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"content": "\u003cp>\u003cem>Updated 3:35 p.m. Wednesday\u003c/em>\u003c/p>\n\u003cp>California’s fiscal outlook has taken a turn for the worse, \u003ca href=\"https://www.kqed.org/news/tag/gavin-newsom\">Gov. Gavin Newsom\u003c/a> said as he unveiled an updated 2025–26 state budget plan on Wednesday with a projected $11.9 billion shortfall.\u003c/p>\n\u003cp>The governor said President Donald Trump’s tariffs and market volatility, combined with rising state health care costs, have derailed what appeared to be a relatively \u003ca href=\"https://www.kqed.org/news/12020389/newsom-projects-slight-budget-surplus-with-focus-on-saving-accountability\">healthy budget\u003c/a> just a few months ago. In response, he is proposing cuts that include scaling back the state’s offer of \u003ca href=\"https://www.kqed.org/news/12031544/providing-health-care-for-immigrants-is-costing-california-more-than-expected-is-coverage-at-risk\">health insurance\u003c/a> to low-income undocumented immigrants.\u003c/p>\n\u003cp>And he pledged to continue pushing back against the president’s agenda in court. California has already filed more than a dozen lawsuits against this Trump administration, \u003ca href=\"https://www.kqed.org/news/12036199/trumps-tariffs-could-wreck-californias-economy-the-state-is-suing\">including one last month targeting the tariffs.\u003c/a>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“California is under assault,” Newsom said, arguing that the uncertainty caused by the tariffs, in particular, has made it difficult to plan ahead. “The impacts of these tariffs … are being felt disproportionately in the fourth-largest economy in the world that has so much goods, volume and trade.”\u003c/p>\n\u003cp>Newsom’s proposal kicks off a month of high-stakes negotiations with leaders of the state Legislature, which must pass a budget plan by June 15. In a statement, Assembly Speaker Robert Rivas echoed the governor’s blame of Trump for revenue shortfalls.\u003c/p>\n\u003cp>“The Assembly will thoroughly review the Governor’s May budget revision during public hearings, and we will continue to stand up to the chaotic actions of Trump and his Republican allies,” Rivas said.\u003c/p>\n\u003cfigure id=\"attachment_11753593\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11753593\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/06/RS5067_NurseChecksBloodPressure-e1747249186287.jpg\" alt=\"As part of a budget deal, low-income adults between the ages of 19 and 25 living in California illegally could become eligible for California's Medicaid program, Medi-Cal.\" width=\"2000\" height=\"1333\">\u003cfigcaption class=\"wp-caption-text\">Under the governor’s plan, Medi-Cal will stop enrolling new undocumented immigrants starting Jan. 1. Those already covered can keep their benefits, but adults over 18 will face a $100 monthly premium beginning in 2027. \u003ccite>(David McNew/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Under the governor’s plan, Medi-Cal, the state’s Medicaid program for Californians with low incomes or disabilities, will stop enrolling new undocumented adults beginning on Jan. 1. Californians without legal status currently on the program will maintain coverage, but beginning in 2027, enrollees older than 18 will be charged a $100 monthly premium.\u003c/p>\n\u003cp>“We believe that people should have some skin in the game as it relates to contributions,” Newsom said.\u003c/p>\n\u003cp>The changes will save the state an estimated $5.4 billion by 2028–29, but advocates for immigrants are already warning that they will result in hundreds of thousands of Californians losing health care coverage.\u003c/p>\n\u003cp>“We are outraged,” said Joshua Stehlik, policy director for the California Immigrant Policy Center. “We feel like the governor is abandoning his legacy with this proposed rollback.”[aside postID=news_12039730 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/080924-ENCAMPMENT-SWEEP-MD-01-KQED-1020x680.jpg']“It feels like a particularly difficult moment to target vulnerable immigrants when they’re under such relentless attacks by the Trump administration,” Stehlik added.\u003c/p>\n\u003cp>Republicans in the state legislature said Newsom should have acted earlier to rein in healthcare spending on undocumented Californians.\u003c/p>\n\u003cp>“I urged the governor to immediately freeze his reckless Medi-Cal expansion for illegal immigrants a year and a half ago, before it buried our healthcare system and bankrupted the state,” said Senate Republican Leader Brian Jones in a statement. “Had he listened, we wouldn’t be in this crisis — breaking promises, scrambling for loans, and cutting services for legal Californians just to keep this broken program afloat.”\u003c/p>\n\u003cp>Newsom blamed Trump’s increased tariffs for what he dubbed a “Trump Slump” in the stock market. California’s progressive tax system leaves the state’s revenue heavily reliant on high-income earners and especially vulnerable to dips in the market.\u003c/p>\n\u003cp>The governor said Trump’s protectionist policies have led to an estimated $16 billion decline in state revenues through the next fiscal year — $10 billion of it from losses in expected capital gains tax. And he cited declines in tourism and port activity as further evidence of how the president’s trade policy is hurting the Golden State.\u003c/p>\n\u003cfigure id=\"attachment_12034427\" class=\"wp-caption aligncenter\" style=\"max-width: 1600px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12034427\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/npr.brightspotcdn-copy-4.jpg\" alt=\"\" width=\"1600\" height=\"1067\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/npr.brightspotcdn-copy-4.jpg 1600w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/npr.brightspotcdn-copy-4-800x534.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/npr.brightspotcdn-copy-4-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/npr.brightspotcdn-copy-4-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/npr.brightspotcdn-copy-4-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1600px) 100vw, 1600px\">\u003cfigcaption class=\"wp-caption-text\">President Donald Trump holds a chart as he delivers remarks on reciprocal tariffs during an event in the Rose Garden entitled “Make America Wealthy Again” at the White House in Washington, D.C., on April 2, 2025. \u003ccite>(Brendan Smialowski/AFP via Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>As Trump has eased the tariffs he announced in early April, major stock indexes have recovered their losses, with the S&P 500 returning to positive territory for the year this week.\u003c/p>\n\u003cp>Before the April downturn, an extended surge in the stock market had filled California’s budget coffers. Newsom’s initial January spending plan projected a modest $363 million surplus and no spending cuts — although the governor proposed using $7.1 billion from the state’s rainy day reserve fund.[aside postID=science_1996769 hero='https://cdn.kqed.org/wp-content/uploads/sites/35/2025/05/DeltaGetty-1020x574.jpg']During a two-hour press conference announcing his spending plan, Newsom pinned responsibility for revenue declines on Trump’s trade agenda, but maintained he was “not blaming the president for the deficit.”\u003c/p>\n\u003cp>“I certainly am attaching those revenue concerns directly to the activities of the administration, unquestionable,” Newsom said. “But not the totality of the deficit.”\u003c/p>\n\u003cp>Despite the downturn in revenues, Newsom labeled the current deficit “pretty mild,” as it accounts for just 5.8% of the total $226 billion general fund budget.\u003c/p>\n\u003cp>But the budget picture could get worse.\u003c/p>\n\u003cp>Republicans in Congress are considering a budget bill that cuts funding to programs such as Medicaid, which is paid for jointly by the federal government and states. Those cuts could require Newsom and legislative leaders to amend their spending plan later this year.\u003c/p>\n\u003cp>“I wouldn’t be surprised if we’re talking about significant revisions to the state budget in August,” said Chris Hoene, executive director of the California Budget & Policy Center.\u003c/p>\n\u003cfigure id=\"attachment_12030841\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12030841\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/GettyImages-2201320740.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/GettyImages-2201320740.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/GettyImages-2201320740-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/GettyImages-2201320740-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/GettyImages-2201320740-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/GettyImages-2201320740-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/GettyImages-2201320740-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">A “Save Medicaid” sign is affixed to the podium for the House Democrats’ press event to oppose the Republicans’ budget on the House steps of the Capitol on Feb. 25, 2024. \u003ccite>(Bill Clark/CQ-Roll Call, Inc., via Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>One proposal in the current House spending plan would reduce federal Medicaid funding to states, such as California, that provide health coverage to undocumented immigrants. That change could cost California $27 billion between 2028 and 2034, according to \u003ca href=\"https://www.cbpp.org/research/health/house-republican-bill-would-cut-medicaid-funding-to-states-providing-own-health\">an estimate\u003c/a> from the Center on Budget and Policy Priorities.\u003c/p>\n\u003cp>As governor, Newsom has pushed the expansion of Medi-Cal to cover California residents regardless of legal status. He has championed the initiative as a way to save the state money in the long run, but the program’s full rollout has cost $2.7 billion more than his administration expected.\u003c/p>\n\u003cp>“No state has done more than the state of California, no state will continue to do more than the state of California, by a long shot,” Newsom said about the undocumented health care program. “That’s a point of pride and it’s a point of privilege to be [a] governor that’s been part of that effort.”\u003c/p>\n\u003cp>In addition to the changes to undocumented health care, Newsom is proposing to close the shortfall by shifting more than $5 billion in from special funds, capping overtime for in-home supportive service workers and paying for $1.7 billion in state firefighting costs with revenue raised from polluters through the state’s cap-and-trade program — which he proposed extending through 2045.\u003c/p>\n\u003cp>\u003cem>KQED’s \u003ca href=\"https://www.kqed.org/author/tychehendricks\">Tyche Hendricks\u003c/a> contributed to this report. \u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"excerpt": "Gov. Gavin Newsom said tariffs, market volatility and rising state health care costs have led to a projected $12 billion budget gap after projecting a modest surplus a few months ago. ",
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"title": "Citing ‘Trump Slump,’ Newsom Unveils Budget Gap, Aims to Cap Undocumented Health Care | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>Updated 3:35 p.m. Wednesday\u003c/em>\u003c/p>\n\u003cp>California’s fiscal outlook has taken a turn for the worse, \u003ca href=\"https://www.kqed.org/news/tag/gavin-newsom\">Gov. Gavin Newsom\u003c/a> said as he unveiled an updated 2025–26 state budget plan on Wednesday with a projected $11.9 billion shortfall.\u003c/p>\n\u003cp>The governor said President Donald Trump’s tariffs and market volatility, combined with rising state health care costs, have derailed what appeared to be a relatively \u003ca href=\"https://www.kqed.org/news/12020389/newsom-projects-slight-budget-surplus-with-focus-on-saving-accountability\">healthy budget\u003c/a> just a few months ago. In response, he is proposing cuts that include scaling back the state’s offer of \u003ca href=\"https://www.kqed.org/news/12031544/providing-health-care-for-immigrants-is-costing-california-more-than-expected-is-coverage-at-risk\">health insurance\u003c/a> to low-income undocumented immigrants.\u003c/p>\n\u003cp>And he pledged to continue pushing back against the president’s agenda in court. California has already filed more than a dozen lawsuits against this Trump administration, \u003ca href=\"https://www.kqed.org/news/12036199/trumps-tariffs-could-wreck-californias-economy-the-state-is-suing\">including one last month targeting the tariffs.\u003c/a>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“California is under assault,” Newsom said, arguing that the uncertainty caused by the tariffs, in particular, has made it difficult to plan ahead. “The impacts of these tariffs … are being felt disproportionately in the fourth-largest economy in the world that has so much goods, volume and trade.”\u003c/p>\n\u003cp>Newsom’s proposal kicks off a month of high-stakes negotiations with leaders of the state Legislature, which must pass a budget plan by June 15. In a statement, Assembly Speaker Robert Rivas echoed the governor’s blame of Trump for revenue shortfalls.\u003c/p>\n\u003cp>“The Assembly will thoroughly review the Governor’s May budget revision during public hearings, and we will continue to stand up to the chaotic actions of Trump and his Republican allies,” Rivas said.\u003c/p>\n\u003cfigure id=\"attachment_11753593\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11753593\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/06/RS5067_NurseChecksBloodPressure-e1747249186287.jpg\" alt=\"As part of a budget deal, low-income adults between the ages of 19 and 25 living in California illegally could become eligible for California's Medicaid program, Medi-Cal.\" width=\"2000\" height=\"1333\">\u003cfigcaption class=\"wp-caption-text\">Under the governor’s plan, Medi-Cal will stop enrolling new undocumented immigrants starting Jan. 1. Those already covered can keep their benefits, but adults over 18 will face a $100 monthly premium beginning in 2027. \u003ccite>(David McNew/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Under the governor’s plan, Medi-Cal, the state’s Medicaid program for Californians with low incomes or disabilities, will stop enrolling new undocumented adults beginning on Jan. 1. Californians without legal status currently on the program will maintain coverage, but beginning in 2027, enrollees older than 18 will be charged a $100 monthly premium.\u003c/p>\n\u003cp>“We believe that people should have some skin in the game as it relates to contributions,” Newsom said.\u003c/p>\n\u003cp>The changes will save the state an estimated $5.4 billion by 2028–29, but advocates for immigrants are already warning that they will result in hundreds of thousands of Californians losing health care coverage.\u003c/p>\n\u003cp>“We are outraged,” said Joshua Stehlik, policy director for the California Immigrant Policy Center. “We feel like the governor is abandoning his legacy with this proposed rollback.”\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“It feels like a particularly difficult moment to target vulnerable immigrants when they’re under such relentless attacks by the Trump administration,” Stehlik added.\u003c/p>\n\u003cp>Republicans in the state legislature said Newsom should have acted earlier to rein in healthcare spending on undocumented Californians.\u003c/p>\n\u003cp>“I urged the governor to immediately freeze his reckless Medi-Cal expansion for illegal immigrants a year and a half ago, before it buried our healthcare system and bankrupted the state,” said Senate Republican Leader Brian Jones in a statement. “Had he listened, we wouldn’t be in this crisis — breaking promises, scrambling for loans, and cutting services for legal Californians just to keep this broken program afloat.”\u003c/p>\n\u003cp>Newsom blamed Trump’s increased tariffs for what he dubbed a “Trump Slump” in the stock market. California’s progressive tax system leaves the state’s revenue heavily reliant on high-income earners and especially vulnerable to dips in the market.\u003c/p>\n\u003cp>The governor said Trump’s protectionist policies have led to an estimated $16 billion decline in state revenues through the next fiscal year — $10 billion of it from losses in expected capital gains tax. And he cited declines in tourism and port activity as further evidence of how the president’s trade policy is hurting the Golden State.\u003c/p>\n\u003cfigure id=\"attachment_12034427\" class=\"wp-caption aligncenter\" style=\"max-width: 1600px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12034427\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/npr.brightspotcdn-copy-4.jpg\" alt=\"\" width=\"1600\" height=\"1067\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/npr.brightspotcdn-copy-4.jpg 1600w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/npr.brightspotcdn-copy-4-800x534.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/npr.brightspotcdn-copy-4-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/npr.brightspotcdn-copy-4-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/npr.brightspotcdn-copy-4-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1600px) 100vw, 1600px\">\u003cfigcaption class=\"wp-caption-text\">President Donald Trump holds a chart as he delivers remarks on reciprocal tariffs during an event in the Rose Garden entitled “Make America Wealthy Again” at the White House in Washington, D.C., on April 2, 2025. \u003ccite>(Brendan Smialowski/AFP via Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>As Trump has eased the tariffs he announced in early April, major stock indexes have recovered their losses, with the S&P 500 returning to positive territory for the year this week.\u003c/p>\n\u003cp>Before the April downturn, an extended surge in the stock market had filled California’s budget coffers. Newsom’s initial January spending plan projected a modest $363 million surplus and no spending cuts — although the governor proposed using $7.1 billion from the state’s rainy day reserve fund.