- About 15 million adults and children, or about 1 in 3 of California residents, rely on Medi-Cal.
- The Newsom administration projects that federal changes could push 1.3 million people off Medi-Cal by 2029-30.
When Congress passed the big, ugly bill known as HR 1 last year, most Americans understood it meant cuts to Medicaid, the safety net program millions rely on for medical insurance.
But few Californians realized just how much it will affect the Golden State when its provisions really kick in, starting after the midterms (the Republicans aren’t that dumb) and continuing on in cascading cuts for the next few years.
Millions of Californians — not just low-income folks — are going to feel the effects, whether through a loss of insurance, fewer providers able to keep their doors open, or rising premiums and costs.
“This problem trickles up,” state Senate leader Monique Limón (D-Goleta) told me. “This is not just going to impact the people that have a public healthcare plan. When you see a hospital close, when you see medical providers no longer being able to practice, it is absolutely going to impact everybody, the middle class included.”
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Added to the loss of federal funds, Gov. Gavin Newsom’s most recent budget plan (which the Legislature has to debate in coming weeks) includes cuts at the state level. This is in part to contend with the loss of federal money, but also because healthcare costs keep rising and even in this wealthy state, we can’t afford the bills — at least not without some changes.
What those changes are — and who should bear the brunt of them — is a complicated and largely ignored debate happening right now. While our candidates for governor have been grilled on whether they support single-payer healthcare or not, (Becerra is a sort-of, Steyer is a yes) the real question isn’t how is the next governor going to expand access to care — but how are we going to keep the whole system from collapsing right now.
“This is not hypothetical, this is what’s coming down the line,” Limón said.
The problem
About 15 million adults and children, or about 1 in 3 of our state’s residents, rely on Medi-Cal, which is what California calls its Medicaid program.
Through a creative bit of state financing called the Managed Care Organization, or MCO, tax, the federal government has been paying for a big chunk of the costs of that insurance, about $7 billion a year. President Trump’s HR 1 makes that money go bye-bye by greatly reducing the MCO, leaving the state to figure out how to backfill that cash. And that’s just one of the ways the big, ugly bill hurts California. Yes, it’s complicated.
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