CalOptima & IEHP Project 30% Membership Drops by 2028 — Managed Care Revenue Cliff for FQHCs

California's two largest county-organized Medi-Cal plans are projecting catastrophic enrollment losses. CalOptima (Orange County) forecasts losing 650,000 of its 2.2M members by 2028 — a 30% drop.

IEHP (Inland Empire) — one of the nation's ten largest Medicaid plans — projects a similar 650,000-member loss from its 2.5M membership by 2028 (the same reporting cites ~300,000 members in the nearer term). Combined, 1.3 million managed care members could lose coverage across just two plans.

This is orders of magnitude beyond the initial 8% drops reported in early March. FQHCs dependent on managed care reimbursement face a compounding revenue crisis as their largest payers shrink.