California Proposes $222.4B Medi-Cal Budget — Must Absorb $1.1B+ in Federal Medicaid Shortfalls
California's proposed 2026–27 budget includes $222.4 billion for Medi-Cal, requiring the state to absorb over $1.1 billion in federal Medicaid funding losses from H.R. 1.
The Legislative Analyst's Office warns that federal FMAP sunsetting, enrollment verification requirements, and UIS benefit restrictions compound to create a multi-billion-dollar structural gap by 2028. Budget negotiations will determine whether FQHC supplemental payments, ECM funding, and community health worker billing survive or face further cuts.
Key takeaways
- CA proposed 2026-27 budget: $222.4B for Medi-Cal, absorbing $1.1B+ in federal losses
- LAO warns: FMAP sunsetting + enrollment verification + UIS restrictions = multi-billion gap by 2028
- Budget negotiations will determine survival of FQHC supplemental payments, ECM funding, and CHW billing
Primary source
CA Legislative Analyst's OfficeSource packet
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FQHC Talent. (2026, March 10). California Proposes $222.4B Medi-Cal Budget — Must Absorb $1.1B+ in Federal Medicaid Shortfalls. Primary source: CA Legislative Analyst's Office. Retrieved July 28, 2026, from https://www.fqhctalent.com/intel/ca-budget-222b-medi-cal-2026-27
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