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>During a two-hour press conference announcing his spending plan, Newsom pinned responsibility for revenue declines on Trump’s trade agenda, but maintained he was “not blaming the president for the deficit.”\u003c/p>\n\u003cp>“I certainly am attaching those revenue concerns directly to the activities of the administration, unquestionable,” Newsom said. “But not the totality of the deficit.”\u003c/p>\n\u003cp>Despite the downturn in revenues, Newsom labeled the current deficit “pretty mild,” as it accounts for just 5.8% of the total $226 billion general fund budget.\u003c/p>\n\u003cp>But the budget picture could get worse.\u003c/p>\n\u003cp>Republicans in Congress are considering a budget bill that cuts funding to programs such as Medicaid, which is paid for jointly by the federal government and states. Those cuts could require Newsom and legislative leaders to amend their spending plan later this year.\u003c/p>\n\u003cp>“I wouldn’t be surprised if we’re talking about significant revisions to the state budget in August,” said Chris Hoene, executive director of the California Budget & Policy Center.\u003c/p>\n\u003cfigure id=\"attachment_12030841\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12030841\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/GettyImages-2201320740.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/GettyImages-2201320740.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/GettyImages-2201320740-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/GettyImages-2201320740-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/GettyImages-2201320740-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/GettyImages-2201320740-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/GettyImages-2201320740-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">A “Save Medicaid” sign is affixed to the podium for the House Democrats’ press event to oppose the Republicans’ budget on the House steps of the Capitol on Feb. 25, 2024. \u003ccite>(Bill Clark/CQ-Roll Call, Inc., via Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>One proposal in the current House spending plan would reduce federal Medicaid funding to states, such as California, that provide health coverage to undocumented immigrants. That change could cost California $27 billion between 2028 and 2034, according to \u003ca href=\"https://www.cbpp.org/research/health/house-republican-bill-would-cut-medicaid-funding-to-states-providing-own-health\">an estimate\u003c/a> from the Center on Budget and Policy Priorities.\u003c/p>\n\u003cp>As governor, Newsom has pushed the expansion of Medi-Cal to cover California residents regardless of legal status. He has championed the initiative as a way to save the state money in the long run, but the program’s full rollout has cost $2.7 billion more than his administration expected.\u003c/p>\n\u003cp>“No state has done more than the state of California, no state will continue to do more than the state of California, by a long shot,” Newsom said about the undocumented health care program. “That’s a point of pride and it’s a point of privilege to be [a] governor that’s been part of that effort.”\u003c/p>\n\u003cp>In addition to the changes to undocumented health care, Newsom is proposing to close the shortfall by shifting more than $5 billion in from special funds, capping overtime for in-home supportive service workers and paying for $1.7 billion in state firefighting costs with revenue raised from polluters through the state’s cap-and-trade program — which he proposed extending through 2045.\u003c/p>\n\u003cp>\u003cem>KQED’s \u003ca href=\"https://www.kqed.org/author/tychehendricks\">Tyche Hendricks\u003c/a> contributed to this report. \u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"slug": "californians-worried-about-medi-cal-congressional-republicans-consider-cuts",
"title": "Californians Worried About Medi-Cal as Congressional Republicans Consider Cuts",
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"headTitle": "Californians Worried About Medi-Cal as Congressional Republicans Consider Cuts | KQED",
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"content": "\u003cp>Californians are expressing widespread worry about the future of \u003ca href=\"https://www.kqed.org/news/tag/medicaid\">Medicaid\u003c/a>, as Republicans in Congress weigh cuts to the program that covers health care for Americans with low incomes and disabilities.\u003c/p>\n\u003cp>GOP leaders are looking for budget savings to pay for the extension of tax cuts favored by President Donald Trump, but the idea of cutting Medicaid has raised alarm among some in the party — including \u003ca href=\"https://www.kqed.org/news/12032994/democrats-focus-their-message-on-gop-cuts-to-medicaid\">California Republicans\u003c/a> who represent districts with high numbers of Medicaid recipients. A \u003ca href=\"https://escholarship.org/uc/item/1nd0h87z\">pair of surveys\u003c/a> released \u003ca href=\"https://escholarship.org/uc/item/40r36594\">this week\u003c/a> by the UC Berkeley Institute of Governmental Studies found broad concern about \u003ca href=\"https://www.kqed.org/news/tag/medi-cal\">Medi-Cal\u003c/a>, the state’s Medicaid program, among California voters.\u003c/p>\n\u003cp>A full two-thirds, 67%, of registered voters who receive coverage through Medi-Cal are worried that they, or a family member, will lose insurance due to changes being pursued by the Trump administration. In a separate survey, 56% of voters polled said that the Trump administration’s proposed changes to Medi-Cal will have a “negative impact” on California.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Only tariffs ranked higher on voters’ lists of issues facing negative headwinds from Washington, said Mark DiCamillo, the poll’s director.\u003c/p>\n\u003cp>“Medi-Cal was right up there, so it’s one of the areas where most voters have concerns,” he said.\u003c/p>\n\u003cp>The program has emerged as a key inflection point in House Republicans’ budget talks this week. House Speaker Mike Johnson has been meeting privately in his office with groups of Republicans, as he works to enact the president’s legislative agenda with a slim seven-seat majority.\u003c/p>\n\u003cfigure id=\"attachment_12030841\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12030841\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/GettyImages-2201320740.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/GettyImages-2201320740.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/GettyImages-2201320740-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/GettyImages-2201320740-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/GettyImages-2201320740-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/GettyImages-2201320740-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/GettyImages-2201320740-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">A “Save Medicaid” sign is affixed to the podium for the House Democrats’ press event to oppose the Republicans’ budget on the House steps of the Capitol on Tuesday, February 25, 2024. \u003ccite>(Bill Clark/CQ-Roll Call, Inc., via Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The IGS surveys did not ask specifically about the budget plan, which sets a target of $880 billion in spending cuts over the next decade from the committee that oversees Medicaid spending. Trump has supported the budget framework, but told NBC last week that House Republicans are “not cutting [Medicaid]. They’re looking at fraud, waste and abuse.”\u003c/p>\n\u003cp>An \u003ca href=\"https://www.cbo.gov/system/files/2025-03/61235-Boyle-Pallone.pdf\">analysis\u003c/a> by the nonpartisan Congressional Budget Office shows that there is no way to reach the spending target without cutting Medicaid.\u003c/p>\n\u003cp>For most enrollees, Medi-Cal costs are shared evenly between California and the federal government. However, the federal government picks up 90% of the tab for the Medicaid expansion authorized through the Affordable Care Act, which covers Californians making up to $21,597.\u003c/p>\n\u003cp>Fiscal conservatives in the GOP caucus have floated ideas such as reducing the federal cost-share for expansion enrollees or enacting a per-enrollee cap on federal spending. Those proposals would generate significant savings in the range of $700 billion, according to the Congressional Budget Office, but also result in millions of Americans losing their health insurance.[aside postID=news_12038904 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2024/05/20240524_MobileHeadStart-34_qut-1020x680.jpg']Supporters of Medi-Cal warn that the impact of cuts will ripple beyond the patients who lose insurance. A \u003ca href=\"https://laborcenter.berkeley.edu/california-could-lose-up-to-217000-jobs-if-congress-cuts-medicaid/\">report\u003c/a> from the UC Berkeley Labor Center found that reductions to the healthcare program could result in the loss of up to 217,000 jobs.\u003c/p>\n\u003cp>In the rural Central Valley community of Visalia, Kaweah Health Center receives more than 30% of its revenue from Medi-Cal. The hospital is also the largest employer in Tulare County.\u003c/p>\n\u003cp>“When a healthcare job is lost, that healthcare worker has less money to spend in their community, at the stores they normally shop at,” said Laurel Lucia, director of the Health Care Program at the Labor Center. “That in turn could lead to job losses in those other non-healthcare industries.”\u003c/p>\n\u003cp>The potential cuts could also slow Republican momentum in California heading into the 2026 midterm elections. A \u003ca href=\"https://www.kqed.org/news/12033802/how-cuts-medicaid-republican-gains-california\">KQED analysis\u003c/a> found the congressional districts that shifted most toward Trump between 2020 and 2024 rely disproportionately on Medi-Cal. Enrollment is especially high in a pair of Central Valley swing districts held by Republican Rep. David Valadao and Democratic Rep. Adam Gray.\u003c/p>\n\u003cp>Republicans may be backing away from changes to the federal matching fund rates provided to the states.\u003c/p>\n\u003cp>New Jersey Republican Rep. Jeff Van Drew said those Medicaid changes “are dead.”\u003c/p>\n\u003cp>Instead, moderate Republicans have emphasized support for a different suite of ideas, such as restricting Medicaid access for undocumented immigrants and adults without jobs — ideas that would likely result in fewer savings, but generate less political blowback.\u003c/p>\n\u003cp>California has expanded Medi-Cal enrollment to residents without citizenship, a move that appears broadly popular in the new IGS polling. Support for providing Medi-Cal coverage for undocumented Californians stands at 61% for undocumented children, 49% for adults up to age 49, and 53% for those over age 50.\u003c/p>\n\u003cp>\u003cem>This story includes reporting from \u003c/em>\u003ca href=\"https://apnews.com/\">\u003cem>The Associated Press\u003c/em>\u003c/a>\u003cem> and KQED’s \u003c/em>\u003ca href=\"https://www.kqed.org/author/mbolanos\">\u003cem>Madi Bolaños\u003c/em>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n",
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"excerpt": "New polling from the UC Berkeley Institute of Governmental Studies finds two-thirds of California voters on Medi-Cal fear losing their health coverage.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Californians are expressing widespread worry about the future of \u003ca href=\"https://www.kqed.org/news/tag/medicaid\">Medicaid\u003c/a>, as Republicans in Congress weigh cuts to the program that covers health care for Americans with low incomes and disabilities.\u003c/p>\n\u003cp>GOP leaders are looking for budget savings to pay for the extension of tax cuts favored by President Donald Trump, but the idea of cutting Medicaid has raised alarm among some in the party — including \u003ca href=\"https://www.kqed.org/news/12032994/democrats-focus-their-message-on-gop-cuts-to-medicaid\">California Republicans\u003c/a> who represent districts with high numbers of Medicaid recipients. A \u003ca href=\"https://escholarship.org/uc/item/1nd0h87z\">pair of surveys\u003c/a> released \u003ca href=\"https://escholarship.org/uc/item/40r36594\">this week\u003c/a> by the UC Berkeley Institute of Governmental Studies found broad concern about \u003ca href=\"https://www.kqed.org/news/tag/medi-cal\">Medi-Cal\u003c/a>, the state’s Medicaid program, among California voters.\u003c/p>\n\u003cp>A full two-thirds, 67%, of registered voters who receive coverage through Medi-Cal are worried that they, or a family member, will lose insurance due to changes being pursued by the Trump administration. In a separate survey, 56% of voters polled said that the Trump administration’s proposed changes to Medi-Cal will have a “negative impact” on California.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Only tariffs ranked higher on voters’ lists of issues facing negative headwinds from Washington, said Mark DiCamillo, the poll’s director.\u003c/p>\n\u003cp>“Medi-Cal was right up there, so it’s one of the areas where most voters have concerns,” he said.\u003c/p>\n\u003cp>The program has emerged as a key inflection point in House Republicans’ budget talks this week. House Speaker Mike Johnson has been meeting privately in his office with groups of Republicans, as he works to enact the president’s legislative agenda with a slim seven-seat majority.\u003c/p>\n\u003cfigure id=\"attachment_12030841\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12030841\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/GettyImages-2201320740.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/GettyImages-2201320740.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/GettyImages-2201320740-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/GettyImages-2201320740-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/GettyImages-2201320740-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/GettyImages-2201320740-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/GettyImages-2201320740-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">A “Save Medicaid” sign is affixed to the podium for the House Democrats’ press event to oppose the Republicans’ budget on the House steps of the Capitol on Tuesday, February 25, 2024. \u003ccite>(Bill Clark/CQ-Roll Call, Inc., via Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The IGS surveys did not ask specifically about the budget plan, which sets a target of $880 billion in spending cuts over the next decade from the committee that oversees Medicaid spending. Trump has supported the budget framework, but told NBC last week that House Republicans are “not cutting [Medicaid]. They’re looking at fraud, waste and abuse.”\u003c/p>\n\u003cp>An \u003ca href=\"https://www.cbo.gov/system/files/2025-03/61235-Boyle-Pallone.pdf\">analysis\u003c/a> by the nonpartisan Congressional Budget Office shows that there is no way to reach the spending target without cutting Medicaid.\u003c/p>\n\u003cp>For most enrollees, Medi-Cal costs are shared evenly between California and the federal government. However, the federal government picks up 90% of the tab for the Medicaid expansion authorized through the Affordable Care Act, which covers Californians making up to $21,597.\u003c/p>\n\u003cp>Fiscal conservatives in the GOP caucus have floated ideas such as reducing the federal cost-share for expansion enrollees or enacting a per-enrollee cap on federal spending. Those proposals would generate significant savings in the range of $700 billion, according to the Congressional Budget Office, but also result in millions of Americans losing their health insurance.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Supporters of Medi-Cal warn that the impact of cuts will ripple beyond the patients who lose insurance. A \u003ca href=\"https://laborcenter.berkeley.edu/california-could-lose-up-to-217000-jobs-if-congress-cuts-medicaid/\">report\u003c/a> from the UC Berkeley Labor Center found that reductions to the healthcare program could result in the loss of up to 217,000 jobs.\u003c/p>\n\u003cp>In the rural Central Valley community of Visalia, Kaweah Health Center receives more than 30% of its revenue from Medi-Cal. The hospital is also the largest employer in Tulare County.\u003c/p>\n\u003cp>“When a healthcare job is lost, that healthcare worker has less money to spend in their community, at the stores they normally shop at,” said Laurel Lucia, director of the Health Care Program at the Labor Center. “That in turn could lead to job losses in those other non-healthcare industries.”\u003c/p>\n\u003cp>The potential cuts could also slow Republican momentum in California heading into the 2026 midterm elections. A \u003ca href=\"https://www.kqed.org/news/12033802/how-cuts-medicaid-republican-gains-california\">KQED analysis\u003c/a> found the congressional districts that shifted most toward Trump between 2020 and 2024 rely disproportionately on Medi-Cal. Enrollment is especially high in a pair of Central Valley swing districts held by Republican Rep. David Valadao and Democratic Rep. Adam Gray.\u003c/p>\n\u003cp>Republicans may be backing away from changes to the federal matching fund rates provided to the states.\u003c/p>\n\u003cp>New Jersey Republican Rep. Jeff Van Drew said those Medicaid changes “are dead.”\u003c/p>\n\u003cp>Instead, moderate Republicans have emphasized support for a different suite of ideas, such as restricting Medicaid access for undocumented immigrants and adults without jobs — ideas that would likely result in fewer savings, but generate less political blowback.\u003c/p>\n\u003cp>California has expanded Medi-Cal enrollment to residents without citizenship, a move that appears broadly popular in the new IGS polling. Support for providing Medi-Cal coverage for undocumented Californians stands at 61% for undocumented children, 49% for adults up to age 49, and 53% for those over age 50.\u003c/p>\n\u003cp>\u003cem>This story includes reporting from \u003c/em>\u003ca href=\"https://apnews.com/\">\u003cem>The Associated Press\u003c/em>\u003c/a>\u003cem> and KQED’s \u003c/em>\u003ca href=\"https://www.kqed.org/author/mbolanos\">\u003cem>Madi Bolaños\u003c/em>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"slug": "ct-scans-save-lives-but-as-theyre-used-more-often-how-many-are-causing-cancer",
