Just over a year ago, Congress passed the One Big Beautiful Bill Act (OBBBA), ushering in monumental changes for California’s Medicaid program, known as Medi-Cal. Nearly 400 days since the legislation was signed into law, its impact on hospitals and the communities they serve is only beginning to take shape — and Hospital Council is mobilizing to meet the moment.
Last week, Partnership HealthPlan of California, in collaboration with Hospital Council, the California Hospital Association, and the District Hospital Leadership Forum, convened a regional forum to assess these impacts and chart how stakeholders can collaborate to navigate the road ahead.
Among the first tangible impacts is declining Medi-Cal enrollment, driven by changes to work requirements, stricter immigration status rules, and more onerous redetermination requirements. Partnership HealthPlan alone projects a loss of 11% of its total membership in 2026 — roughly 87,000 Californians who stand to go without health insurance, yet whose health care needs will not disappear.
Counties and the state are hardly immune. Shifting redetermination cycles from annually to twice-yearly would double the caseload for the 4.8 million Californians affected, straining state and county operations. Add uncertainty around work requirements, and California faces a Jan. 1, 2027, deadline that leadership at the Department of Health Care Services has called “nearly impossible” to meet.
Yet challenges of this magnitude are precisely where our field does its best work. In the afterglow of the U.S.’s successful hosting of the 2026 FIFA World Cup, we’re reminded of Argentine soccer legend Diego Maradona’s words: “Football, like life, is filled with ups and downs, and the most important thing is to keep moving forward and never give up.”
If the 25 hospitals that joined last week’s forum are any indication, giving up is not on the table. Hospitals are banding together, communicating with peers and stakeholders more than ever before, and working to anticipate and adapt to a rapidly shifting landscape. That spirit of collaboration is Hospital Council’s greatest asset, and it’s why we face what’s ahead with optimism.
With so much beyond our control, Hospital Council and our member hospitals remain firmly in command of what matters most: our grit, our perseverance, and our unwavering commitment to patients throughout California. Together, we will meet this moment and will emerge stronger for it.