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County staff present enrollment counts and options as eligibility changes take effect
Summary
County presenters and partners provided counts of residents affected by eligibility changes (51,200; 74,000; 57,600; 10,600) and warned that HealthPAC and clinic reimbursement shortfalls could force tough program decisions if state/federal changes proceed without mitigation.
County analysts and provider advocates outlined the county’s current caseloads and potential exposures as HR 1‑related rules and the governor’s budget phase in.
Juan Matanea (Social Services Agency) gave detailed county counts: an estimated 51,200 individuals enrolled into full‑scope Medi‑Cal as a result of recent expansions (19–49 and older adult) who could be affected by the Jan. 1 enrollment freeze for adults with unsatisfactory immigration status; about 74,000 people currently enrolled who would lose dental benefits on July 1, 2026 under the state budget changes; approximately 10,600 individuals who would be affected by the Oct. 1, 2026 redefinition of "qualified non‑citizen" status; and an estimated 57,600 adults (19–59) who could face a $30 monthly premium beginning July 2027. Matanea emphasized the county is monitoring demographic breakdowns by supervisorial district and country of origin and is pulling monthly data to measure reenrollment rates and roll‑off.
Provider and payer representatives detailed operational consequences. Matt Woodruff (Alameda Alliance for Health) said the county currently has roughly 407,000 Medi‑Cal enrollees and that state modeling suggests the county could drop to ~240,000 enrollees by 2028 if all changes proceed. He also reported a preliminary January file showing an initial drop of about 7,000 UIS enrollees after redeterminations; staff noted a 90‑day window for reenrollment and said final counts are published in month‑end files. Andy Martinez Patterson (CEO, Alameda Health Consortium) warned that community clinics would suffer disproportionate revenue loss and cited a figure of $188,000,000 in cuts for FQHCs across the county.
Dr. Kathleen Clannan reviewed HealthPAC (Health Program of Alameda County) and legal obligations under Welfare & Institutions Code Section 17000, which obligates counties to provide medical relief to indigent residents. She said HealthPAC currently covers about 2,600 people (down from an early program high near 90,000) and that large influxes into HealthPAC or sustained enrollment declines in Medi‑Cal could make it infeasible to provide Medi‑Cal‑level services without added state or federal support.
County staff and providers agreed the data are preliminary and contingent on implementation guidance and federal approvals; staff committed to monthly reporting to the joint committee and to present more refined projections in March and during the May revise.
No formal actions were taken.
