by Dianne Anderson

Medi-Cal deep cuts are set to rip away services for California seniors, people with disabilities, and low-income families – not to mention new work requirements to determine eligibility.

If passed, over eight million statewide could lose coverage under the Republican-led proposal. California’s CalAIM program, which supports whole-person care and community services, is also at risk of losing federal funding that helps provide critical housing support and meals.

Everyone is bracing for the fallout.

In Long Beach, Jennifer Rice Epstein said an estimated 33.5% of residents – roughly 157,000 – are Medi-Cal members. If benefits are reduced, those residents would likely face reduced access to care.

At this point, she said most of the Health Department’s federal grants cover the cost of program managers and coordinators to provide direct services. But, there are growing concerns about how federal funding cuts will affect local employment, particularly in the healthcare sector.

“They also typically cover the cost of some administrative staff to provide financial supports. Historically speaking, when funding is terminated, the department attempts to place impacted staff in vacant positions within the City of Long Beach. However, it does sometimes result in layoffs,” she said.

She said the Health Department works closely with the County Health Executives Association of California to maintain critical state investments in public health. CHEAC represents the 61 local health jurisdictions in California, including the Long Beach Health Department.

“Additionally, the Department collaborates with Big Cities Health Coalition (BCHC) and the National Association of County and City Health Officials (NACCHO) to discuss public health at the national level. Both organizations have long histories of working with Republican and Democrat administrations to advance public health,” she said.

In a UC Berkeley Labor Center 2024 report on Medi-Cal Enrollment and Spending by District and County shows enrollment at 44% in the 42nd Congressional District and 46% in the 44th in Long Beach.

In the Inland Empire, about 42% of Riverside County residents and 45% of San Bernardino County residents were enrolled in Medi-Cal.

The center also warns that the GOP plan to cut $880 billion from Medicaid could cost the state up to 217,000 jobs with serious economic impacts. An estimated two-thirds of lost jobs, from 72,000 to 145,000, would come from healthcare sectors, including hospitals, clinics, doctor’s offices, nursing homes, insurance companies, and in-home care.

Between $10 – $20 billion is projected to be slashed from federal funding for Medi-Cal each year, directly impacting roughly 15 million Californians.

“These estimates do not include potential employment impacts from other proposed and enacted federal actions such as cuts to SNAP food assistance, tariffs, and increased deportations. Nor do these estimates include the impacts of other federal health care and public health cuts already made, such as millions of dollars in canceled CDC grants supporting community health in the Central Valley,” the report said.

For the Inland Empire Health Plan (IEHP), cuts to Medi-Cal would also see a huge impact.

Kristina Hernandez said the health and financial stability of the region’s working families, the most vulnerable communities, will be weakened, and devastate the Inland Empire’s entire healthcare infrastructure.

Hospitals and clinics would need to scale back services or close up altogether, triggering ripple effects across local businesses and services.

Expected funding cuts within the IEHP network alone could affect over 1.6 million members in San Bernardino and Riverside counties, including adults, families with children, seniors, and people with disabilities.

She said their network is deeply committed to ensuring that all individuals, regardless of income or insurance status, can access the healthcare they need.

“We’re collaborating with our provider network and hospital partners on solutions that address the effects of potential Medicaid cuts. And we’ll always partner with our members on their health care, so they can continue living their best lives,” said Hernandez, spokesperson for the Inland Empire Health Plan (IEHP).

Next up for cuts is Behavioral Health Services, the major provider of mental health and substance use treatment, as well as crisis hotlines and opioid overdose reversal medications.

In March, Rep. Pete Aguilar came out against the plan with his Medicaid Day of Action rally, featuring several local health leaders calling for the Republican Congress to reject Medicaid funding cuts.

Last week, Rep. Aguilar said cutting Medi-Cal would make health care less accessible and more expensive for nearly 400,000 people in the community, and it would take away an essential lifeline for local hospitals, children, and the elderly.

“More than half of the people I represent in Congress are enrolled in Medi-Cal or receive benefits from health care subsidies that keep the cost of health insurance down. I will continue to fight to protect Medi-Cal from being taken away to help pay for tax cuts for billionaires and wealthy corporations,” said Rep. Aguilar, Chair of the House Democratic Caucus.

In April, Attorney General Rob Bonta also filed a lawsuit against the U.S. Department of Health and Human Services (HHS) for abruptly terminating federal grants that support essential public health programs, including those that impact Medi-Cal services.

“Over and over, I’ve made clear that my office will only take legal action against the Trump Administration when it breaks the law. Unfortunately, but predictably, that has happened once again,” said AG Bonta. “Congress explicitly authorized funding for the grants at issue to help keep our country healthy and protect us from future pandemics.”

If passed, the elderly will also take a big hit.

Justice in Aging, a national nonprofit legal advocacy group, said the proposed Medi-Cal work requirements would take services from family caregivers and older adults who are not yet eligible for Medicare.

“Though most people targeted by work requirements should remain eligible, the red tape alone will take away coverage from people who are already working, older adults who are retired or have difficulty finding work, people with disabilities, and family caregivers. Moreover, resources spent on implementing these bureaucratic hurdles will delay access to critical health, financial, and food support for everyone,” the report said.

Representing Black physicians and patients, the National Medical Association (NMA), is also coming out strongly against the cuts.

Virginia A. Caine, MD, said the $1.9 trillion reduction could make about 20 million people ineligible for Medicaid, leading to an estimated 34,200 avoidable deaths each year—disproportionately impacting communities already facing serious health disparities.

NMA, with 50,000 African American physicians and professional members, estimates that slapping federal work reporting requirements on Medicaid expansion enrollees could also result in approximately 15,400 avoidable deaths annually.

“The Trump Administration has proposed significant cuts to several social safety net programs, including Medicaid and the Supplemental Nutrition Assistance Program (SNAP), in its latest budget plan,” said Dr. Caine, the 125th president of the NMA. “Reducing financial support of these programs will have a devastating impact on millions of Americans. Additionally, this action further exacerbates health disparities, widening the gap between sick and healthy communities even more.”

To see all AG Bonta’s lawsuits against the Trump Administration:
https://oag.ca.gov/federal-accountability