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San Francisco DPH projects hundreds of millions in losses from H.R.1 and state budget changes; lays out mitigation steps
Summary
DPH warned the Health Commission that H.R.1 and recent state budget changes could reduce Medi-Cal funding and state-directed payments, projecting $300M+ near-term impacts and up to $400M annually by 2037'38; the department described outreach, automation and local mitigation options but said localities cannot fully absorb the cuts.
Tangerine Brigham, deputy director and chief operating officer for the Health Network at the San Francisco Department of Public Health, told the commission the combined effects of federal H.R.1 provisions and state budget changes pose significant fiscal threats to Medi-Cal-dependent services and to food-security programs such as CalFresh.
"This is devastating," Brigham said, summarizing the policy changes she described as reducing eligibility and federal participation, introducing more frequent redeterminations, and narrowing reimbursement avenues. DPH projected an estimated $300,000,000 impact in fiscal year 2027'28 and said the number could rise toward $400,000,000 annually by 2037'38…
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