"title": "CT Scans Save Lives. But as They’re Used More Often, How Many Are Causing Cancer?",
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"headTitle": "CT Scans Save Lives. But as They’re Used More Often, How Many Are Causing Cancer? | KQED",
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"content": "\u003cp>As CT scans become increasingly prevalent in U.S. health care, radiation from the often lifesaving imaging technique could come with a steep long-term cost: tens of thousands more cases of cancer, according to a \u003ca href=\"https://www.kqed.org/news/tag/ucsf\">UCSF\u003c/a> study published Monday in \u003ca href=\"https://jamanetwork.com/journals/jamainternalmedicine\">JAMA Internal Medicine\u003c/a>.\u003c/p>\n\u003cp>Researchers analyzed CT scan data and estimated that the 93 million scans performed in 2023 — nearly one for every three people in the country — could lead to approximately 103,000 future cancer cases over patients’ lifetimes. A similar analysis years earlier estimated that routine CT exposures in 2007 would lead to about 29,000 future cancer cases.\u003c/p>\n\u003cp>The projection reflects both the sharp rise in how often CT scans are used and the higher radiation doses many patients now receive.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“Most patients will not develop cancer from a CT scan,” said Dr. Rebecca Smith-Bindman, lead author and professor of epidemiology and biostatistics at UCSF. “But if you’re not getting any benefit, then even a small risk is unacceptable.”\u003c/p>\n\u003cp>During a CT scan, a patient lies on a table that slides through a large, donut-shaped machine. Inside, an X-ray tube rotates around the body, capturing images of thin slices — like layers of a loaf of bread. A computer then assembles those slices into a 3D image that doctors use to spot injuries, tumors or other abnormalities.\u003c/p>\n\u003cfigure id=\"attachment_12032820\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12032820\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/UCSFGetty.jpg\" alt=\"\" width=\"2000\" height=\"1343\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/UCSFGetty.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/UCSFGetty-800x537.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/UCSFGetty-1020x685.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/UCSFGetty-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/UCSFGetty-1536x1031.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/UCSFGetty-1920x1289.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">UCSF Mission Bay campus on Feb. 10, 2025, in San Francisco, California. \u003ccite>(Justin Sullivan/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The process exposes the body to radiation, which can alter DNA. Most of the time, the body repairs these changes. However, occasionally, a cell keeps dividing abnormally, and over time, that can lead to cancer.\u003c/p>\n\u003cp>“There’s DNA damage response pathways that are active all the time that take these insults, and they repair your DNA,” said Dr. Patricia Nguyen, a cardiologist at Stanford who was not involved in the study. “But as we age, those responses aren’t as strong … and that’s when damaged cells can turn into cancer.”\u003c/p>\n\u003cp>The researchers used the National Cancer Institute’s Radiation Risk Assessment Tool, which estimates cancer risk based on scan type, patient age and radiation dose. The model draws on historical data, including studies of Japanese atomic bomb survivors. While the methodology is widely accepted in public health research, it has limitations.\u003c/p>\n\u003cp>“They don’t know what’s happening biologically to the actual patient,” Nguyen said. “They are just basing it on formulas or retrospective data … we don’t know what happens in each individual.”[aside postID=news_12035344 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250408-CAL-TECH-TESTING-113-ZS-KQED-1020x680.jpg']CT scans are often essential — especially in emergencies like a serious car crash, when doctors need to quickly check for internal bleeding. But they’re also used far more often than necessary. Some are ordered for mild headaches or routine infections, when they’re unlikely to change a diagnosis or improve care.\u003c/p>\n\u003cp>“Our estimates put CT on par with other significant risk factors, such as alcohol consumption and excess body weight,” Smith-Bindman said. “Reducing the number of scans and reducing doses per scan would save lives.”\u003c/p>\n\u003cp>Use of the technology has climbed 35% over the last decade. A mix of pressure and convenience drives the increase: Doctors have less time with patients, imaging is typically reimbursed by insurance, and patients often expect a clear answer. Meanwhile, as medicine shifts away from open surgeries to less invasive procedures, physicians increasingly rely on CT scans to plan and guide treatment.\u003c/p>\n\u003cp>The researchers found that certain types of CT scans — especially of the abdomen and pelvis — were responsible for a large share of the projected cancer cases. Many involved “multiphase” imaging, where a patient is scanned two or three times in one session. While that approach can be clinically useful, the study found it’s often unnecessary.\u003c/p>\n\u003cp>The takeaway isn’t to avoid CT scans but to be more thoughtful about when they’re used — and why. For some patients, asking a simple question may be the best safeguard.\u003c/p>\n\u003cp>“Every test has potential risks,” Nguyen said. “And patients should ask: Why am I getting this? What will the result change?”\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>As CT scans become increasingly prevalent in U.S. health care, radiation from the often lifesaving imaging technique could come with a steep long-term cost: tens of thousands more cases of cancer, according to a \u003ca href=\"https://www.kqed.org/news/tag/ucsf\">UCSF\u003c/a> study published Monday in \u003ca href=\"https://jamanetwork.com/journals/jamainternalmedicine\">JAMA Internal Medicine\u003c/a>.\u003c/p>\n\u003cp>Researchers analyzed CT scan data and estimated that the 93 million scans performed in 2023 — nearly one for every three people in the country — could lead to approximately 103,000 future cancer cases over patients’ lifetimes. A similar analysis years earlier estimated that routine CT exposures in 2007 would lead to about 29,000 future cancer cases.\u003c/p>\n\u003cp>The projection reflects both the sharp rise in how often CT scans are used and the higher radiation doses many patients now receive.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“Most patients will not develop cancer from a CT scan,” said Dr. Rebecca Smith-Bindman, lead author and professor of epidemiology and biostatistics at UCSF. “But if you’re not getting any benefit, then even a small risk is unacceptable.”\u003c/p>\n\u003cp>During a CT scan, a patient lies on a table that slides through a large, donut-shaped machine. Inside, an X-ray tube rotates around the body, capturing images of thin slices — like layers of a loaf of bread. A computer then assembles those slices into a 3D image that doctors use to spot injuries, tumors or other abnormalities.\u003c/p>\n\u003cfigure id=\"attachment_12032820\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12032820\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/UCSFGetty.jpg\" alt=\"\" width=\"2000\" height=\"1343\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/UCSFGetty.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/UCSFGetty-800x537.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/UCSFGetty-1020x685.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/UCSFGetty-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/UCSFGetty-1536x1031.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/UCSFGetty-1920x1289.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">UCSF Mission Bay campus on Feb. 10, 2025, in San Francisco, California. \u003ccite>(Justin Sullivan/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The process exposes the body to radiation, which can alter DNA. Most of the time, the body repairs these changes. However, occasionally, a cell keeps dividing abnormally, and over time, that can lead to cancer.\u003c/p>\n\u003cp>“There’s DNA damage response pathways that are active all the time that take these insults, and they repair your DNA,” said Dr. Patricia Nguyen, a cardiologist at Stanford who was not involved in the study. “But as we age, those responses aren’t as strong … and that’s when damaged cells can turn into cancer.”\u003c/p>\n\u003cp>The researchers used the National Cancer Institute’s Radiation Risk Assessment Tool, which estimates cancer risk based on scan type, patient age and radiation dose. The model draws on historical data, including studies of Japanese atomic bomb survivors. While the methodology is widely accepted in public health research, it has limitations.\u003c/p>\n\u003cp>“They don’t know what’s happening biologically to the actual patient,” Nguyen said. “They are just basing it on formulas or retrospective data … we don’t know what happens in each individual.”\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>CT scans are often essential — especially in emergencies like a serious car crash, when doctors need to quickly check for internal bleeding. But they’re also used far more often than necessary. Some are ordered for mild headaches or routine infections, when they’re unlikely to change a diagnosis or improve care.\u003c/p>\n\u003cp>“Our estimates put CT on par with other significant risk factors, such as alcohol consumption and excess body weight,” Smith-Bindman said. “Reducing the number of scans and reducing doses per scan would save lives.”\u003c/p>\n\u003cp>Use of the technology has climbed 35% over the last decade. A mix of pressure and convenience drives the increase: Doctors have less time with patients, imaging is typically reimbursed by insurance, and patients often expect a clear answer. Meanwhile, as medicine shifts away from open surgeries to less invasive procedures, physicians increasingly rely on CT scans to plan and guide treatment.\u003c/p>\n\u003cp>The researchers found that certain types of CT scans — especially of the abdomen and pelvis — were responsible for a large share of the projected cancer cases. Many involved “multiphase” imaging, where a patient is scanned two or three times in one session. While that approach can be clinically useful, the study found it’s often unnecessary.\u003c/p>\n\u003cp>The takeaway isn’t to avoid CT scans but to be more thoughtful about when they’re used — and why. For some patients, asking a simple question may be the best safeguard.\u003c/p>\n\u003cp>“Every test has potential risks,” Nguyen said. “And patients should ask: Why am I getting this? What will the result change?”\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Tens of thousands of workers in health care, service, research and other roles at the \u003ca href=\"https://www.kqed.org/news/12027153/uc-workers-vote-to-strike-amid-federal-funding-threats\">University of California\u003c/a> walked off the job on Tuesday for the third time in five months as contentious contract negotiations drag on.\u003c/p>\n\u003cp>Labor experts said \u003ca href=\"https://www.kqed.org/news/12028446/tens-of-thousands-uc-workers-strike-disrupting-campuses-hospitals-labs\">yet another strike\u003c/a> across all UC campuses, hospitals and laboratories — this one limited to a single day — points to a high level of frustration with the state’s second-largest employer as workers push for improved wages and staffing.\u003c/p>\n\u003cp>“These workers — who are community members but also patients in the health care system — are determined to make sure that these jobs are sustainable and that they can remain in these jobs,” said Rebecca Givan, a professor of labor studies and employment relations at Rutgers University who has followed the health care industry for decades.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Tuesday’s walkout over UC’s alleged unfair labor practices was initiated by the University Professional and Technical Employees (UPTE), which represents about 20,000 physician assistants, pharmacists, IT analysts and others. An additional 37,000 patient care, technical and service workers represented by the American Federation of State, County and Municipal Employees (AFSCME) joined the strike in solidarity.\u003c/p>\n\u003cp>Both unions have repeatedly gone to state regulators to accuse the UC system of unlawful bad-faith bargaining, which the university strongly denies. The California Public Employment Relations Board is investigating the allegations.\u003c/p>\n\u003cp>At UC Berkeley on Tuesday, a long line of workers marched around campus, holding signs that read “For our patients, for our research, for our students,” and “On Strike,” before a midday rally.\u003c/p>\n\u003cp>[aside postID=news_12032232 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/GettyImages-2201544551-1020x729.jpg']\u003c/p>\n\u003cp>“All we want is to be able to have adequate staffing, to have enough co-workers to accomplish whatever our mission is at our worksite,” said Catherine Callaway, a UC Berkeley museum scientist and UPTE worksite representative. “What it feels like day to day is looking at all the things that you can’t possibly get done, watching your co-workers slowly burn out, watching people leave before they should really have to.”\u003c/p>\n\u003cp>UPTE members \u003ca href=\"https://upte.org/ucstrike\">argue that the university’s plans\u003c/a> to increase their health care costs without bargaining over the changes will exacerbate a recruitment and retention crisis that is hurting patient care and research. The university denies that a staffing crisis is taking place, \u003ca href=\"https://labor.universityofcalifornia.edu/_files/upte-2025-fact-sheet.pdf\">pointing (PDF)\u003c/a> to lower turnover rates and increasing headcounts.\u003c/p>\n\u003cp>Last month, UC President Michael Drake announced \u003ca href=\"https://www.kqed.org/news/12032232/head-of-ucs-largest-union-blasts-top-brass-for-hiring-freeze-amid-massive-vacancy-crisis\">a systemwide hiring freeze\u003c/a> and other cost-saving measures as the university faces threats to its federal and state funding. Since contract negotiations with AFSCME and UPTE began in January and June 2024, respectively, UC has offered “generous wage increases,” expanded sick leave and other benefits to try to avoid strike disruptions, according to a \u003ca href=\"https://www.universityofcalifornia.edu/press-room/statement-april-1-upte-and-afscme-strike\">statement\u003c/a> by the university.\u003c/p>\n\u003cp>“These strikes cost the University system millions of dollars, at a time when federal and state funding is uncertain,” the UC statement read. “UPTE and AFSCME are not being forthright in their characterizations, which is upsetting since we’ve made sincere efforts to find mutually beneficial solutions. Regardless, we are hopeful AFSCME and UPTE will make meaningful efforts to settle these contracts soon.”\u003c/p>\n\u003cfigure id=\"attachment_12034103\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12034103\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250226-UC-STRIKE-MD-12_qed.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250226-UC-STRIKE-MD-12_qed.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250226-UC-STRIKE-MD-12_qed-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250226-UC-STRIKE-MD-12_qed-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250226-UC-STRIKE-MD-12_qed-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250226-UC-STRIKE-MD-12_qed-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250226-UC-STRIKE-MD-12_qed-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Members of the University Professional and Technical Employees Local 9119 and the American Federation of State County and Municipal Employees Local 3299 strike at the UC Mission Bay Campus in San Francisco on Feb. 26, 2025. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The unions argue that even if budget reductions are necessary, the cuts should not be disproportionately shouldered by their members’ paychecks and working conditions. They have noted that the university approved big raises for campus chancellors last year and continued to invest in new hospital buildings and other large capital projects.\u003c/p>\n\u003cp>AFSCME and UC representatives are scheduled to meet in the coming weeks, according to a university spokesperson. State regulators have intervened in the UPTE negotiations after that union declared in January that talks with UC broke down.\u003c/p>\n\u003cp>The strikes by UPTE and AFSCME, including for a few days in November and February, have been the largest in the country in 2024 and so far this year, according to Johnnie Kallas, who directs the \u003ca href=\"https://striketracker.ilr.cornell.edu/\">Labor Action Tracker\u003c/a>, a project by Cornell University and the University of Illinois.\u003c/p>\n\u003cp>In health care, education and other settings, limited-duration strikes are much more common than indefinite walkouts, which tend to be more disruptive for employers as well as workers who forgo their paychecks, Kallas added.\u003c/p>\n\u003cp>“Workers and their representatives in the unions are very frustrated that UC hasn’t — at least in their mind — meaningfully come to the table to resolve their outstanding issues,” he said. “But it hasn’t reached the point where, for a variety of reasons, the union and the workers have decided they want to go on an even longer strike, which would be even more disruptive.”\u003c/p>\n\u003cp>\u003cem>KQED’s \u003c/em>\u003ca href=\"https://www.kqed.org/author/bkrans\">\u003cem>Brian Krans\u003c/em>\u003c/a>\u003cem> contributed to this report.