Alameda Health System in Oakland, California began notifying 296 employees of layoffs on January 6, 2026. The layoffs affect staff across administrative services, clinical care, management, and support roles throughout the system's five hospitals and four wellness centers. The reductions are attributed to funding cuts from H.R. 1, which significantly reduces Medicaid and safety-net program reimbursements. The system employs approximately 4,500 workers total.