Key Takeaways
- 2026 will be a pivotal year for California health officials and lawmakers as they navigate federal funding cuts, policy shifts, and major Medicaid shakeups.
- The Future of Medi-Cal Commission has been formed to create a 10-year blueprint for the program, which covers over 14 million low-income residents.
- Experts warn that millions of Californians on Medicaid could lose coverage under H.R.1, which makes sweeping changes to the country’s safety net programs.
- The commission’s co-chairs, Ann O’Leary and Dr. Mark Ghaly, will lead the 29-member commission in developing recommendations to ensure the program’s sustainability and effectiveness.
- The commission’s report is expected to be delivered in early 2027, and its recommendations will be usable by policymakers to improve and modernize the Medi-Cal program.
Introduction to the Future of Medi-Cal Commission
The California health care system is facing significant challenges in 2026, with federal funding cuts, policy shifts, and major Medicaid shakeups on the horizon. In response to these challenges, a group of health foundations has formed the Future of Medi-Cal Commission to create a 10-year blueprint for the program. The commission’s co-chairs, Ann O’Leary and Dr. Mark Ghaly, will lead the 29-member commission in developing recommendations to ensure the program’s sustainability and effectiveness. Dr. Ghaly, who previously led the state’s response to the COVID-19 pandemic, spoke to CalMatters about the commission and the challenges ahead, stating that "nothing forces you to think about these things more than the threat to your current existence."
The Origin Story of the Commission
The health foundations that formed the Future of Medi-Cal Commission recognized the need for a proactive approach to addressing the challenges facing the Medi-Cal program. Dr. Ghaly explained that the commission was established as a "forcing function moment" to consider the implications of federal funding cuts and policy shifts on the program. The commission’s goal is to develop a comprehensive plan that will ensure the program’s continued effectiveness and sustainability. Dr. Ghaly noted that the commission’s work will be crucial in addressing the "now" worries, such as eligibility and service cuts, as well as the "future" worries, including sustainability and cost growth.
Challenges Facing the Medi-Cal Program
The Medi-Cal program is facing significant challenges, including the potential loss of coverage for millions of Californians under H.R.1. Dr. Ghaly identified the biggest challenge for the program as the potential loss of coverage for those who have become confident and comfortable in their care. He also noted that the program’s growth and cost are concerns that need to be addressed. The program has grown extensively over the last several years, and some have argued that it has grown too big. However, Dr. Ghaly emphasized that the program has become a true health program, not just a health care program, and that it is essential to ensure that the services provided are effective in driving health outcomes.
The Commission’s Role in Addressing Challenges
The Future of Medi-Cal Commission will play a crucial role in addressing the challenges facing the program. Dr. Ghaly noted that the commission’s recommendations will be usable by policymakers to improve and modernize the program. The commission’s makeup, which includes operators who understand how to implement high-level ideas on the ground, is a significant strength. Dr. Ghaly emphasized that the commission’s work will be essential in ensuring that the program is maintained and supported, and that it will be a major freeway in the healthcare environment that the next governor can influence and control.
The Impact of Federal Funding Cuts and Policy Shifts
The federal funding cuts and policy shifts will have a significant impact on the Medi-Cal program. Dr. Ghaly noted that the state is already freezing enrollment and cutting benefits due to budget pressures. While it is difficult to predict the exact impact of the federal changes, Dr. Ghaly emphasized that the state has a responsibility to ensure that its budget is well and balanced. The commission’s work will be essential in developing a comprehensive plan that addresses the challenges facing the program and ensures its sustainability and effectiveness.
The Next Governor’s Role in Addressing Healthcare Challenges
The next governor of California will play a critical role in addressing the healthcare challenges facing the state. Dr. Ghaly emphasized that the governor should be hungry to understand the issues and be willing to work to improve and modernize the Medi-Cal program. He noted that healthcare is a huge piece of the California economy and that most people in the state think about how to secure and preserve access to healthcare and live in a healthy community. The governor’s priorities should include ensuring that the Medi-Cal program is maintained and supported, and that it continues to provide essential services to low-income residents.