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Tens of thousands of workers in health care, service, research and other roles at the \u003ca href=\"https://www.kqed.org/news/12027153/uc-workers-vote-to-strike-amid-federal-funding-threats\">University of California\u003c/a> walked off the job on Tuesday for the third time in five months as contentious contract negotiations drag on.\u003c/p>\n\u003cp>Labor experts said \u003ca href=\"https://www.kqed.org/news/12028446/tens-of-thousands-uc-workers-strike-disrupting-campuses-hospitals-labs\">yet another strike\u003c/a> across all UC campuses, hospitals and laboratories — this one limited to a single day — points to a high level of frustration with the state’s second-largest employer as workers push for improved wages and staffing.\u003c/p>\n\u003cp>“These workers — who are community members but also patients in the health care system — are determined to make sure that these jobs are sustainable and that they can remain in these jobs,” said Rebecca Givan, a professor of labor studies and employment relations at Rutgers University who has followed the health care industry for decades.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Tuesday’s walkout over UC’s alleged unfair labor practices was initiated by the University Professional and Technical Employees (UPTE), which represents about 20,000 physician assistants, pharmacists, IT analysts and others. An additional 37,000 patient care, technical and service workers represented by the American Federation of State, County and Municipal Employees (AFSCME) joined the strike in solidarity.\u003c/p>\n\u003cp>Both unions have repeatedly gone to state regulators to accuse the UC system of unlawful bad-faith bargaining, which the university strongly denies. The California Public Employment Relations Board is investigating the allegations.\u003c/p>\n\u003cp>At UC Berkeley on Tuesday, a long line of workers marched around campus, holding signs that read “For our patients, for our research, for our students,” and “On Strike,” before a midday rally.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“All we want is to be able to have adequate staffing, to have enough co-workers to accomplish whatever our mission is at our worksite,” said Catherine Callaway, a UC Berkeley museum scientist and UPTE worksite representative. “What it feels like day to day is looking at all the things that you can’t possibly get done, watching your co-workers slowly burn out, watching people leave before they should really have to.”\u003c/p>\n\u003cp>UPTE members \u003ca href=\"https://upte.org/ucstrike\">argue that the university’s plans\u003c/a> to increase their health care costs without bargaining over the changes will exacerbate a recruitment and retention crisis that is hurting patient care and research. The university denies that a staffing crisis is taking place, \u003ca href=\"https://labor.universityofcalifornia.edu/_files/upte-2025-fact-sheet.pdf\">pointing (PDF)\u003c/a> to lower turnover rates and increasing headcounts.\u003c/p>\n\u003cp>Last month, UC President Michael Drake announced \u003ca href=\"https://www.kqed.org/news/12032232/head-of-ucs-largest-union-blasts-top-brass-for-hiring-freeze-amid-massive-vacancy-crisis\">a systemwide hiring freeze\u003c/a> and other cost-saving measures as the university faces threats to its federal and state funding. Since contract negotiations with AFSCME and UPTE began in January and June 2024, respectively, UC has offered “generous wage increases,” expanded sick leave and other benefits to try to avoid strike disruptions, according to a \u003ca href=\"https://www.universityofcalifornia.edu/press-room/statement-april-1-upte-and-afscme-strike\">statement\u003c/a> by the university.\u003c/p>\n\u003cp>“These strikes cost the University system millions of dollars, at a time when federal and state funding is uncertain,” the UC statement read. “UPTE and AFSCME are not being forthright in their characterizations, which is upsetting since we’ve made sincere efforts to find mutually beneficial solutions. Regardless, we are hopeful AFSCME and UPTE will make meaningful efforts to settle these contracts soon.”\u003c/p>\n\u003cfigure id=\"attachment_12034103\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12034103\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250226-UC-STRIKE-MD-12_qed.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250226-UC-STRIKE-MD-12_qed.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250226-UC-STRIKE-MD-12_qed-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250226-UC-STRIKE-MD-12_qed-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250226-UC-STRIKE-MD-12_qed-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250226-UC-STRIKE-MD-12_qed-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250226-UC-STRIKE-MD-12_qed-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Members of the University Professional and Technical Employees Local 9119 and the American Federation of State County and Municipal Employees Local 3299 strike at the UC Mission Bay Campus in San Francisco on Feb. 26, 2025. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The unions argue that even if budget reductions are necessary, the cuts should not be disproportionately shouldered by their members’ paychecks and working conditions. They have noted that the university approved big raises for campus chancellors last year and continued to invest in new hospital buildings and other large capital projects.\u003c/p>\n\u003cp>AFSCME and UC representatives are scheduled to meet in the coming weeks, according to a university spokesperson. State regulators have intervened in the UPTE negotiations after that union declared in January that talks with UC broke down.\u003c/p>\n\u003cp>The strikes by UPTE and AFSCME, including for a few days in November and February, have been the largest in the country in 2024 and so far this year, according to Johnnie Kallas, who directs the \u003ca href=\"https://striketracker.ilr.cornell.edu/\">Labor Action Tracker\u003c/a>, a project by Cornell University and the University of Illinois.\u003c/p>\n\u003cp>In health care, education and other settings, limited-duration strikes are much more common than indefinite walkouts, which tend to be more disruptive for employers as well as workers who forgo their paychecks, Kallas added.\u003c/p>\n\u003cp>“Workers and their representatives in the unions are very frustrated that UC hasn’t — at least in their mind — meaningfully come to the table to resolve their outstanding issues,” he said. “But it hasn’t reached the point where, for a variety of reasons, the union and the workers have decided they want to go on an even longer strike, which would be even more disruptive.”\u003c/p>\n\u003cp>\u003cem>KQED’s \u003c/em>\u003ca href=\"https://www.kqed.org/author/bkrans\">\u003cem>Brian Krans\u003c/em>\u003c/a>\u003cem> contributed to this report.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Santa Clara County has officially \u003ca href=\"https://www.kqed.org/news/12021981/santa-clara-county-reaches-definitive-deal-to-buy-east-san-jose-hospital-for-150-million\">brought a crucial regional hospital into public ownership\u003c/a>, following more than a year of turmoil that was touched off when a national health care corporation announced it would shutter the East San José facility’s trauma center and downgrade services.\u003c/p>\n\u003cp>Tuesday marked the first day that Regional Medical Center is operating under the umbrella of Santa Clara Valley Healthcare — the county’s public hospital and clinic system — joining Valley Medical Center and O’Connor Hospital in San José, as well as St. Louise Regional Hospital in Gilroy.\u003c/p>\n\u003cp>The county announced Tuesday that the facility’s Level II trauma center, which was downgraded by the hospital’s previous owner, HCA Healthcare, in August, has been restored and is fully operational again, along with other service reinstatements.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“This is about a commitment to excellence in service. This is about a commitment to ensuring access to health care. This is about providing opportunity to families who otherwise would go without,” James R. Williams, the county executive, said Tuesday during a ceremony at the facility,\u003c/p>\n\u003cp>Williams said the county board and other leaders have shown great leadership to ensure every resident in the county has access to quality health care.\u003c/p>\n\u003cfigure id=\"attachment_12034081\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-12034081 size-full\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250401-REGIONALMED-JG-3_qed.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250401-REGIONALMED-JG-3_qed.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250401-REGIONALMED-JG-3_qed-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250401-REGIONALMED-JG-3_qed-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250401-REGIONALMED-JG-3_qed-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250401-REGIONALMED-JG-3_qed-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250401-REGIONALMED-JG-3_qed-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Santa Clara County executive James R. Williams speaks during a ceremony at Regional Medical Center in East San José to mark the county’s first day of ownership of the facility on April 1, 2025. \u003ccite>(Joseph Geha/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“Even in the face of extraordinary challenges at the federal level, we are making that investment because we know what is possible, we know what is necessary,” Williams said. “We know what it means for the people who live here.”\u003c/p>\n\u003cp>The county’s takeover of Regional Medical Center follows months of negotiations with HCA over a purchase agreement. The county \u003ca href=\"https://www.kqed.org/news/12001214/santa-clara-county-plans-to-buy-east-san-jose-hospital-to-reverse-cuts-to-care\">initially announced its plan to buy the hospital in August\u003c/a> at roughly $175 million, which was \u003ca href=\"https://www.kqed.org/news/12021981/santa-clara-county-reaches-definitive-deal-to-buy-east-san-jose-hospital-for-150-million\">reduced to $150 million\u003c/a> in a January update from the county about the finalization of the deal.[aside postID=news_12021981 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2024/06/240613-REGIONALMED-JG-1-1020x680.jpg']The 258-bed hospital is the main emergency facility for East San José and much of the eastern portion of Santa Clara County. Nashville-based HCA sent shockwaves into the region when it announced in February 2024 that it planned to close the trauma center and completely eliminate severe heart attack services and downgrade stroke services in August.\u003c/p>\n\u003cp>Following months of public outcry, including \u003ca href=\"https://www.kqed.org/news/11990284/doctors-community-leaders-ramp-up-efforts-to-halt-closure-of-east-san-jose-trauma-center\">protests and demonstrations\u003c/a> by health care workers and local and regional elected officials, HCA partially backed off those plans in mid-July, though it still made several reductions in levels of service and care.\u003c/p>\n\u003cp>County officials warned the closures and reductions would significantly impact people living in the surrounding areas, \u003ca href=\"https://www.kqed.org/news/11987665/advocates-urge-state-to-intervene-in-closure-of-san-jose-trauma-center\">including some of the most diverse and socioeconomically disadvantaged\u003c/a> portions of the county.\u003c/p>\n\u003cp>More than half of the residents in the area are Latino, about a third are Asian American, roughly 11% are white, and just under 2.5% are African American. People living there face higher rates of chronic disease, trauma and poverty — and they are twice as likely to lack health insurance, the county said.\u003c/p>\n\u003cp>“Today is a great day for the county of Santa Clara and for the residents of East San José, and for our entire county community,” said Betty Duong, the District 2 supervisor for Santa Clara County, who represents the area where the Regional Medical Center operates.\u003c/p>\n\u003cfigure id=\"attachment_12034077\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-12034077 size-full\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250401-REGIONALMED-JG-7_qed.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250401-REGIONALMED-JG-7_qed.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250401-REGIONALMED-JG-7_qed-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250401-REGIONALMED-JG-7_qed-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250401-REGIONALMED-JG-7_qed-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250401-REGIONALMED-JG-7_qed-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250401-REGIONALMED-JG-7_qed-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Betty Duong, the District 2 supervisor for Santa Clara County, speaks during a ceremony at Regional Medical Center in East San José on April 1, 2025. \u003ccite>(Joseph Geha/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Duong said her father was treated at the hospital when he was hit by a car, and her mother was treated there when she had a stroke, and she expressed gratitude to the roughly 1,000 staff members of the facility.\u003c/p>\n\u003cp>“For years, the Regional Medical Center staff has been part of our family. And now I am so proud to be able to say that I’m part of yours,” she said.\u003c/p>\n\u003cp>In addition to the trauma center, the county has brought back vital stroke and severe heart attack services, also known as the ST-elevation myocardial infarction (STEMI) program. Labor and delivery care, which was eliminated by HCA in 2020, will also eventually be offered again at the hospital under the county’s stewardship, officials said.\u003c/p>\n\u003cp>“We are restoring critical, life-saving services to our community through this important acquisition,” said Supervisor Otto Lee, president of the Santa Clara County Board of Supervisors.\u003c/p>\n\u003cfigure id=\"attachment_12034078\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-12034078 size-full\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250401-REGIONALMED-JG-6_qed.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250401-REGIONALMED-JG-6_qed.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250401-REGIONALMED-JG-6_qed-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250401-REGIONALMED-JG-6_qed-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250401-REGIONALMED-JG-6_qed-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250401-REGIONALMED-JG-6_qed-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250401-REGIONALMED-JG-6_qed-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Sylvia Arenas, the District 1 supervisor for Santa Clara County, speaks during a ceremony at Regional Medical Center in East San José to mark the county’s first day of ownership of the facility, on April 1, 2025. \u003ccite>(Joseph Geha/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Dr. Gloria Jiménez, a trauma surgeon who previously worked at Regional Medical Center before it was shuttered in August, asked to return to the staff and work the first shift at the reopened trauma center.\u003c/p>\n\u003cp>“I contacted the leadership, and I said, ‘I’ve been there, that’s my family. I want to go back home, and I want to be there the first day,’” Jiménez said. “Walking through the hallways this morning, it was like coming home.”[aside postID=news_12032727 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/20240324_SANTACLARAMEDICALSTRIKE_GC-9-KQED-1020x680.jpg']She said having the facility owned in perpetuity by the county will offer residents not only life-saving services closer to home but confidence they will always have access to care.\u003c/p>\n\u003cp>The county is paying for the purchase of the hospital almost entirely through reimbursements the county received from the Federal Emergency Management Agency last year for its pandemic-related expenditures.\u003c/p>\n\u003cp>Not purchasing the hospital would have also resulted in significant costs to the county, officials said, as the service cuts at Regional Medical Center would require an increase in staffing and facility space at Valley Medical Center — which houses the only other trauma center within 15 miles — to serve additional patients.\u003c/p>\n\u003cp>In the first month after services were cut at Regional Medical Center in August, Valley Medical Center’s trauma center saw a 50% increase in patients compared to the same period from the prior year.\u003c/p>\n\u003cfigure id=\"attachment_12034092\" class=\"wp-caption aligncenter\" style=\"max-width: 1999px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12034092\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250401-REGIONALMED-JG-5_qed.jpg\" alt=\"\" width=\"1999\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250401-REGIONALMED-JG-5_qed.jpg 1999w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250401-REGIONALMED-JG-5_qed-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250401-REGIONALMED-JG-5_qed-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250401-REGIONALMED-JG-5_qed-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250401-REGIONALMED-JG-5_qed-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250401-REGIONALMED-JG-5_qed-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 1999px) 100vw, 1999px\">\u003cfigcaption class=\"wp-caption-text\">Susan Ellenberg, the District 4 supervisor for Santa Clara County, speaks during a ceremony at Regional Medical Center in East San José on April 1, 2025. \u003ccite>(Joseph Geha/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Supervisor Susan Ellenberg, who was the board president at the time the purchase agreement talks began, said Regional Medical Center not only plays a vital role in the eastern portion of the county but helps balance the loads at the other county facilities.\u003c/p>\n\u003cp>“Our emergency departments are near capacity most days, and ensuring a healthy RMC means that patients in this area can get service close to home, leading to better outcomes for them and to less pressure and other E.R. locations, enabling everyone who needs emergency care to receive it in a timely manner,” Ellenberg said.