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San Francisco Health Commission hears warning of large federal and state Medicaid cuts, local impacts uncertain
Summary
Deputy Director Naveena Baba told the Health Commission that recent federal reconciliation legislation and the state budget will reduce Medicaid funding and eligibility in stages beginning in 2026, potentially shrinking coverage and shifting costs to local providers and the city.
At a San Francisco Health Commission meeting, Deputy Director Naveena Baba of the Department of Public Health briefed commissioners on recent federal and state budget actions she said will shrink Medicaid coverage and change payment rules, with effects beginning as early as 2026.
"These are the most significant cuts that Medicaid has faced since its inception," Baba told the commission, summarizing the federal reconciliation bill and the California budget actions she has reviewed. She said the department is still completing fiscal analysis and will return with more precise local estimates.
Baba outlined a multi-year timeline the department expects based on current federal and state proposals and passage to date. Among the items she described: a January 2026 state restriction that would freeze Medi‑Cal enrollment for adults 19 and older with what the…
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