{
  "version": 1,
  "generatedAt": "2026-09-07T04:32:07.308636+00:00",
  "data": {
    "asOf": "2026-08-23",
    "status": "illustrative exposure screen, not a forecast or allocation of federal cuts",
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      "year": 2024,
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    },
    "policyParameters": [
      {
        "parameter": "Enactment",
        "value": "Public Law 119-21 enacted July 4, 2025",
        "status": "enacted",
        "source": "U.S. Congress, Public Law 119-21"
      },
      {
        "parameter": "Provider-tax safe-harbor ceiling in Medicaid expansion states",
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        "status": "enacted; implementation details continue through federal rulemaking",
        "source": "P.L. 119-21 section 71115; LAO 2026-27 Medi-Cal Fiscal Outlook; CMS July 21, 2026 proposed rule fact sheet"
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      {
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        "status": "enacted limit; May 20, 2026 CMS implementation rule remains proposed as of the scenario date",
        "source": "P.L. 119-21 section 71116; CMS May 20, 2026 proposed rule fact sheet; DHCS Medi-Cal Financing page"
      },
      {
        "parameter": "California private hospital fee baseline",
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        "source": "LAO 2026-27 Medi-Cal Fiscal Outlook; DHCS May 2026 Local Assistance Appropriation Estimate"
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            "5Percent": 53457402.4
          }
        },
        {
          "facilityId": "106190529",
          "facilityName": "USC ARCADIA HOSPITAL",
          "healthServiceArea": "11 - LOS ANGELES COUNTY",
          "mediCalNetPatientRevenue2024": 6188756.0,
          "allPayerNetPatientRevenue2024": 321839258.0,
          "mediCalPayerMixShare": 0.019229,
          "shareOfCohortMediCalNetPatientRevenue": 0.00013969,
          "sensitivity": {
            "1Percent": 61887.56,
            "3Percent": 185662.68,
            "5Percent": 309437.8
          }
        },
        {
          "facilityId": "106190818",
          "facilityName": "USC VERDUGO HILLS HOSPITAL",
          "healthServiceArea": "11 - LOS ANGELES COUNTY",
          "mediCalNetPatientRevenue2024": 14915517.0,
          "allPayerNetPatientRevenue2024": 161982201.0,
          "mediCalPayerMixShare": 0.092081,
          "shareOfCohortMediCalNetPatientRevenue": 0.00033666,
          "sensitivity": {
            "1Percent": 149155.17,
            "3Percent": 447465.51,
            "5Percent": 745775.85
          }
        },
        {
          "facilityId": "106204019",
          "facilityName": "VALLEY CHILDREN'S HOSPITAL",
          "healthServiceArea": "09 - CENTRAL",
          "mediCalNetPatientRevenue2024": 506470822.0,
          "allPayerNetPatientRevenue2024": 810438133.0,
          "mediCalPayerMixShare": 0.624935,
          "shareOfCohortMediCalNetPatientRevenue": 0.01143161,
          "sensitivity": {
            "1Percent": 5064708.22,
            "3Percent": 15194124.66,
            "5Percent": 25323541.1
          }
        },
        {
          "facilityId": "106190812",
          "facilityName": "VALLEY PRESBYTERIAN HOSPITAL",
          "healthServiceArea": "11 - LOS ANGELES COUNTY",
          "mediCalNetPatientRevenue2024": 431575651.0,
          "allPayerNetPatientRevenue2024": 543262472.0,
          "mediCalPayerMixShare": 0.794415,
          "shareOfCohortMediCalNetPatientRevenue": 0.00974114,
          "sensitivity": {
            "1Percent": 4315756.51,
            "3Percent": 12947269.53,
            "5Percent": 21578782.55
          }
        },
        {
          "facilityId": "106560481",
          "facilityName": "VENTURA COUNTY MEDICAL CENTER",
          "healthServiceArea": "10 - SANTA BARBARA / VENTURA",
          "mediCalNetPatientRevenue2024": 356659305.0,
          "allPayerNetPatientRevenue2024": 516754659.0,
          "mediCalPayerMixShare": 0.690191,
          "shareOfCohortMediCalNetPatientRevenue": 0.00805019,
          "sensitivity": {
            "1Percent": 3566593.05,
            "3Percent": 10699779.15,
            "5Percent": 17832965.25
          }
        },
        {
          "facilityId": "106361370",
          "facilityName": "VICTOR VALLEY GLOBAL MEDICAL CENTER",
          "healthServiceArea": "12 - INLAND COUNTIES",
          "mediCalNetPatientRevenue2024": 57420436.0,
          "allPayerNetPatientRevenue2024": 105269047.0,
          "mediCalPayerMixShare": 0.545464,
          "shareOfCohortMediCalNetPatientRevenue": 0.00129604,
          "sensitivity": {
            "1Percent": 574204.36,
