CHCF: Up to 2M Californians Could Lose Medi-Cal — State Policy Alternatives Modeled at $3.1B–$6.7B/yr
California Health Care Foundation released (April 29, 2026) a major analysis modeling state-level coverage alternatives for the up-to-2-million Californians projected to lose Medi-Cal coverage from H.R. 1 work mandates, 6-month redetermination cycles, and immigrant restrictions.
CHCF models two illustrative state options at $3.1B–$4.6B/yr versus $6.7B/yr for full Medi-Cal-equivalent replacement. The analysis frames the policy debate Sacramento will run through 2027 and intersects directly with the May 14 May Revision: if the Newsom Revise tightens UIS or freezes safety-net programs, the $3.1B–$6.7B coverage gap moves from the modeling stage into legislative session priorities.
Strategic implication for FQHC executives: 2M uninsured falls disproportionately on FQHCs as providers of last resort.
Annual financial planning should now incorporate
Pairs with the Durazo Medi-Cal restoration bill and SB 1422 already tracked.
Key takeaways
- Up to 2M Californians projected to lose Medi-Cal — disproportionate FQHC absorption
- State alternatives priced at $3.1B–$4.6B/yr versus $6.7B/yr full equivalent
- May 14 Revise determines whether modeling moves to legislative session
- Build uncompensated-care, sliding-scale, redetermination CM into FY26-27 plans
Linked evidence
California Health Care FoundationSource packet
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FQHC Talent. (2026, April 29). CHCF: Up to 2M Californians Could Lose Medi-Cal — State Policy Alternatives Modeled at $3.1B–$6.7B/yr. Linked evidence: California Health Care Foundation. Retrieved September 20, 2026, from https://www.fqhctalent.com/intel/chcf-new-uninsured-state-policy-options-april-29-2026
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