Sacramento County Projects 73,000 to Lose Medi-Cal Coverage Next Year — Patient Surge Signal for Sacramento FQHCs
Sacramento County DHHS estimates 73,000 residents will lose Medi-Cal coverage in the next 12 months due to H.R. 1-driven eligibility changes (six-month redeterminations by Dec 31, 2026), the new $30/mo UIS premium starting July 2027, and the federal admin match cut from 50% to 25% (Oct 2026).
Direct implication for Sacramento's 11 FQHCs (2,196 staff, 319K patients): a meaningful share of the 73K disenrolled will keep showing up for care, but as uninsured rather than Medi-Cal — increasing uncompensated care exposure. Most affected: WellSpace Health (largest BH+primary care footprint), Sacramento Native American Health Center, One Community Health (HIV-focused), Elica Health Centers, and The Effort.
Strategic implications:
- update FY26-27 charity care budget assumptions
- accelerate patient outreach for redetermination support
- negotiate MCP capitation rates that reflect rising churn
- consider Sliding Fee Scale rate adjustments.
The May Revise (mid-May) is the next state-level signal for whether the county estimate will hold or worsen.
Key takeaways
- 73,000 Sacramento residents projected to lose Medi-Cal in next 12 months
- Disenrolled patients still show up — uncompensated care exposure rises
- WellSpace, SNAHC, OCH, Elica, The Effort = Sacramento FQHCs most at risk
- Update FY26-27 charity care budget + accelerate redetermination outreach
Primary source
ABC10 Sacramento / Sacramento County DHHSAffected FQHCs
FQHC Talent. (2026, May 4). Sacramento County Projects 73,000 to Lose Medi-Cal Coverage Next Year — Patient Surge Signal for Sacramento FQHCs. Primary source: ABC10 Sacramento / Sacramento County DHHS. Retrieved June 28, 2026, from https://www.fqhctalent.com/intel/sacramento-county-73k-medi-cal-disenrollment-projection-may-2026
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