            "3Percent": 1722613.08,
            "5Percent": 2871021.8
          }
        },
        {
          "facilityId": "106010987",
          "facilityName": "WASHINGTON HOSPITAL - FREMONT",
          "healthServiceArea": "05 - EAST BAY",
          "mediCalNetPatientRevenue2024": 57243350.0,
          "allPayerNetPatientRevenue2024": 544625966.0,
          "mediCalPayerMixShare": 0.105106,
          "shareOfCohortMediCalNetPatientRevenue": 0.00129205,
          "sensitivity": {
            "1Percent": 572433.5,
            "3Percent": 1717300.5,
            "5Percent": 2862167.5
          }
        },
        {
          "facilityId": "106444013",
          "facilityName": "WATSONVILLE COMMUNITY HOSPITAL",
          "healthServiceArea": "08 - MID-COAST",
          "mediCalNetPatientRevenue2024": 50974779.0,
          "allPayerNetPatientRevenue2024": 122578837.0,
          "mediCalPayerMixShare": 0.415853,
          "shareOfCohortMediCalNetPatientRevenue": 0.00115056,
          "sensitivity": {
            "1Percent": 509747.79,
            "3Percent": 1529243.37,
            "5Percent": 2548738.95
          }
        },
        {
          "facilityId": "106301379",
          "facilityName": "WEST ANAHEIM MEDICAL CENTER",
          "healthServiceArea": "13 - ORANGE COUNTY",
          "mediCalNetPatientRevenue2024": 63836693.0,
          "allPayerNetPatientRevenue2024": 161392229.0,
          "mediCalPayerMixShare": 0.395538,
          "shareOfCohortMediCalNetPatientRevenue": 0.00144086,
          "sensitivity": {
            "1Percent": 638366.93,
            "3Percent": 1915100.79,
            "5Percent": 3191834.65
          }
        },
        {
          "facilityId": "106190883",
          "facilityName": "WHITTIER HOSPITAL MEDICAL CENTER",
          "healthServiceArea": "11 - LOS ANGELES COUNTY",
          "mediCalNetPatientRevenue2024": 62700134.0,
          "allPayerNetPatientRevenue2024": 123883109.0,
          "mediCalPayerMixShare": 0.506123,
          "shareOfCohortMediCalNetPatientRevenue": 0.00141521,
          "sensitivity": {
            "1Percent": 627001.34,
            "3Percent": 1881004.02,
            "5Percent": 3135006.7
          }
        },
        {
          "facilityId": "106571086",
          "facilityName": "WOODLAND MEMORIAL HOSPITAL",
          "healthServiceArea": "02 - GOLDEN EMPIRE",
          "mediCalNetPatientRevenue2024": 58513115.0,
          "allPayerNetPatientRevenue2024": 239547721.0,
          "mediCalPayerMixShare": 0.244265,
          "shareOfCohortMediCalNetPatientRevenue": 0.00132071,
          "sensitivity": {
            "1Percent": 585131.15,
            "3Percent": 1755393.45,
            "5Percent": 2925655.75
          }
        },
        {
          "facilityId": "106380939",
          "facilityName": "ZUCKERBERG SAN FRANCISCO GENERAL HOSPITAL & TRAUMA CENTER",
          "healthServiceArea": "04 - WEST BAY",
          "mediCalNetPatientRevenue2024": 552154696.0,
          "allPayerNetPatientRevenue2024": 963983886.0,
          "mediCalPayerMixShare": 0.572784,
          "shareOfCohortMediCalNetPatientRevenue": 0.01246274,
          "sensitivity": {
            "1Percent": 5521546.96,
            "3Percent": 16564640.88,
            "5Percent": 27607734.8
          }
        }
      ]
    },
    "hqafFinancingCompressionScreen": {
      "formula": "FY 2026-27 HQAF revenue \u00d7 (1 - 3.5% / about 5%)",
      "hqafRevenue2026_27": 9853027000,
      "approximateCurrentTaxShare": 0.05,
      "ffy2032Ceiling": 0.035,
      "mechanicalCompressionShare": 0.3,
      "mechanicalAmount": 2955908100.0,
      "interpretation": "A constant-base financing-cap screen only. It is not a hospital payment loss, state budget forecast, net fiscal effect, or facility allocation."
    },
    "uncertainty": [
      "The 1%, 3%, and 5% rates are analyst-selected sensitivities, not official estimates or probabilities.",
      "A change in provider-tax financing or state-directed-payment authority does not translate one-for-one into hospital revenue; California can change fee design, payment methods, eligibility policy, timing, or General Fund support subject to law and approval.",
      "The HAFD payer fields are accounting allocations for each hospital's reporting period, not claims, capitation, supplemental-payment eligibility, or service-level reimbursement.",
      "The screen holds utilization, enrollment, case mix, provider participation, inflation, and hospital behavior constant and does not model federal matching or state backfill.",
      "Facility rows are exposure indicators only; hospitals cannot be ranked as predicted winners or losers from this file."
    ]
  }
}