\u003c/p>\n\u003cp>HCA faced significant criticism for its decision to cut services at Regional Medical Center and was accused by advocates and officials of putting profits over people’s health, as it estimated it would rake in $6 billion in profit for 2024 across its privately owned hospital portfolio.\u003c/p>\n\u003cp>The company’s proposal to overhaul and expand Good Samaritan Hospital in San José’s West Valley area also faced opposition from residents and community advocates, in large part due to its cuts in East San José. However, the San José City Council ultimately approved the major development plan in November.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"excerpt": "A trauma center at Regional Medical Center in East San José that had been downgraded is back in operation on the first day under county ownership. ",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Santa Clara County has officially \u003ca href=\"https://www.kqed.org/news/12021981/santa-clara-county-reaches-definitive-deal-to-buy-east-san-jose-hospital-for-150-million\">brought a crucial regional hospital into public ownership\u003c/a>, following more than a year of turmoil that was touched off when a national health care corporation announced it would shutter the East San José facility’s trauma center and downgrade services.\u003c/p>\n\u003cp>Tuesday marked the first day that Regional Medical Center is operating under the umbrella of Santa Clara Valley Healthcare — the county’s public hospital and clinic system — joining Valley Medical Center and O’Connor Hospital in San José, as well as St. Louise Regional Hospital in Gilroy.\u003c/p>\n\u003cp>The county announced Tuesday that the facility’s Level II trauma center, which was downgraded by the hospital’s previous owner, HCA Healthcare, in August, has been restored and is fully operational again, along with other service reinstatements.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“This is about a commitment to excellence in service. This is about a commitment to ensuring access to health care. This is about providing opportunity to families who otherwise would go without,” James R. Williams, the county executive, said Tuesday during a ceremony at the facility,\u003c/p>\n\u003cp>Williams said the county board and other leaders have shown great leadership to ensure every resident in the county has access to quality health care.\u003c/p>\n\u003cfigure id=\"attachment_12034081\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-12034081 size-full\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250401-REGIONALMED-JG-3_qed.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250401-REGIONALMED-JG-3_qed.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250401-REGIONALMED-JG-3_qed-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250401-REGIONALMED-JG-3_qed-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250401-REGIONALMED-JG-3_qed-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250401-REGIONALMED-JG-3_qed-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250401-REGIONALMED-JG-3_qed-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Santa Clara County executive James R. Williams speaks during a ceremony at Regional Medical Center in East San José to mark the county’s first day of ownership of the facility on April 1, 2025. \u003ccite>(Joseph Geha/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“Even in the face of extraordinary challenges at the federal level, we are making that investment because we know what is possible, we know what is necessary,” Williams said. “We know what it means for the people who live here.”\u003c/p>\n\u003cp>The county’s takeover of Regional Medical Center follows months of negotiations with HCA over a purchase agreement. The county \u003ca href=\"https://www.kqed.org/news/12001214/santa-clara-county-plans-to-buy-east-san-jose-hospital-to-reverse-cuts-to-care\">initially announced its plan to buy the hospital in August\u003c/a> at roughly $175 million, which was \u003ca href=\"https://www.kqed.org/news/12021981/santa-clara-county-reaches-definitive-deal-to-buy-east-san-jose-hospital-for-150-million\">reduced to $150 million\u003c/a> in a January update from the county about the finalization of the deal.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The 258-bed hospital is the main emergency facility for East San José and much of the eastern portion of Santa Clara County. Nashville-based HCA sent shockwaves into the region when it announced in February 2024 that it planned to close the trauma center and completely eliminate severe heart attack services and downgrade stroke services in August.\u003c/p>\n\u003cp>Following months of public outcry, including \u003ca href=\"https://www.kqed.org/news/11990284/doctors-community-leaders-ramp-up-efforts-to-halt-closure-of-east-san-jose-trauma-center\">protests and demonstrations\u003c/a> by health care workers and local and regional elected officials, HCA partially backed off those plans in mid-July, though it still made several reductions in levels of service and care.\u003c/p>\n\u003cp>County officials warned the closures and reductions would significantly impact people living in the surrounding areas, \u003ca href=\"https://www.kqed.org/news/11987665/advocates-urge-state-to-intervene-in-closure-of-san-jose-trauma-center\">including some of the most diverse and socioeconomically disadvantaged\u003c/a> portions of the county.\u003c/p>\n\u003cp>More than half of the residents in the area are Latino, about a third are Asian American, roughly 11% are white, and just under 2.5% are African American. People living there face higher rates of chronic disease, trauma and poverty — and they are twice as likely to lack health insurance, the county said.\u003c/p>\n\u003cp>“Today is a great day for the county of Santa Clara and for the residents of East San José, and for our entire county community,” said Betty Duong, the District 2 supervisor for Santa Clara County, who represents the area where the Regional Medical Center operates.\u003c/p>\n\u003cfigure id=\"attachment_12034077\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-12034077 size-full\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250401-REGIONALMED-JG-7_qed.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250401-REGIONALMED-JG-7_qed.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250401-REGIONALMED-JG-7_qed-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250401-REGIONALMED-JG-7_qed-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250401-REGIONALMED-JG-7_qed-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250401-REGIONALMED-JG-7_qed-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250401-REGIONALMED-JG-7_qed-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Betty Duong, the District 2 supervisor for Santa Clara County, speaks during a ceremony at Regional Medical Center in East San José on April 1, 2025. \u003ccite>(Joseph Geha/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Duong said her father was treated at the hospital when he was hit by a car, and her mother was treated there when she had a stroke, and she expressed gratitude to the roughly 1,000 staff members of the facility.\u003c/p>\n\u003cp>“For years, the Regional Medical Center staff has been part of our family. And now I am so proud to be able to say that I’m part of yours,” she said.\u003c/p>\n\u003cp>In addition to the trauma center, the county has brought back vital stroke and severe heart attack services, also known as the ST-elevation myocardial infarction (STEMI) program. Labor and delivery care, which was eliminated by HCA in 2020, will also eventually be offered again at the hospital under the county’s stewardship, officials said.\u003c/p>\n\u003cp>“We are restoring critical, life-saving services to our community through this important acquisition,” said Supervisor Otto Lee, president of the Santa Clara County Board of Supervisors.\u003c/p>\n\u003cfigure id=\"attachment_12034078\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-12034078 size-full\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250401-REGIONALMED-JG-6_qed.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250401-REGIONALMED-JG-6_qed.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250401-REGIONALMED-JG-6_qed-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250401-REGIONALMED-JG-6_qed-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250401-REGIONALMED-JG-6_qed-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250401-REGIONALMED-JG-6_qed-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250401-REGIONALMED-JG-6_qed-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Sylvia Arenas, the District 1 supervisor for Santa Clara County, speaks during a ceremony at Regional Medical Center in East San José to mark the county’s first day of ownership of the facility, on April 1, 2025. \u003ccite>(Joseph Geha/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Dr. Gloria Jiménez, a trauma surgeon who previously worked at Regional Medical Center before it was shuttered in August, asked to return to the staff and work the first shift at the reopened trauma center.\u003c/p>\n\u003cp>“I contacted the leadership, and I said, ‘I’ve been there, that’s my family. I want to go back home, and I want to be there the first day,’” Jiménez said. “Walking through the hallways this morning, it was like coming home.”\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>She said having the facility owned in perpetuity by the county will offer residents not only life-saving services closer to home but confidence they will always have access to care.\u003c/p>\n\u003cp>The county is paying for the purchase of the hospital almost entirely through reimbursements the county received from the Federal Emergency Management Agency last year for its pandemic-related expenditures.\u003c/p>\n\u003cp>Not purchasing the hospital would have also resulted in significant costs to the county, officials said, as the service cuts at Regional Medical Center would require an increase in staffing and facility space at Valley Medical Center — which houses the only other trauma center within 15 miles — to serve additional patients.\u003c/p>\n\u003cp>In the first month after services were cut at Regional Medical Center in August, Valley Medical Center’s trauma center saw a 50% increase in patients compared to the same period from the prior year.\u003c/p>\n\u003cfigure id=\"attachment_12034092\" class=\"wp-caption aligncenter\" style=\"max-width: 1999px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12034092\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250401-REGIONALMED-JG-5_qed.jpg\" alt=\"\" width=\"1999\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250401-REGIONALMED-JG-5_qed.jpg 1999w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250401-REGIONALMED-JG-5_qed-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250401-REGIONALMED-JG-5_qed-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250401-REGIONALMED-JG-5_qed-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250401-REGIONALMED-JG-5_qed-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/04/250401-REGIONALMED-JG-5_qed-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 1999px) 100vw, 1999px\">\u003cfigcaption class=\"wp-caption-text\">Susan Ellenberg, the District 4 supervisor for Santa Clara County, speaks during a ceremony at Regional Medical Center in East San José on April 1, 2025. \u003ccite>(Joseph Geha/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Supervisor Susan Ellenberg, who was the board president at the time the purchase agreement talks began, said Regional Medical Center not only plays a vital role in the eastern portion of the county but helps balance the loads at the other county facilities.\u003c/p>\n\u003cp>“Our emergency departments are near capacity most days, and ensuring a healthy RMC means that patients in this area can get service close to home, leading to better outcomes for them and to less pressure and other E.R. locations, enabling everyone who needs emergency care to receive it in a timely manner,” Ellenberg said.\u003c/p>\n\u003cp>HCA faced significant criticism for its decision to cut services at Regional Medical Center and was accused by advocates and officials of putting profits over people’s health, as it estimated it would rake in $6 billion in profit for 2024 across its privately owned hospital portfolio.\u003c/p>\n\u003cp>The company’s proposal to overhaul and expand Good Samaritan Hospital in San José’s West Valley area also faced opposition from residents and community advocates, in large part due to its cuts in East San José. However, the San José City Council ultimately approved the major development plan in November.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"title": "San Francisco’s HHS Office to Close in ‘Irresponsible’ Federal Health Cuts, Pelosi Says",
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"content": "\u003cp>The Trump administration will shutter San Francisco’s \u003ca href=\"https://www.kqed.org/news/tag/department-of-health-and-human-services\">Department of Health and Human Services\u003c/a> office this spring, Speaker Emerita Nancy Pelosi’s office confirmed Tuesday as thousands of layoffs began amid wide cuts to the federal health agency.\u003c/p>\n\u003cp>The regional office, located in the Speaker Nancy Pelosi Federal Building at 7th and Mission streets, is the home of \u003ca href=\"https://www.kqed.org/news/12033802/how-cuts-medicaid-republican-gains-california\">federal health programs like Medicaid\u003c/a> and Medicare, substance abuse and mental health resources and HIV/AIDS care for the western states of California, Arizona, Hawaii and Nevada, along with six nearby American territories.\u003c/p>\n\u003cp>It also employs hundreds of San Franciscans, who are among those across the department who began receiving layoff notices on Tuesday morning, according to reporting from the Associated Press.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“By closing our regional office, the Trump Administration would choose to put the health and safety of Bay Area residents and all Californians in jeopardy, gut vital public health initiatives like the Ryan White HIV/AIDS Program, and potentially axe hundreds of career civil servant jobs held by hard working Californians,” Pelosi said in a statement to KQED.\u003c/p>\n\u003cp>The nationwide layoffs are part of \u003ca href=\"https://www.kqed.org/news/12033326/preparing-trump-cuts-california-senator-proposes-research-vaccine-access-bills\">a massive overhaul\u003c/a> led by Health Secretary Robert F. Kennedy Jr., who announced last week that in the name of the administration’s focus on “government efficiency,” the department would terminate about an eighth of the workforce, or around 10,000 people. Combined with another 10,000 who have already left via early retirement or other means, the department is expected to shrink from about 82,000 employees to 62,000.[aside postID=news_12033802 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/250323-DEM-TOWN-HALLS-MD-14-KQED-1-1020x680.jpg']Kennedy announced in a statement that he plans to downsize the department, which is responsible for monitoring global trends and disease outbreaks, as well as \u003ca href=\"https://www.kqed.org/news/12033412/trump-administration-revokes-11-billion-in-funding-for-addiction-mental-health-care\">conducting medical research\u003c/a> and housing the Food and Drug Administration and federal health insurance programs.\u003c/p>\n\u003cp>He plans to halve the number of regional offices, like San Francisco’s, and decrease the number of divisions within the agency.\u003c/p>\n\u003cp>Notably, the new “Administration for a Healthy America” would merge the Substance Abuse and Mental Health Services Administration and the Agency for Toxic Substances and Disease Registry with three other agencies to “improve coordination of health resources for low income Americans.”\u003c/p>\n\u003cp>Pelosi said she and other Congress members were “examining all possible avenues to fight back against these irresponsible cuts,” saying that the decision is “shortsighted” and will slow down services for San Franciscans.\u003c/p>\n\u003cp>“Make no mistake: the reported plans to restructure HHS and close the San Francisco regional office would directly harm our most vulnerable communities and make America sicker,” Pelosi wrote in her statement.\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The Trump administration will shutter San Francisco’s \u003ca href=\"https://www.kqed.org/news/tag/department-of-health-and-human-services\">Department of Health and Human Services\u003c/a> office this spring, Speaker Emerita Nancy Pelosi’s office confirmed Tuesday as thousands of layoffs began amid wide cuts to the federal health agency.\u003c/p>\n\u003cp>The regional office, located in the Speaker Nancy Pelosi Federal Building at 7th and Mission streets, is the home of \u003ca href=\"https://www.kqed.org/news/12033802/how-cuts-medicaid-republican-gains-california\">federal health programs like Medicaid\u003c/a> and Medicare, substance abuse and mental health resources and HIV/AIDS care for the western states of California, Arizona, Hawaii and Nevada, along with six nearby American territories.\u003c/p>\n\u003cp>It also employs hundreds of San Franciscans, who are among those across the department who began receiving layoff notices on Tuesday morning, according to reporting from the Associated Press.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“By closing our regional office, the Trump Administration would choose to put the health and safety of Bay Area residents and all Californians in jeopardy, gut vital public health initiatives like the Ryan White HIV/AIDS Program, and potentially axe hundreds of career civil servant jobs held by hard working Californians,” Pelosi said in a statement to KQED.\u003c/p>\n\u003cp>The nationwide layoffs are part of \u003ca href=\"https://www.kqed.org/news/12033326/preparing-trump-cuts-california-senator-proposes-research-vaccine-access-bills\">a massive overhaul\u003c/a> led by Health Secretary Robert F. Kennedy Jr., who announced last week that in the name of the administration’s focus on “government efficiency,” the department would terminate about an eighth of the workforce, or around 10,000 people. Combined with another 10,000 who have already left via early retirement or other means, the department is expected to shrink from about 82,000 employees to 62,000.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Kennedy announced in a statement that he plans to downsize the department, which is responsible for monitoring global trends and disease outbreaks, as well as \u003ca href=\"https://www.kqed.org/news/12033412/trump-administration-revokes-11-billion-in-funding-for-addiction-mental-health-care\">conducting medical research\u003c/a> and housing the Food and Drug Administration and federal health insurance programs.\u003c/p>\n\u003cp>He plans to halve the number of regional offices, like San Francisco’s, and decrease the number of divisions within the agency.\u003c/p>\n\u003cp>Notably, the new “Administration for a Healthy America” would merge the Substance Abuse and Mental Health Services Administration and the Agency for Toxic Substances and Disease Registry with three other agencies to “improve coordination of health resources for low income Americans.”\u003c/p>\n\u003cp>Pelosi said she and other Congress members were “examining all possible avenues to fight back against these irresponsible cuts,” saying that the decision is “shortsighted” and will slow down services for San Franciscans.\u003c/p>\n\u003cp>“Make no mistake: the reported plans to restructure HHS and close the San Francisco regional office would directly harm our most vulnerable communities and make America sicker,” Pelosi wrote in her statement.\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"slug": "how-cuts-medicaid-republican-gains-california",
