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 (1) elevated uncompensated-care projections, (2) sliding-scale fee schedule capacity reviews, (3) Medi-Cal redetermination case management staffing models, (4) advocacy alignment with CPCA/CCALAC behind whichever option the Legislature prioritizes. Pairs with the Durazo Medi-Cal restoration bill and SB 1422 already tracked.