To: Joint Conference Committee (JCC) Members
From: Brian Buchanan, Chief Financial Officer (Interim), Finance
Date: October 3, 2025
Subject: Anticipated Impact from HR1 and California State Budget
Purpose
This summary is to show the major financial impact to CCHP
H.R. 1
Section 71113 Family planning provider band impacts CCHP immaterially due to CCHP's family planning expense is 98% reimbursed by DHCS. Less spending means less reimbursement. However, this bill will impact family planning health providers significantly.
Section 71113 Retro Medicaid and CHIP (California Children's Health Insurance Program) limits to one month will potentially impact a few CHIP members not receiving retro coverage. Financial impact to CCHP is immaterial.
Section 71119 Work requirement 80 hours per month for aged 19-64 Medi-Cal members will cause an estimated disenrollment of 67,000 members. At an estimated $360 revenue per member month, the reduction of revenue is expected to be $290 million. As a result of Medi-Cal disenrollment, CCHP also expects to see a $276 million reduction of medical expenses, which shall result in an estimated net loss of $14 million annually to CCHP. The biggest financial impact will be to the providers who see these members.
Section 71201 Medicare coverage limit to certain aliens impacts CCHP immaterially due to CCHP's new Medicare D-SNP line of business shall have a 3-year loss. Having less members will create less loss immaterially.
State Budget
SB116 Elimination of certain over-the-counter Medi-Cal drug coverage impacts CCHP primarily on the elimination of COVID testing. CCHP expects to save annually $6 million based on historical spending level.
SB116 Enrollment freeze for full-scope Medi-Cal Expansion to Undocumented Californians, adult ages 19 will cause an estimated disenrollment of 15,000 members. At an estimated $360 revenue per member month, the reduction of revenue is expected to be $65 million. As a result of Medi-Cal disenrollment, CCH...
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