Costa Welcomes House Democratic Caucus Chair Pete Aguilar to Central Valley Health Care Roundtable
FRESNO, Calif. - This week, during Affordable Healthcare for Every American Week of Action, Congressman Jim Costa (CA-21) welcomed Congressman Pete Aguilar (CA-33), Chair of the House Democratic Caucus, to the Central Valley for a roundtable hosted by Community Health System to hear directly from local hospitals and health care leaders focused on the federal funding reductions under H.R.1, including changes to Medicaid and the Affordable Care Act, as well as the Administration's decision to withhold approximately $867.5 million in federal Medicaid funding from California.
The meeting builds on Congressman Costa's ongoing efforts to elevate the concerns of Valley health care providers and patients following the enactment of H.R. 1 and its changes to Medicaid and the Affordable Care Act. Congressman Costa and Congressman Aguilar also highlighted House Democrats' ongoing efforts to protect and expand access to quality, affordable health care for families across California and communities nationwide.
“Today, Central Valley families, hospitals, and health care providers continue to feel the effects of the largest cuts to Medicaid and the Affordable Care Act in our nation’s history under H.R. 1,” said Congressman Costa. “These essential providers are being forced to make difficult decisions about staffing, patient care, and the services they provide. That’s why I was pleased to welcome Congressman Aguilar to the Central Valley—to hear directly from those on the front lines, elevate the challenges they are facing, and reaffirm our commitment to protecting affordable health care for families in the California and across the nation.”
“From the Central Valley to the Inland Empire, Californians’ healthcare is under attack because of cuts made by Trump’s and Republicans’ budget bill,” said House Democratic Caucus Chair Pete Aguilar. “I was proud to join Congressman Jim Costa and California healthcare leaders for a roundtable on how Republican cuts to Medi-Cal and Medicare have hurt people and healthcare facilities in our state and what House Democrats are doing to fight back. We will keep using every tool at our disposal to stop the Republican healthcare crisis and deliver quality, affordable care to families here in California and across the country.”
“At a time when federal healthcare funding reductions, including those under H.R. 1, are significantly affecting patient access to care across the Central Valley, we appreciate the collaboration and support of Congressmen Jim Costa and Pete Aguilar,” said Community President and Chief Executive Officer Craig A. Wagoner. “With more than half of our region’s population impacted by Medi-Cal reductions, conversations like these are an important step toward identifying solutions that help ensure continued access to care for our nation’s most vulnerable patients."
BACKGROUND
In July 2025, President Trump signed H.R. 1 into law after it passed Congress. The legislation included significant changes to Medicaid and the Affordable Care Act that health care leaders say are affecting hospitals, providers, and patients throughout California's Central Valley, where approximately 1.8 million residents—more than half the region's population—receive health coverage through Medi-Cal.
Key provisions of H.R. 1 include:
- Biannual Eligibility Redeterminations: Starting in 2026, states must verify Medicaid eligibility every six months, increasing administrative burdens and risking coverage losses.
- New Work Requirements: Beginning January 1, 2027, certain adults aged 19–64 will be required to work or participate in training/community service 80 hours per month to maintain coverage, which could result in coverage loss for millions.
- Increased Cost-Sharing and Reduced ACA Marketplace Subsidies: Low-income individuals face higher out-of-pocket costs, and DACA recipients are barred from ACA marketplace coverage.
- Restrictions on State Financing Tools: Limits on provider taxes and directed payments may undercut funding for hospitals and clinics that rely on Medi-Cal reimbursement.
- Reduced Retroactive Coverage: Beginning January 1, 2027, retroactive Medicaid coverage will be reduced from three months to one month for expansion adults and two months for other beneficiaries, potentially leaving patients responsible for medical bills incurred before enrollment.
Rural Health Transformation Program (RHTP)
H.R.1 created the $50 billion RHTP to strengthen rural health systems nationwide. California was awarded $233.6 million this year (FY26) to support sustainable access, workforce development, technology modernization, and care coordination in rural areas, including the San Joaquin Valley.
California is administering the funding through the California Rural Health Transformation Program, led by the California Department of Health Care Access and Information. Funding will be distributed through several competitive grant opportunities rather than automatically allocated to individual hospitals and clinics.
Current California application deadlines include August 14, 2026, for Accelerator Partners and the Family Medicine Obstetrics Fellowship Program; August 21, 2026, for Electronic Health Record Modernization grants; and August 31, 2026, for Workforce Development Recruitment and Retention grants.
While these funds provide targeted support, they are not sufficient to offset the broader reductions enacted under H.R.1.
The Administration's Withholding of $867 Million in Federal Medicaid Funding to California
On July 21, 2026, the Trump Administration announced it would withhold approximately $867 million in federal Medicaid funding from California. The Administration stated that the action was intended to target high-risk, disputed Medicaid claims while additional documentation is reviewed to rule out potential fraud.
This funding deferral creates a significant concern for patients, health care providers, and hospitals that depend on the program to deliver care.
To view videos and photos of the meeting, click here.