"title": "Here’s How Cuts to Medicaid Could Blunt Republican Gains in California",
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"content": "\u003cp>BAKERSFIELD — In 2021, \u003ca href=\"https://www.kqed.org/news/tag/bakersfield\">Bakersfield\u003c/a> resident Elizabeth Ramirez’s mother broke three bones in a fall, leaving Ramirez with a new set of responsibilities: cooking and cleaning for her mom, bathing her and driving her to appointments.\u003c/p>\n\u003cp>“So I was caregiving for her on top of my kids,” Ramirez said. “It was just a lot.”\u003c/p>\n\u003cp>After a few years of juggling, Ramirez became a registered care provider for her mother through the state’s In-Home Supportive Services, a program provided \u003ca href=\"https://www.kqed.org/news/12032878/gop-cuts-to-medicaid-snap-would-shrink-californias-economy-by-17-billion-and-kill-nearly-140000-jobs-new-study-finds\" target=\"_blank\" rel=\"noopener\">through Medi-Cal\u003c/a>.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“So the work I put into making sure she’s safe and healthy, I get paid for it now,” Ramirez said. “It’s such a good support system that keeps people from drowning.”\u003c/p>\n\u003cp>No congressional seat in California relies more on Medi-Cal than the 22nd District, which follows Interstate 5 and Highway 99 as they stretch southeast from Avenal and Delano, through almond and pistachio orchards, to Bakersfield.\u003c/p>\n\u003cp>Two-thirds of residents are enrolled in Medi-Cal, the state’s Medicaid program, which provides health care to low-income residents, people with disabilities and those living in nursing homes or need of a personal caregiver.\u003c/p>\n\u003cfigure id=\"attachment_11933948\" class=\"wp-caption aligncenter\" style=\"max-width: 1024px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11933948 size-full\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/12/GettyImages-1245162773.jpg\" alt=\"oil pumps in a field\" width=\"1024\" height=\"683\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/12/GettyImages-1245162773.jpg 1024w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/12/GettyImages-1245162773-800x534.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/12/GettyImages-1245162773-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/12/GettyImages-1245162773-160x107.jpg 160w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\">\u003cfigcaption class=\"wp-caption-text\">Oil wells are seen at an oil facility by Interstate 5 near Bakersfield. \u003ccite>(Tayfun Coskun/Anadolu Agency via Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The 22nd District is also experiencing an intense political shift.\u003c/p>\n\u003cp>Back in 2020, voters here supported Joe Biden over Donald Trump in the presidential election by a 55%-42% margin. In November, Trump won the 22nd District, 52%-46% over Kamala Harris. The 19-point shift between 2020 and 2024 was the largest in California, securing incumbent Rep. David Valadao a comfortable victory that helped the GOP maintain control of the House of Representatives.\u003c/p>\n\u003cp>Connie Conway, the chair of the Republican Party of Tulare County, said Trump drew support from new voters — enough to start a young Republicans chapter in the county — and disaffected Democrats.\u003c/p>\n\u003cp>“I say this to people all the time, and I know because I’m a lifelong Central Valley girl, ‘We’re pretty conservative no matter what your party registration is,” Conway said.\u003c/p>\n\u003cp>Across California, Trump made his largest gains in districts like the 22nd — inland, working class, majority-Latino and, according to a KQED analysis, heavily reliant on Medi-Cal.\u003c/p>\n\u003cp>“We’re not known for our excess wealth, at least in our part of the Central Valley. We’re just hard-working people that share a lot of the same values: family, faith,” Conway said. “I think in this past election, that really resonated with a lot of folks.”\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" title=\"GOP Gains and Medi-Cal Enrollment\" aria-label=\"Scatter Plot\" id=\"datawrapper-chart-svLzI\" src=\"https://datawrapper.dwcdn.net/svLzI/6/\" scrolling=\"no\" frameborder=\"0\" style=\"width: 0; min-width: 100% !important; border: none;\" height=\"576\" data-external=\"1\" width=\"100%\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>Now, Republicans in Congress are moving ahead with plans to slash the health care program.\u003c/p>\n\u003cp>House Republicans passed a budget resolution in February that set a goal of $2 trillion in spending cuts. It was the first step toward passing a budget that party leaders hope will include over $4.5 trillion in new spending and tax cuts.\u003c/p>\n\u003cp>Top Republicans ruled out reductions to Social Security, Medicare and defense, leaving Medicaid as the most expensive program on the chopping block.\u003c/p>\n\u003cp>The path to achieving the centerpiece of Trump’s legislative agenda could go straight through the pocketbooks of the voters who powered GOP progress in 2024. Cuts to Medicaid, which has enjoyed bipartisan support, could imperil representatives like Valadao and give \u003ca href=\"https://www.kqed.org/news/12032994/democrats-focus-their-message-on-gop-cuts-to-medicaid\">new life to Democrats\u003c/a> looking for ways to reverse their decline in California’s working class communities.\u003c/p>\n\u003cp>[aside postID=news_12033446 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/DonaldTrump100DaysGetty-1020x680.jpg']\u003c/p>\n\u003cp>“I don’t want to say that there is an opportunity, since nothing good will come out of this budget, but the opportunity to clarify and define what we as a party are doing in this term of Trump is going to be critical,” said Orrin Evans, a Democratic strategist who has worked on multiple House campaigns in the state. “We have to be united in standing against this.”\u003c/p>\n\u003cp>KQED cross-referenced district-by-district Medicaid enrollment numbers from the UC Berkeley Labor Center with presidential vote totals from the 2020 and 2024 elections in each of the state’s 52 congressional districts, compiled by the California Target Book.\u003c/p>\n\u003cp>Of the 13 seats with the largest shift toward Trump in 2024 — the top quartile of districts — eight were among the top quartile in Medi-Cal reliance. Twelve of the 13 had Medi-Cal populations above the state average.\u003c/p>\n\u003cp>While Valadao voted for the budget resolution, he has expressed concerns for his constituents who benefit from Medi-Cal and said he would not vote for a final budget bill “that risks leaving them behind.” It’s unclear how the party would offset the costs of tax cuts without targeting Medicaid.\u003c/p>\n\u003cp>Doing so could bring political risk for California Republicans beyond just vulnerable incumbents like Valadao. The GOP made \u003ca href=\"https://www.kqed.org/news/12025617/confronting-trump-gotten-harder-california-legislature\">significant inroads\u003c/a> in communities still represented by Democrats in Congress — in the Central Valley, Inland Empire and along the state’s southern border — which fueled Republican gains further down the ballot in 2024.\u003c/p>\n\u003cp>The shifts reflect the acceleration of a yearslong \u003ca href=\"https://www.kqed.org/news/12011642/how-the-diploma-divide-is-reshaping-politics-in-a-key-california-house-race\">political realignment\u003c/a> along \u003ca href=\"https://www.kqed.org/forum/2010101908312/how-the-diploma-divide-polarizes-the-u-s-electorate\">educational lines\u003c/a>. During the Trump era, Democrats have gained ground in highly-educated suburban areas, such as coastal Orange and San Diego counties, and lost support in more working-class counties further inland.\u003c/p>\n\u003cfigure id=\"attachment_12010091\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-12010091 size-full\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/GettyImages-1255046550-1-scaled-e1743452454384.jpg\" alt=\"\" width=\"2000\" height=\"1334\">\u003cfigcaption class=\"wp-caption-text\">Republican Rep. David Valadao of California’s 22nd Congressional District, pictured in 2022. \u003ccite>(Irfan Khan/Los Angeles Times via Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In November, Republicans scored \u003ca href=\"https://www.kqed.org/news/12016328/special-session-to-trump-proof-california-opens-in-sacramento\">two shocking victories\u003c/a> in state Assembly districts long held by Democrats in Imperial and Riverside counties.\u003c/p>\n\u003cp>Valadao’s Bakersfield seat fits the profile of these areas in political transition. According to estimates from the U.S. Census’ American Community Survey, nearly 60% of the citizen voting-age population is Latino, the most of any district in California. Meanwhile, fewer than one in 10 residents over age 24 hold a college degree, the lowest share of any district in the state.\u003c/p>\n\u003cp>“That particular district, President Trump did far better than other Republican candidates had done at the top of the ticket,” said Tal Eslick, Valadao’s former chief of staff, on KQED’s \u003ca href=\"https://www.kqed.org/news/12030830/could-gop-spending-cuts-cost-republicans-the-house\">\u003cem>Political Breakdown\u003c/em>\u003c/a>. “So I think this is an example of a district that’s changing, especially among, I would say, Hispanic males.”\u003c/p>\n\u003cp>Eslick and Conway attributed the GOP’s 2024 turnaround in the area to a mix of economic concerns, such as the cost of living, and social issues, including the debate over transgender rights.\u003c/p>\n\u003cp>“If you can imagine a 70-year-old Hispanic female from Corcoran, I don’t think the trans issues or other issues like that resonated with her,” Eslick said. “I think [Democrats] lost many of those folks, and those folks went towards President Trump.”\u003c/p>\n\u003cp>But it’s exactly in these areas of the state that the health care coverage provided by Medi-Cal is a lifeline for residents, said Scott Graves, budget director at the California Budget & Policy Center.\u003c/p>\n\u003cp>“In the more rural areas of the state, in farming communities, they’re doing some pretty backbreaking jobs,” Graves said. “They’re not getting very well compensated for it, and they’re very unlikely to be offered a health coverage plan.”\u003c/p>\n\u003cp>The federal government covers roughly half of most Medicaid costs in California, splitting the expense with the state government. Under the Affordable Care Act, Medicaid expanded to cover Californians making up to 138% of the federal poverty level ($21,597 for a single adult in 2025), with the federal government covering 90% of the new costs.\u003c/p>\n\u003cfigure id=\"attachment_12032710\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-12032710 size-full\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/250323-DEM-TOWN-HALLS-MD-16-KQED-3.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/250323-DEM-TOWN-HALLS-MD-16-KQED-3.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/250323-DEM-TOWN-HALLS-MD-16-KQED-3-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/250323-DEM-TOWN-HALLS-MD-16-KQED-3-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/250323-DEM-TOWN-HALLS-MD-16-KQED-3-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/250323-DEM-TOWN-HALLS-MD-16-KQED-3-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/250323-DEM-TOWN-HALLS-MD-16-KQED-3-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Elizabeth Ramirez outside the MLK Community Center in Bakersfield, where Rep. Ro Khanna held a town hall meeting on March 23, 2025, the first of three town hall events Khanna was set to hold in Republican-held congressional districts across the state. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Medi-Cal dollars are inextricably woven into the local economy in this part of the state. Kaweah Health Medical Center in Visalia is the largest hospital in Tulare County. It’s also the county’s largest employer.\u003c/p>\n\u003cp>The hospital receives more than 30% of its revenue through Medi-Cal, according to Gary Herbst, Kaweah’s CEO, compared to less than 20% from private insurance. When Herbst first arrived at Kaweah in 1992, that ratio was reversed.\u003c/p>\n\u003cp>Herbst has begun planning for various scenarios of cuts to Medicaid. If the federal government were to lower its cost-sharing to 45% for both traditional and expansion Medi-Cal enrollees, the loss for Kaweah would be around $60 million a year.\u003c/p>\n\u003cp>“If we were to lose 50, 60 million dollars a year in Medi-Cal funding, then where would I cut? How many hundreds of people would I have to lay off? How many services would I have to close?” he said. “We’ve never faced losses of this magnitude.”[aside postID=news_12022068 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2024/11/GettyImages-536950177-1020x680.jpg']Doctors and nurses at Kaweah would still be required to provide emergency services to anyone who shows up at the hospital, regardless of their ability to pay. So the cuts could potentially come to services such as colonoscopy screenings, surgeries for hip and knee replacements or primary care visits.\u003c/p>\n\u003cp>“It’s not possible to cover a $50- to $60-million reduction in funding and say, ‘Oh, we’re just going to stop providing services to Medi-Cal patients,’” Herbst said. “We would literally be forced to close an entire service, probably multiple services, so it would affect all patients that are receiving those services.”\u003c/p>\n\u003cp>The consequences appeared to be on Valadao’s mind when he spoke on the House floor before voting to advance the GOP budget framework.\u003c/p>\n\u003cp>“I’ve heard from countless constituents who tell me the only way they can afford health care is through programs like Medicaid, and I will not support a final reconciliation bill that risks leaving them behind,” he said.\u003c/p>\n\u003cp>Valadao said Congress is faced with “a historic opportunity to advance the key priorities of this administration.” By cutting spending, Congress would be able to extend crucial provisions of the 2017 Tax Cuts and Jobs Act, such as the doubling of the standard deduction and the child tax credit.\u003c/p>\n\u003cp>After Valadao spoke, Rep. Steve Scalise, the House Majority Leader, said California’s 22nd District “is going to have a very loud voice as this process moves forward.” He said Medicaid could be strengthened by weeding out “waste, fraud and abuse,” without providing details on where that exists in the program.\u003c/p>\n\u003cfigure id=\"attachment_11930872\" class=\"wp-caption aligncenter\" style=\"max-width: 1024px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11930872 size-full\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/11/GettyImages-1231769719.jpg\" alt=\"A white man in a blue suit.\" width=\"1024\" height=\"683\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/11/GettyImages-1231769719.jpg 1024w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/11/GettyImages-1231769719-800x534.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/11/GettyImages-1231769719-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/11/GettyImages-1231769719-160x107.jpg 160w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\">\u003cfigcaption class=\"wp-caption-text\">Rep. David Valadao (R-Calif.) speaks during a news conference with other House Republican members on immigration in Washington in 2021. \u003ccite>(Caroline Brehman/CQ-Roll Call, Inc via Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Valadao declined an interview for this story. Longtime allies such as Eslick and Conway were skeptical that Republicans in Congress would actually carry out large cuts to Medicaid.\u003c/p>\n\u003cp>“I don’t see a scenario in which Republicans, or for that matter any politician, go after an entitlement program that is pretty popular and obviously a key issue for a large swath of people,” Eslick said.