Monterey County Warns of Projected $13.9 Million Health Department and $11.7 Million Natividad Revenue Reductions in 2027–28

SALINAS, Calif. — October 27, 2026. Monterey County officials are warning that changes to federal and state health-coverage policies could create substantial financial pressure for local medical providers in fiscal year 2027–28. In an October 20 Board of Supervisors staff report, the county Health Department projected approximately $13.9 million in reduced revenue, while Natividad Medical Center projected another $11.7 million.

These figures are preliminary projections, not reductions already recorded in county accounts. The report identifies the federal budget reconciliation measure commonly called H.R. 1 and parallel California Medi-Cal policy changes as the main sources of uncertainty. The timing and actual effect of particular requirements will depend on implementing rules, state actions, coverage changes and individual circumstances.

What local services are at stake?

The Monterey County Health Department operates 12 federally qualified health centers in Salinas, Marina and Seaside and a mobile clinic visiting school sites in Soledad, Salinas and Castroville, according to the county’s report. The clinic network serves more than 40,000 patients receiving primary care, pediatric, dental, women’s health and other services. This is a figure for patients seen by the county clinic system, not an estimate of the number who will lose insurance.

Natividad is the county’s only Level II trauma center and teaching hospital, the report says. More than half of its patients have Medi-Cal coverage. County staff cited potential impacts from changes in eligibility, reimbursement and the insured/uninsured patient mix.

What the health plan told the county

The Central California Alliance for Health, a public-agency Medi-Cal plan, participated in the presentation. Its enrollment of more than 415,000 members applies across five counties—Mariposa, Merced, Monterey, San Benito and Santa Cruz, not Monterey County alone.

Agency staff discussed risks including potential coverage gaps, more uninsured patients and financial strain on safety-net providers. Their estimates should not be interpreted as proof that a specific person has lost Medi-Cal, that a clinic is closing, or that a particular service is already unavailable.

What residents can do now

Residents who receive notices from Medi-Cal or their health plan should follow the instructions on the notice and contact the plan or county eligibility office for case-specific help. Do not stop using approved coverage based on a future budget projection. For local application guidance, see California58’s MC-CHOICE enrollment-assistance guide.

The county’s October 20 agenda called for an informational presentation—not a vote to close facilities, cancel individual benefits or approve the projected losses.

Primary source: Monterey County, item 26-885, October 20, 2026: Alliance, Health Department and Natividad presentation and staff report.

Published October 27, 2026. This report describes agency estimates and does not substitute for individual healthcare or benefits advice.

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