With federal activity top of mind, the Hospital Council Board of Directors met this week to discuss priority issues for hospitals across Northern California.
Carmela Coyle, President & CEO of the California Hospital Association (CHA), shared with the board the significant implications of newly passed federal legislation that will impose the most substantial cut to Medicaid funding in the program’s history. Despite coordinated advocacy from CHA, Hospital Council, member hospitals, the American Hospital Association, and partner organizations across the country, the final bill presents unprecedented fiscal challenges for California’s hospital community.
CHA’s early analysis projects that California hospitals stand to lose between $66 billion and $128 billion in Medi-Cal revenue over the next 10 years — a reduction of 14% to 30%. These cuts are driven primarily by sweeping changes to provider tax law, state-directed payments, and coverage eligibility.
In California, up to 1.8 million residents may lose health insurance coverage, leading to a projected $9.5 billion increase in uncompensated care costs over the next decade. This issue remains a top priority, as the magnitude of these cuts poses serious risks to patient access, hospital sustainability, and the broader health care delivery system. Hospital Council and CHA will continue to engage with state and federal policymakers to advocate for mitigation strategies and funding protections.
Hospital Council Board discussion also touched on Hospital Council’s groundbreaking partnership with Pacific Gas & Electric (PG&E), which was born of crisis: Disruptive public safety power shutoff (PSPS) events during the 2018-19 wildfire season crippled hospital operations and threatened public health. This partnership has matured into a trusted, strategic alliance focused on resilience, infrastructure modernization, and climate adaptation. Through targeted grid upgrades, real-time coordination protocols, and enhanced microgrid support, hospitals have not lost power during PSPS events in recent years — a testament to the partnership’s success. Looking ahead, PG&E’s new “Climate Optimist” strategy underscores a shared commitment to long-term reliability and climate resilience, making them a unique and valued partner in safeguarding health care delivery across the region.
The board also received updates on priorities across Hospital Council’s 50 counties — including behavioral health initiatives, ambulance patient offload time challenges, and collaboration with community partners and local elected officials. This discussion made clear that our member hospitals and community partners view Hospital Council as not just a convener of community leaders, but also a catalyst to implement local and regional solutions.
As hospital leaders consider the headwinds faced across our counties, this ability to not simply convene, but to drive change, will become increasingly more important. Navigating the coming storm will require that we continue to build relationships, lean on the partnerships we hold dear, and invest in the strength of our combined advocacy.