\u003c/p>\n\u003cp>It seems impossible for Republicans to achieve their ambitious goals for cutting spending without touching Medicaid. The budget plan passed by the House called for $880 billion in cuts over the next 10 years from programs overseen by the Committee on Energy and Commerce. Just $581 billion of spending \u003ca href=\"https://www.cbo.gov/system/files/2025-03/61235-Boyle-Pallone.pdf\">under the committee’s\u003c/a> jurisdiction is for programs other than Medicaid, according to the Congressional Budget Office.[aside postID=news_12032718 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/250323-DEM-TOWN-HALLS-MD-21-KQED-5-1020x680.jpg']Valadao is a political survivor, one of just two Republicans left in the House who voted to impeach Trump in 2021, but he’s not immune to the high-stakes politics of health care. In 2017, he voted to repeal the Affordable Care Act. A year later, he lost his campaign for re-election.\u003c/p>\n\u003cp>“David Valadao has a very clear choice: he can vote on behalf of his district or he can take another step towards a successful lobbying career which he will assume as soon as he is defeated,” said Evans, the Democratic strategist. “Voting for this draconian budget, there is no argument in how it would advance or help constituents in his district.”\u003c/p>\n\u003cp>Another clue about Medicaid’s political potency lies in a little-noticed ballot measure passed in November by California voters. Proposition 35 extended a state tax on providers of health care plans and restricted the revenue to fund Medi-Cal.\u003c/p>\n\u003cp>The initiative passed overwhelmingly with 68% of the vote — outpacing other ballot measures with similar levels of bipartisan support — and it tallied 70% approval in those 13 seats that saw the largest shift toward Trump.\u003c/p>\n\u003cp>Dustin Corcoran, CEO of the California Medical Association, which represents physicians in the state, said Medicaid is often a blind spot for policymakers and elected officials, who typically receive health coverage on the private market.\u003c/p>\n\u003cp>Corcoran saw a different reality as he traveled the state as co-chair of the Proposition 35 campaign. One stop took him to the campus of the UC Merced, in the heart of the 13th Congressional District, which has the third-highest Medi-Cal population and fourth-largest shift toward Trump.\u003c/p>\n\u003cp>He asked this icebreaker: Who knows what Medicaid is?\u003c/p>\n\u003cp>“Every hand went up,” Corcoran said. “Every single hand in the room.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"excerpt": "A KQED analysis found the Congressional Districts that shifted most toward President Donald Trump also rely disproportionately on Medi-Cal.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>BAKERSFIELD — In 2021, \u003ca href=\"https://www.kqed.org/news/tag/bakersfield\">Bakersfield\u003c/a> resident Elizabeth Ramirez’s mother broke three bones in a fall, leaving Ramirez with a new set of responsibilities: cooking and cleaning for her mom, bathing her and driving her to appointments.\u003c/p>\n\u003cp>“So I was caregiving for her on top of my kids,” Ramirez said. “It was just a lot.”\u003c/p>\n\u003cp>After a few years of juggling, Ramirez became a registered care provider for her mother through the state’s In-Home Supportive Services, a program provided \u003ca href=\"https://www.kqed.org/news/12032878/gop-cuts-to-medicaid-snap-would-shrink-californias-economy-by-17-billion-and-kill-nearly-140000-jobs-new-study-finds\" target=\"_blank\" rel=\"noopener\">through Medi-Cal\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“So the work I put into making sure she’s safe and healthy, I get paid for it now,” Ramirez said. “It’s such a good support system that keeps people from drowning.”\u003c/p>\n\u003cp>No congressional seat in California relies more on Medi-Cal than the 22nd District, which follows Interstate 5 and Highway 99 as they stretch southeast from Avenal and Delano, through almond and pistachio orchards, to Bakersfield.\u003c/p>\n\u003cp>Two-thirds of residents are enrolled in Medi-Cal, the state’s Medicaid program, which provides health care to low-income residents, people with disabilities and those living in nursing homes or need of a personal caregiver.\u003c/p>\n\u003cfigure id=\"attachment_11933948\" class=\"wp-caption aligncenter\" style=\"max-width: 1024px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11933948 size-full\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/12/GettyImages-1245162773.jpg\" alt=\"oil pumps in a field\" width=\"1024\" height=\"683\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/12/GettyImages-1245162773.jpg 1024w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/12/GettyImages-1245162773-800x534.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/12/GettyImages-1245162773-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/12/GettyImages-1245162773-160x107.jpg 160w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\">\u003cfigcaption class=\"wp-caption-text\">Oil wells are seen at an oil facility by Interstate 5 near Bakersfield. \u003ccite>(Tayfun Coskun/Anadolu Agency via Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The 22nd District is also experiencing an intense political shift.\u003c/p>\n\u003cp>Back in 2020, voters here supported Joe Biden over Donald Trump in the presidential election by a 55%-42% margin. In November, Trump won the 22nd District, 52%-46% over Kamala Harris. The 19-point shift between 2020 and 2024 was the largest in California, securing incumbent Rep. David Valadao a comfortable victory that helped the GOP maintain control of the House of Representatives.\u003c/p>\n\u003cp>Connie Conway, the chair of the Republican Party of Tulare County, said Trump drew support from new voters — enough to start a young Republicans chapter in the county — and disaffected Democrats.\u003c/p>\n\u003cp>“I say this to people all the time, and I know because I’m a lifelong Central Valley girl, ‘We’re pretty conservative no matter what your party registration is,” Conway said.\u003c/p>\n\u003cp>Across California, Trump made his largest gains in districts like the 22nd — inland, working class, majority-Latino and, according to a KQED analysis, heavily reliant on Medi-Cal.\u003c/p>\n\u003cp>“We’re not known for our excess wealth, at least in our part of the Central Valley. We’re just hard-working people that share a lot of the same values: family, faith,” Conway said. “I think in this past election, that really resonated with a lot of folks.”\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" title=\"GOP Gains and Medi-Cal Enrollment\" aria-label=\"Scatter Plot\" id=\"datawrapper-chart-svLzI\" src=\"https://datawrapper.dwcdn.net/svLzI/6/\" scrolling=\"no\" frameborder=\"0\" style=\"width: 0; min-width: 100% !important; border: none;\" height=\"576\" data-external=\"1\" width=\"100%\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>Now, Republicans in Congress are moving ahead with plans to slash the health care program.\u003c/p>\n\u003cp>House Republicans passed a budget resolution in February that set a goal of $2 trillion in spending cuts. It was the first step toward passing a budget that party leaders hope will include over $4.5 trillion in new spending and tax cuts.\u003c/p>\n\u003cp>Top Republicans ruled out reductions to Social Security, Medicare and defense, leaving Medicaid as the most expensive program on the chopping block.\u003c/p>\n\u003cp>The path to achieving the centerpiece of Trump’s legislative agenda could go straight through the pocketbooks of the voters who powered GOP progress in 2024. Cuts to Medicaid, which has enjoyed bipartisan support, could imperil representatives like Valadao and give \u003ca href=\"https://www.kqed.org/news/12032994/democrats-focus-their-message-on-gop-cuts-to-medicaid\">new life to Democrats\u003c/a> looking for ways to reverse their decline in California’s working class communities.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“I don’t want to say that there is an opportunity, since nothing good will come out of this budget, but the opportunity to clarify and define what we as a party are doing in this term of Trump is going to be critical,” said Orrin Evans, a Democratic strategist who has worked on multiple House campaigns in the state. “We have to be united in standing against this.”\u003c/p>\n\u003cp>KQED cross-referenced district-by-district Medicaid enrollment numbers from the UC Berkeley Labor Center with presidential vote totals from the 2020 and 2024 elections in each of the state’s 52 congressional districts, compiled by the California Target Book.\u003c/p>\n\u003cp>Of the 13 seats with the largest shift toward Trump in 2024 — the top quartile of districts — eight were among the top quartile in Medi-Cal reliance. Twelve of the 13 had Medi-Cal populations above the state average.\u003c/p>\n\u003cp>While Valadao voted for the budget resolution, he has expressed concerns for his constituents who benefit from Medi-Cal and said he would not vote for a final budget bill “that risks leaving them behind.” It’s unclear how the party would offset the costs of tax cuts without targeting Medicaid.\u003c/p>\n\u003cp>Doing so could bring political risk for California Republicans beyond just vulnerable incumbents like Valadao. The GOP made \u003ca href=\"https://www.kqed.org/news/12025617/confronting-trump-gotten-harder-california-legislature\">significant inroads\u003c/a> in communities still represented by Democrats in Congress — in the Central Valley, Inland Empire and along the state’s southern border — which fueled Republican gains further down the ballot in 2024.\u003c/p>\n\u003cp>The shifts reflect the acceleration of a yearslong \u003ca href=\"https://www.kqed.org/news/12011642/how-the-diploma-divide-is-reshaping-politics-in-a-key-california-house-race\">political realignment\u003c/a> along \u003ca href=\"https://www.kqed.org/forum/2010101908312/how-the-diploma-divide-polarizes-the-u-s-electorate\">educational lines\u003c/a>. During the Trump era, Democrats have gained ground in highly-educated suburban areas, such as coastal Orange and San Diego counties, and lost support in more working-class counties further inland.\u003c/p>\n\u003cfigure id=\"attachment_12010091\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-12010091 size-full\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/10/GettyImages-1255046550-1-scaled-e1743452454384.jpg\" alt=\"\" width=\"2000\" height=\"1334\">\u003cfigcaption class=\"wp-caption-text\">Republican Rep. David Valadao of California’s 22nd Congressional District, pictured in 2022. \u003ccite>(Irfan Khan/Los Angeles Times via Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In November, Republicans scored \u003ca href=\"https://www.kqed.org/news/12016328/special-session-to-trump-proof-california-opens-in-sacramento\">two shocking victories\u003c/a> in state Assembly districts long held by Democrats in Imperial and Riverside counties.\u003c/p>\n\u003cp>Valadao’s Bakersfield seat fits the profile of these areas in political transition. According to estimates from the U.S. Census’ American Community Survey, nearly 60% of the citizen voting-age population is Latino, the most of any district in California. Meanwhile, fewer than one in 10 residents over age 24 hold a college degree, the lowest share of any district in the state.\u003c/p>\n\u003cp>“That particular district, President Trump did far better than other Republican candidates had done at the top of the ticket,” said Tal Eslick, Valadao’s former chief of staff, on KQED’s \u003ca href=\"https://www.kqed.org/news/12030830/could-gop-spending-cuts-cost-republicans-the-house\">\u003cem>Political Breakdown\u003c/em>\u003c/a>. “So I think this is an example of a district that’s changing, especially among, I would say, Hispanic males.”\u003c/p>\n\u003cp>Eslick and Conway attributed the GOP’s 2024 turnaround in the area to a mix of economic concerns, such as the cost of living, and social issues, including the debate over transgender rights.\u003c/p>\n\u003cp>“If you can imagine a 70-year-old Hispanic female from Corcoran, I don’t think the trans issues or other issues like that resonated with her,” Eslick said. “I think [Democrats] lost many of those folks, and those folks went towards President Trump.”\u003c/p>\n\u003cp>But it’s exactly in these areas of the state that the health care coverage provided by Medi-Cal is a lifeline for residents, said Scott Graves, budget director at the California Budget & Policy Center.\u003c/p>\n\u003cp>“In the more rural areas of the state, in farming communities, they’re doing some pretty backbreaking jobs,” Graves said. “They’re not getting very well compensated for it, and they’re very unlikely to be offered a health coverage plan.”\u003c/p>\n\u003cp>The federal government covers roughly half of most Medicaid costs in California, splitting the expense with the state government. Under the Affordable Care Act, Medicaid expanded to cover Californians making up to 138% of the federal poverty level ($21,597 for a single adult in 2025), with the federal government covering 90% of the new costs.\u003c/p>\n\u003cfigure id=\"attachment_12032710\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-12032710 size-full\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/250323-DEM-TOWN-HALLS-MD-16-KQED-3.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/250323-DEM-TOWN-HALLS-MD-16-KQED-3.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/250323-DEM-TOWN-HALLS-MD-16-KQED-3-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/250323-DEM-TOWN-HALLS-MD-16-KQED-3-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/250323-DEM-TOWN-HALLS-MD-16-KQED-3-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/250323-DEM-TOWN-HALLS-MD-16-KQED-3-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/250323-DEM-TOWN-HALLS-MD-16-KQED-3-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Elizabeth Ramirez outside the MLK Community Center in Bakersfield, where Rep. Ro Khanna held a town hall meeting on March 23, 2025, the first of three town hall events Khanna was set to hold in Republican-held congressional districts across the state. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Medi-Cal dollars are inextricably woven into the local economy in this part of the state. Kaweah Health Medical Center in Visalia is the largest hospital in Tulare County. It’s also the county’s largest employer.\u003c/p>\n\u003cp>The hospital receives more than 30% of its revenue through Medi-Cal, according to Gary Herbst, Kaweah’s CEO, compared to less than 20% from private insurance. When Herbst first arrived at Kaweah in 1992, that ratio was reversed.\u003c/p>\n\u003cp>Herbst has begun planning for various scenarios of cuts to Medicaid. If the federal government were to lower its cost-sharing to 45% for both traditional and expansion Medi-Cal enrollees, the loss for Kaweah would be around $60 million a year.\u003c/p>\n\u003cp>“If we were to lose 50, 60 million dollars a year in Medi-Cal funding, then where would I cut? How many hundreds of people would I have to lay off? How many services would I have to close?” he said. “We’ve never faced losses of this magnitude.”\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Doctors and nurses at Kaweah would still be required to provide emergency services to anyone who shows up at the hospital, regardless of their ability to pay. So the cuts could potentially come to services such as colonoscopy screenings, surgeries for hip and knee replacements or primary care visits.\u003c/p>\n\u003cp>“It’s not possible to cover a $50- to $60-million reduction in funding and say, ‘Oh, we’re just going to stop providing services to Medi-Cal patients,’” Herbst said. “We would literally be forced to close an entire service, probably multiple services, so it would affect all patients that are receiving those services.”\u003c/p>\n\u003cp>The consequences appeared to be on Valadao’s mind when he spoke on the House floor before voting to advance the GOP budget framework.\u003c/p>\n\u003cp>“I’ve heard from countless constituents who tell me the only way they can afford health care is through programs like Medicaid, and I will not support a final reconciliation bill that risks leaving them behind,” he said.\u003c/p>\n\u003cp>Valadao said Congress is faced with “a historic opportunity to advance the key priorities of this administration.” By cutting spending, Congress would be able to extend crucial provisions of the 2017 Tax Cuts and Jobs Act, such as the doubling of the standard deduction and the child tax credit.\u003c/p>\n\u003cp>After Valadao spoke, Rep. Steve Scalise, the House Majority Leader, said California’s 22nd District “is going to have a very loud voice as this process moves forward.” He said Medicaid could be strengthened by weeding out “waste, fraud and abuse,” without providing details on where that exists in the program.\u003c/p>\n\u003cfigure id=\"attachment_11930872\" class=\"wp-caption aligncenter\" style=\"max-width: 1024px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11930872 size-full\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/11/GettyImages-1231769719.jpg\" alt=\"A white man in a blue suit.\" width=\"1024\" height=\"683\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/11/GettyImages-1231769719.jpg 1024w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/11/GettyImages-1231769719-800x534.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/11/GettyImages-1231769719-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/11/GettyImages-1231769719-160x107.jpg 160w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\">\u003cfigcaption class=\"wp-caption-text\">Rep. David Valadao (R-Calif.) speaks during a news conference with other House Republican members on immigration in Washington in 2021. \u003ccite>(Caroline Brehman/CQ-Roll Call, Inc via Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Valadao declined an interview for this story. Longtime allies such as Eslick and Conway were skeptical that Republicans in Congress would actually carry out large cuts to Medicaid.\u003c/p>\n\u003cp>“I don’t see a scenario in which Republicans, or for that matter any politician, go after an entitlement program that is pretty popular and obviously a key issue for a large swath of people,” Eslick said.\u003c/p>\n\u003cp>It seems impossible for Republicans to achieve their ambitious goals for cutting spending without touching Medicaid. The budget plan passed by the House called for $880 billion in cuts over the next 10 years from programs overseen by the Committee on Energy and Commerce. Just $581 billion of spending \u003ca href=\"https://www.cbo.gov/system/files/2025-03/61235-Boyle-Pallone.pdf\">under the committee’s\u003c/a> jurisdiction is for programs other than Medicaid, according to the Congressional Budget Office.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Valadao is a political survivor, one of just two Republicans left in the House who voted to impeach Trump in 2021, but he’s not immune to the high-stakes politics of health care. In 2017, he voted to repeal the Affordable Care Act. A year later, he lost his campaign for re-election.\u003c/p>\n\u003cp>“David Valadao has a very clear choice: he can vote on behalf of his district or he can take another step towards a successful lobbying career which he will assume as soon as he is defeated,” said Evans, the Democratic strategist. “Voting for this draconian budget, there is no argument in how it would advance or help constituents in his district.”\u003c/p>\n\u003cp>Another clue about Medicaid’s political potency lies in a little-noticed ballot measure passed in November by California voters. Proposition 35 extended a state tax on providers of health care plans and restricted the revenue to fund Medi-Cal.\u003c/p>\n\u003cp>The initiative passed overwhelmingly with 68% of the vote — outpacing other ballot measures with similar levels of bipartisan support — and it tallied 70% approval in those 13 seats that saw the largest shift toward Trump.\u003c/p>\n\u003cp>Dustin Corcoran, CEO of the California Medical Association, which represents physicians in the state, said Medicaid is often a blind spot for policymakers and elected officials, who typically receive health coverage on the private market.\u003c/p>\n\u003cp>Corcoran saw a different reality as he traveled the state as co-chair of the Proposition 35 campaign. One stop took him to the campus of the UC Merced, in the heart of the 13th Congressional District, which has the third-highest Medi-Cal population and fourth-largest shift toward Trump.\u003c/p>\n\u003cp>He asked this icebreaker: Who knows what Medicaid is?\u003c/p>\n\u003cp>“Every hand went up,” Corcoran said. “Every single hand in the room.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"slug": "gop-cuts-to-medicaid-snap-would-shrink-californias-economy-by-17-billion-and-kill-nearly-140000-jobs-new-study-finds",
