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Funding & Budget

Contra Costa Health projects a $730 million five-year deficit

Contra Costa CountyMore from California

Issue

California county safety-net budgetsWatching

Next: · Staff report back to the Board on the Community Services Agency deficit and position cuts

Contra Costa Health told county supervisors on August 25, 2026 that it projects a $730 million structural deficit through FY2030-31. The largest piece is $350 million lost when people without confirmed immigration status lose managed Medi-Cal on January 1, 2027.

Its county hospital and 11 clinics, which serve 1 in 5 residents for primary care, take the biggest hit.

Key points

  • The 2026-27 gap fell from $80 million to $10 million, and the department says closing the projected $730 million gap needs state and federal changes.
  • On January 1, 2027, people without confirmed immigration status lose managed Medi-Cal ($350 million) and about 47,500 members move to fee-for-service Medi-Cal ($100 million).
  • The recommended path for the county hospital is multi-specialty growth; closing the hospital was presented as one of four options.

Sources for this story

Contra Costa Health, Fiscal Update presentation to the Contra Costa County Board of Supervisors (August 25, 2026, agenda item 26-3725); Board meeting minutes

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Contra Costa Health

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Cite this analysis

FQHC Talent. (2026, August 25). Contra Costa Health projects a $730 million five-year deficit. Source: Contra Costa Health, Fiscal Update presentation to the Contra Costa County Board of Supervisors (August 25, 2026, agenda item 26-3725); Board meeting minutes. Retrieved November 11, 2026, from https://www.fqhctalent.com/intel/contra-costa-health-730m-structural-deficit-2031-august-2026