H.R. 1 Caps Medi-Cal Directed Payments — Provider Rates Will Edge Toward Medicare Levels by 2028

A distinct revenue threat beyond PPS elimination: H.R. 1 caps state-directed payments, ending California's ability to direct managed care plans to pay providers at commercial insurance rates. Provider rates will edge toward Medicare levels starting 2028. While FQHCs have PPS protection for base rates, supplemental/wrap payments through managed care plans will be affected. CHCF analysis details how the provider tax crackdown and directed payment restrictions will reduce overall Medi-Cal funding flowing to FQHCs through managed care.