HR 1 would sharply change Medi‑Cal eligibility and financing, state officials and providers say

Senate and Assembly health committees heard July 2025 testimony that HR 1, the newly enacted federal law, would make sweeping changes to California's Medi‑Cal program by restricting eligibility, imposing new work and redetermination requirements, limiting financing tools for providers and cutting federal matching payments.

Department of Health Care Services Director Michelle Boss said Medi‑Cal "serves nearly 15,000,000 Californians, roughly 35% of the state," and described HR 1's combined provisions as placing "tens of billions of dollars" of federal funding at risk and creating a real prospect that millions could lose coverage. Boss spoke at the hearing's first panel on state implementation and finance.

Why it matters: Medi‑Cal is the state's largest health program for low‑income residents and finances a large share of care across hospitals, clinics and community health centers. Witnesses warned that funding and eligibility changes would increase uninsured rates, worsen hospital finances and trigger service reductions — particularly in rural and safety‑net facilities.

Key provisions described at the hearing

- Work requirements: HR 1 requires states to condition eligibility for adults ages 19–64 on meeting 80 hours of qualifying activities in a month within each six‑month period, beginning Jan. 1, 2027, unless exemptions or delay requests are approved. Director Boss said the department estimates the change could…