Less than three weeks ago, the One Big Beautiful Bill Act was signed into law, enacting the largest health care cuts in the nation’s history and signifying a new era for how care will be paid for and delivered in America.
As all of us — hospital and health system leaders, state officials, policy experts, and CHA as your advocacy association — begin to understand the impact of this legislation, one thing is clear: The paradigm has shifted, and we need to think differently and adjust accordingly.
Just as hospital and health system leaders are beginning to adapt to this uncharted terrain, so too is CHA. We need to reimagine not only our Medicaid program in California (Medi-Cal), but also health care more broadly — an endeavor that will require thoughtful consultation inside and outside the hospital field.
There are many options to be explored. The challenge is to find paths that elected officials will vote for and to time appropriately the discussion of any solutions based on the politics, the environment, and the impact on the hospital field.
In Washington, D.C., the most important next step is to ensure approval of California’s hospital fee program, critical to supporting short-term financial stability. We also are advocating for the maximum delay on implementation of some of the new law’s provisions and defending against cuts to Medicare, Medicaid disproportionate share hospitals, and the 340B drug program.
In Sacramento, we’ll be working closely with the state and with hospital constituency associations on any needed changes to California’s waivers, the hospital fee program, and other directed payment programs. It’s also vital to partner with the state to both make Medi-Cal more efficient so it can operate within constrained resources and help shape the state’s application for California’s share of Rural Health Transformation grants.
Reimagining and transforming a health care system that has been built over decades will stretch all of us, and while the future is not set, it’s certain that forging the path together rather than individually will help create a stronger and more stable system. We will continue to work closely with all of you and the CHA board to plot this course collaboratively.
This legislation has launched a new age for health care, one that will demand every ounce of your creativity and grit to prevail. Hospitals have proven their mettle time and again — most recently during the COVID-19 pandemic — and your adaptability will be needed now like never before.
California is counting on it.
