required to begin enrolling in a managed health care plan to receive care. The change, which involves Medi-Cal patients in San Francisco and 15 other counties, is not intended to affect the level of care these people receive but could limit their choice of doctors. Some advocates are concerned that it could cause disruptions in care. “Consumer advocates have been worried from the beginning about the capacity of these plans to serve the needs of people with severe health conditions,” said Elizabeth Landsberg, director of legislative advocacy for the Western Center on Law and Poverty. The policy change is an effort to save the state money and is part of a deal with the federal government to make California eligible for $10 billion in federal money over the next five years. The funds will be used for public hospitals and to expand local health programs.