Board revives EsperanzaCare pilot to restore basic primary care for residents losing Medi‑Cal coverage

The board voted Jan. 27 to reestablish a one-year pilot of EsperanzaCare to restore limited primary-care services to residents who will lose Medi‑Cal eligibility due to recent federal changes. County health staff and Natividad Medical Center recommended a 12‑month pilot for 500 members that would cover primary care, pharmacy, labs, radiology and limited specialty services; estimated start date is July 1, 2026; projected initial pilot cost is in the $0.5–1.0 million range.

Health department staff warned that changes to federal matching rules and Medi‑Cal redeterminations could reduce enrollment locally (their local managed‑care plan projected a 27% reduction in members by 2028) and increase uncompensated care costs. Presenters and board members said a local pilot is intended as a stopgap to maintain access while continuing to press the state and federal governments for broader policy fixes.

The board approved the staff recommendation and directed the CAO, Health Department and Natividad to collaborate, analyze costs, identify funding, and involve community partners in design and outreach. Community groups and supervisors urged the county to escalate advocacy in Sacramento and Washington for sustained funding.

The pilot does not supplant efforts to restore full-state coverage for eligible residents; rather it aims to provide immediate, low‑barrier primary-care access while broader policy and funding questions are pursued.