Overview
- A new Department of Public Health and Human Services Agency report estimates losses up to $315 million a year by fiscal 2027, approaching $400 million by 2038 as federal changes take full effect.
- Between 25,400 and 50,500 residents could lose Medi-Cal and nearly 20,000 could lose CalFresh by the end of 2027 under tighter eligibility rules.
- Medi-Cal eligibility checks will occur every six months starting in 2027, creating more paperwork and greater risk of disenrollment.
- Undocumented adults 19 and older become ineligible for full-scope Medi-Cal starting Jan. 1, though a limited coverage option remains.
- City plans include a $400 million reserve, roughly 150 additional HSA staff, technology upgrades, improved Medi-Cal billing, and an expansion of Healthy San Francisco to preserve coverage and revenue.