Federal Health Care Cuts Put 52,000 San Francisco Children at Risk

Health care and housing stability go hand in hand. For San Francisco families struggling to make ends meet, losing health insurance can mean choosing between medical bills, groceries, or rent. One accident or illness could put an entire family on the street. 

Major federal changes to health care could make this a reality for families in the near future. 

Eligibility Shifts: 

In January of 2027, Federal changes from H.R. 1 (the One Big Beautiful Bill Act) could cause 45,000 San Franciscans to lose health coverage within two years (Source: The San Francisco Standard) due to increased eligibility checks, limitations for some non-citizens, expanded work requirements, and other changes that will make it harder for families to remain covered. For families experiencing homelessness, who may have a constantly changing address and complex schedules, these changes create additional barriers in already challenging circumstances. Learn more about all the changes here.  

Expiring Tax Credits: 

H.R. 1 will also see the end of tax credits for those who purchase insurance through state-governed health insurance marketplaces, including Covered California. As a result, thousands more San Franciscans will face higher monthly costs. San Francisco has 37,140 individuals enrolled in Covered California, — 4.5% of the city’s population — and 26,980 of those depend on subsidized tax credits. (Source: UC Berkeley Labor Center) 

Reporting by The Washington Post highlighted how Affordable Care Act premium increases will affect families in San Francisco. 

Parent age	Number of children	Price increase / month (single adult)	Price increase / month (couple)
21	1 child	$125	$147
21	2 children	$180	$252
21	3 or more children	$235	$306
30	1 child	$135	$216
30	2 children	$189	$271
30	3 or more children	$245	$325
40	1 child	$146	$237
40	2 children	$200	$291
40	3 or more children	$254	$346
50	1 child	$181	$309
50	2 children	$237	$363
50	3 or more children	$293	$418

The impact on children in San Francisco could be significant: 

• In January of 2026, there were 50,266 San Francisco children (aged 0-18) certified as eligible for Medi-Cal (source: California Department of Health Care Services). 

• In March of 2026, there were an additional 1,750 San Francisco children (0-17) receiving subsidized care through Covered California. (Source: Covered California) 

That means 52,000 children could be at risk of losing their health insurance. 

At Compass Family Services, we believe every child deserves access to health care, and every family deserves the opportunity to thrive. We will continue advocating for policies that protect health coverage, prevent homelessness, and strengthen all San Francisco families.