Up to 93,000 Contra Costa residents could lose Medi-Cal coverage or face new barriers to staying enrolled by 2029 because of changes tied to the new federal budget law H.R. 1 (the “One Big Beautiful Bill Act”) and recent revisions to California’s Medi-Cal policy, which together tighten eligibility and cut funding, according to county officials.
Contra Costa Health officials say their department could lose more than $300 million in combined state and federal funding through 2029, both from people dropping off Medi-Cal and from cuts to supplemental payments that support public health services. Medi-Cal is California’s Medicaid program that helps low-income people pay for doctor visits, hospital care, medications and other services.
Federal guidance on many parts of H.R. 1 is still in development, and California’s future plans to reduce coverage losses are also evolving. County departments said they will update the board and public as more details become available.
The county is concerned. It says that H.R. 1’s changes to Medi-Cal would impose financing restrictions that strip billions in federal support and create new barriers to eligibility and access. Proposed state changes would also reduce eligibility, especially for adults with Unsatisfactory Immigration Status, and cut reimbursements to Federally Qualified Health Centers for care of the adult UIS population.
In early 2026, Contra Costa Health said it would return to the Board with a proposal to expand health care supports for people who may no longer be eligible for Medi-Cal and lack other options.
County officials encourage residents affected by Medi-Cal changes to stay informed and seek help through local health and human services offices as policy details are finalized.
