California lawmakers heard warnings Wednesday that some county indigent-care systems are dormant or too weak to handle current safety-net demand, even as the Department of Finance projected Medi-Cal enrollment will decline and said federal work-rule changes could narrow exemptions.
At an Assembly Budget Subcommittee No. 7 hearing on accountability and oversight, Santa Barbara County Assistant County Executive Officer Tanya Heitman said the county’s indigent care program has been largely dormant for more than a decade, according to the hearing summary. Tulare County Administrative Officer Jason Britt told lawmakers the county’s indigent-health program is serving a region where more than half of residents are on Medi-Cal and hospitals are financially distressed.
Department of Finance representative Andrew Hewood said the administration had no new or revised disenrollment projections beyond the final state budget, but Finance still projected Medi-Cal enrollment falling from 14.8 million in fiscal 2024-25 to 13.8 million in the current year, the summary said. Finance also said a more restrictive federal interim final rule on medical frailty could affect how many members are exempt from work requirements.
Public-hospital advocates thanked lawmakers for $250 million in budget support and urged better statewide reporting and coordination, according to the hearing summary. The session’s second half turned to audit-reporting questions under the State Leadership Accountability Act, including a Finance proposal to repeal Government Code section 13296 because completed audit reports are already posted publicly and existing law already covers reports to the Legislature when required.
The hearing record provided here does not show a committee vote or final action on county indigent care.
