Dear President Trump,

We respectfully request your immediate assistance directing the U.S. Centers for Medicare & Medicaid Services (CMS) to grant the State of California a 60-day extension to submit the necessary paperwork to receive matching federal funds for the first quarter of 2025, as it relates to Medicaid.

Due to an administrative failure by the State of California and the Department of Health Care Services, the required documents were not submitted in a timely manner. This oversight has placed our constituents and our hospitals—already under constant financial strain—at significant risk. According to the California Legislative Analyst’s Office, the Administration does not have a complete Proposition 35 implementation plan to assess. While the responsibility for this failure lies with the Governor and state officials, it is our belief that the residents of California should not be punished for the shortcomings of their leadership.

We fully support any investigation aimed at identifying and eliminating fraud, waste, or abuse, as doing so not only safeguards public resources but also ensures better outcomes for those we serve. We are actively working with the State to determine the cause of the delay and to implement safeguards that will prevent such failures from occurring in the future. However, immediate federal intervention is critical to prevent further harm to those most in need.

Your direction to CMS to approve this extension would provide critically needed assistance and ensure continuity of care across California. We are deeply appreciative of your time and consideration on this matter, and we thank you in advance for your leadership and support.