Legislation Details

File #: 26-850    Name: H.R.1 and State Policy Changes
Type: General Agenda Item Status: Scheduled PM
File created: 10/1/2026 In control: Board of Supervisors
On agenda: 10/13/2026 Final action:
Title: a. Receive a presentation from the Central California Alliance for Health on emerging coverage gaps and safety-net challenges resulting from H.R.1 and State Policies; b. Receive an overview of anticipated impacts resulting from federal budget reconciliation H.R.1 and parallel state-level Medi-Cal policy changes to the County’s healthcare system from staff at Natividad Medical Center and the Health Department; and c. Provide direction to staff as appropriate.
Attachments: 1. Board Report, 2. The Alliance H.R.1 and State Policy Changes Presentation, 3. Health and Natividad H.R.1 and State Policy Changes Presentation
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Title
a. Receive a presentation from the Central California Alliance for Health on emerging coverage gaps and safety-net challenges resulting from H.R.1 and State Policies;
b. Receive an overview of anticipated impacts resulting from federal budget reconciliation H.R.1 and parallel state-level Medi-Cal policy changes to the County’s healthcare system from staff at Natividad Medical Center and the Health Department; and
c. Provide direction to staff as appropriate.
Report
RECOMMENDATION:
It is recommended that the Board of Supervisors:
a. Receive a presentation from the Central California Alliance for Health on emerging coverage gaps and safety-net challenges resulting from H.R.1 and State Policies;
b. Receive an overview of anticipated impacts resulting from federal budget reconciliation H.R.1 and parallel state-level Medi-Cal policy changes to the County’s healthcare system from staff at Natividad Medical Center and the Health Department; and
c. Provide direction to staff as appropriate.

SUMMARY:
The Central California Alliance for Health (the Alliance) is a local public agency that serves as the regional Medi-Cal health plan. Using the state’s County Organized Health System (COHS) model, the Alliance serves over 415,000 members in Mariposa, Merced, Monterey, San Benito, and Santa Cruz counties. They work in partnership with contracted providers to promote prevention, early detection, and effective treatment, and improve access to quality health care for those we serve. The Health Department and Natividad operate the County’s healthcare system, delivering an array of outpatient, specialty, inpatient, emergency, laboratory, imaging, trauma, and other services to the County’s residents with a focus on ensuring access to the County’s Medi-Cal, underinsured, and uninsured residents. There will be significant changes to the Medi-Cal program resulting in significant reductions in enrollment and reimbursements to healthcare organizations.

DISCUSSION:
H.R.1 in...

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