"title": "California Faces $17 Billion Economic Hit, 140,000 Job Losses Under GOP Budget Cuts",
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"content": "\u003cp>\u003ca href=\"https://www.kqed.org/news/tag/california\">California\u003c/a> could lose nearly 140,000 jobs and see its economy shrink by close to $17 billion next year, far more than any other state, if congressional Republicans push through massive cuts to Medicaid and SNAP programs.\u003c/p>\n\u003cp>That’s according to \u003ca href=\"https://www.commonwealthfund.org/publications/issue-briefs/2025/mar/how-cuts-medicaid-snap-could-trigger-job-loss-state-revenue\">a new study\u003c/a> by the Commonwealth Fund, a left-leaning health policy group, and George Washington University, that estimates the potential economic hit to each state under the current Republican proposal to slash more than $1 trillion from Medicaid and SNAP — the Supplemental Nutrition Assistance Program — over the next decade.\u003c/p>\n\u003cp>While recent analyses have largely focused on the tremendous consequences such sweeping cuts would have on program recipients, far less attention has been given to how such cuts would “necessarily weaken states’ economies and result in substantial job losses through a ‘multiplier effect,’” the study’s authors note.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“Part of the point we’re trying to make is these are not harmless cuts,” said Leighton Ku, the study’s lead author, who is a professor of health policy and management at George Washington University. “We were trying to say there are broader effects for state economies. There are the sorts of things that also lead to unemployment rates going up, to state tax revenues going down as opposed to just the effect for the low-income people.”\u003c/p>\n\u003cp>Although huge numbers of lower-income Americans benefit from the programs, Ku said, the direct recipients of Medicaid payments and SNAP benefits are actually health care providers and grocery stores.\u003c/p>\n\u003cp>“What happens is if they lose money because of the SNAP or Medicaid cutbacks, then these businesses need to reduce how much spending they have,” said Ku, whose analysis is based on each state’s most recent federal medical assistance expenditures, as well as U.S. Department of Agriculture SNAP benefit spending.\u003c/p>\n\u003cp>[aside postID=news_12028454 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2025/02/GettyImages-2177324845-1020x680.jpg']\u003c/p>\n\u003cp>“So they need to lay off staff. They need to buy fewer stuff from other places,” he said. “Ultimately speaking, this leads to broader reductions in the economy.”\u003c/p>\n\u003cp>The cutbacks will also lower the amount of taxes that state and local governments can collect, with state and local tax revenues falling by about $1.4 billion in California alone, Ku added.\u003c/p>\n\u003cp>“This would be in addition to the budget problems the state is already facing,” he said.\u003c/p>\n\u003cp>Medicaid provides health insurance to more than 72 million Americans with limited incomes and funds long-term care for some seniors. In California, \u003ca href=\"https://www.dhcs.ca.gov/dataandstats/dashboards/Pages/Medi-Cal-Enrollment-and-Renewals-Dashboard-January2025.aspx\">nearly 15 million people\u003c/a> — more than a third of residents — are enrolled in Medi-Cal, the state’s version of the program. About two-thirds of funding for state Medicaid programs is federal.\u003c/p>\n\u003cp>Meanwhile, nearly 42 million Americans — including \u003ca href=\"https://www.cbpp.org/sites/default/files/atoms/files/snap_factsheet_california.pdf\">more than 5 million in California\u003c/a> — are enrolled in SNAP, which offers food benefits to lower-income families and is funded entirely by the federal government.\u003c/p>\n\u003cp>Taken together, the Republican proposal to cut upward of $880 billion in funding for Medicaid and $230 billion for SNAP over the next 10 years would collectively reduce state GDPs by $113 billion in 2026, resulting in the loss of more than 1 million jobs, Ku estimates.\u003c/p>\n\u003cp>“I would say the point that we’re trying to make is [Republicans] should be aware that the deep cuts they’re talking about are going to increase unemployment. They’re not going to help strengthen the economy of states,” Ku said. “They’re going to make it harder for states to balance their budgets.”\u003c/p>\n\u003cp>The U.S. House of Representatives’ current budget resolution \u003ca href=\"https://www.nytimes.com/2025/03/10/briefing/republicans-medicaid.html\">offers a blueprint\u003c/a> for the so-called reconciliation bill that Republicans hope to pass in the coming months. The legislation would extend the 2017 tax cuts that lawmakers passed during President Donald Trump’s first term, offsetting the cost by slashing funding to safety net programs, which Republicans have long attacked as being rife with fraud and waste.\u003c/p>\n\u003cp>And while the House resolution doesn’t explicitly call for cutting Medicaid or food assistance, it directs two House committees with jurisdiction over the programs to identify the $1 trillion in cuts, something that would be virtually impossible without slashing Medicaid and SNAP.\u003c/p>\n\u003cp>“There’s a fairness problem here,” Ku said. “These will be cuts that will harm people, will harm state economies, will increase unemployment.”\u003c/p>\n\u003cp>\u003cem>KQED’s \u003c/em>\u003ca href=\"https://www.kqed.org/author/lesleymcclurg\">\u003cem>Lesley McClurg\u003c/em>\u003c/a>\u003cem> contributed to this story\u003c/em>.\u003c/p>\n\u003cp>\u003c/p>\n",
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"excerpt": "Taken together, the Republican proposal to cut upward of $880 billion in funding for Medicaid and $230 billion for SNAP over the next 10 years would collectively reduce state GDPs by $113 billion in 2026, resulting in the loss of more than 1 million jobs, the report estimates.",
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"description": "Taken together, the Republican proposal to cut upward of $880 billion in funding for Medicaid and $230 billion for SNAP over the next 10 years would collectively reduce state GDPs by $113 billion in 2026, resulting in the loss of more than 1 million jobs, the report estimates.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003ca href=\"https://www.kqed.org/news/tag/california\">California\u003c/a> could lose nearly 140,000 jobs and see its economy shrink by close to $17 billion next year, far more than any other state, if congressional Republicans push through massive cuts to Medicaid and SNAP programs.\u003c/p>\n\u003cp>That’s according to \u003ca href=\"https://www.commonwealthfund.org/publications/issue-briefs/2025/mar/how-cuts-medicaid-snap-could-trigger-job-loss-state-revenue\">a new study\u003c/a> by the Commonwealth Fund, a left-leaning health policy group, and George Washington University, that estimates the potential economic hit to each state under the current Republican proposal to slash more than $1 trillion from Medicaid and SNAP — the Supplemental Nutrition Assistance Program — over the next decade.\u003c/p>\n\u003cp>While recent analyses have largely focused on the tremendous consequences such sweeping cuts would have on program recipients, far less attention has been given to how such cuts would “necessarily weaken states’ economies and result in substantial job losses through a ‘multiplier effect,’” the study’s authors note.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“Part of the point we’re trying to make is these are not harmless cuts,” said Leighton Ku, the study’s lead author, who is a professor of health policy and management at George Washington University. “We were trying to say there are broader effects for state economies. There are the sorts of things that also lead to unemployment rates going up, to state tax revenues going down as opposed to just the effect for the low-income people.”\u003c/p>\n\u003cp>Although huge numbers of lower-income Americans benefit from the programs, Ku said, the direct recipients of Medicaid payments and SNAP benefits are actually health care providers and grocery stores.\u003c/p>\n\u003cp>“What happens is if they lose money because of the SNAP or Medicaid cutbacks, then these businesses need to reduce how much spending they have,” said Ku, whose analysis is based on each state’s most recent federal medical assistance expenditures, as well as U.S. Department of Agriculture SNAP benefit spending.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“So they need to lay off staff. They need to buy fewer stuff from other places,” he said. “Ultimately speaking, this leads to broader reductions in the economy.”\u003c/p>\n\u003cp>The cutbacks will also lower the amount of taxes that state and local governments can collect, with state and local tax revenues falling by about $1.4 billion in California alone, Ku added.\u003c/p>\n\u003cp>“This would be in addition to the budget problems the state is already facing,” he said.\u003c/p>\n\u003cp>Medicaid provides health insurance to more than 72 million Americans with limited incomes and funds long-term care for some seniors. In California, \u003ca href=\"https://www.dhcs.ca.gov/dataandstats/dashboards/Pages/Medi-Cal-Enrollment-and-Renewals-Dashboard-January2025.aspx\">nearly 15 million people\u003c/a> — more than a third of residents — are enrolled in Medi-Cal, the state’s version of the program. About two-thirds of funding for state Medicaid programs is federal.\u003c/p>\n\u003cp>Meanwhile, nearly 42 million Americans — including \u003ca href=\"https://www.cbpp.org/sites/default/files/atoms/files/snap_factsheet_california.pdf\">more than 5 million in California\u003c/a> — are enrolled in SNAP, which offers food benefits to lower-income families and is funded entirely by the federal government.\u003c/p>\n\u003cp>Taken together, the Republican proposal to cut upward of $880 billion in funding for Medicaid and $230 billion for SNAP over the next 10 years would collectively reduce state GDPs by $113 billion in 2026, resulting in the loss of more than 1 million jobs, Ku estimates.\u003c/p>\n\u003cp>“I would say the point that we’re trying to make is [Republicans] should be aware that the deep cuts they’re talking about are going to increase unemployment. They’re not going to help strengthen the economy of states,” Ku said. “They’re going to make it harder for states to balance their budgets.”\u003c/p>\n\u003cp>The U.S. House of Representatives’ current budget resolution \u003ca href=\"https://www.nytimes.com/2025/03/10/briefing/republicans-medicaid.html\">offers a blueprint\u003c/a> for the so-called reconciliation bill that Republicans hope to pass in the coming months. The legislation would extend the 2017 tax cuts that lawmakers passed during President Donald Trump’s first term, offsetting the cost by slashing funding to safety net programs, which Republicans have long attacked as being rife with fraud and waste.\u003c/p>\n\u003cp>And while the House resolution doesn’t explicitly call for cutting Medicaid or food assistance, it directs two House committees with jurisdiction over the programs to identify the $1 trillion in cuts, something that would be virtually impossible without slashing Medicaid and SNAP.\u003c/p>\n\u003cp>“There’s a fairness problem here,” Ku said. “These will be cuts that will harm people, will harm state economies, will increase unemployment.”\u003c/p>\n\u003cp>\u003cem>KQED’s \u003c/em>\u003ca href=\"https://www.kqed.org/author/lesleymcclurg\">\u003cem>Lesley McClurg\u003c/em>\u003c/a>\u003cem> contributed to this story\u003c/em>.\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"content": "\u003cp>BAKERSFIELD — Erlinda Carrillo is already exhausted by the first two months of \u003ca href=\"https://www.kqed.org/news/tag/donald-trump\">President Donald Trump’s\u003c/a> second term.\u003c/p>\n\u003cp>Her daughter lost her job at a scientific research institute after the Trump administration canceled its government contract. She’s worried layoffs at the Department of Veterans Affairs will \u003ca href=\"https://www.kqed.org/news/12031166/federal-judge-in-sf-orders-trump-administration-to-reverse-mass-firings-at-6-agencies\">affect care for her brother\u003c/a>, a Vietnam War veteran. And she’s concerned about her Social Security benefits \u003ca href=\"https://www.npr.org/2025/03/22/nx-s1-5320263/social-security-administration-changes-identity-office\">amid cost-cutting\u003c/a> at the Social Security Administration.\u003c/p>\n\u003cp>“I’m tired of all of the backlash that we’re actually getting due to Donald Trump,” she said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Carillo and her husband, Mitch, went looking for inspiration in the gym of a Bakersfield community center, \u003ca href=\"https://www.kqed.org/news/12032453/rep-ro-khanna-on-how-democrats-should-fight-back\">where Rep. Ro Khanna\u003c/a> held a town hall meeting on Sunday — hundreds of miles from his Silicon Valley district.\u003c/p>\n\u003cp>It was part of a day-long barnstorming tour of meetings in three districts represented by California Republicans for Khanna, a Democrat. Khanna mocked Republicans for not holding in-person town halls and denounced the GOP budget framework that could set the table for cuts to Medicaid.\u003c/p>\n\u003cfigure id=\"attachment_12032694\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-12032694 size-full\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/250323-DEM-TOWN-HALLS-MD-12-KQED-1.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/250323-DEM-TOWN-HALLS-MD-12-KQED-1.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/250323-DEM-TOWN-HALLS-MD-12-KQED-1-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/250323-DEM-TOWN-HALLS-MD-12-KQED-1-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/250323-DEM-TOWN-HALLS-MD-12-KQED-1-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/250323-DEM-TOWN-HALLS-MD-12-KQED-1-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/250323-DEM-TOWN-HALLS-MD-12-KQED-1-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Audrey Chavez (center) listens at a town hall meeting with Rep. Ro Khanna at the MLK Community Center in Bakersfield on March 23, 2025. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>He also got a taste of the rising frustration among Democratic voters who have criticized party leaders for lacking vitality and vision in their response to Trump.\u003c/p>\n\u003cp>Dispirited Democrats made up much of the crowd in Bakersfield. They \u003ca href=\"https://www.npr.org/2025/03/13/nx-s1-5327600/house-democrats-outrage-spending\">reserved particular criticism\u003c/a> for Senate Minority Leader Chuck Schumer, who led nine Democrats in voting for a Republican-authored budget resolution to avoid a government shutdown earlier this month.\u003c/p>\n\u003cp>“When is the Democratic Party going to set aside its peacetime leaders and bring up some wartime leaders?” Darren Bly asked Khanna. “Because that’s what we need.”[aside postID=news_12032453 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2024/01/GettyImages-1394023104-1020x680.jpg']Khanna reiterated his stance that the party’s “old guard needs to step aside,” and said, “If the party is letting us down, it’s time to rebuild the party.”\u003c/p>\n\u003cp>“If you are not fighting and marching and organizing, then you don’t understand the moment,” he continued. “We need Democratic leaders who are going to be with the people in the fight.”\u003c/p>\n\u003cp>A \u003ca href=\"https://www.documentcloud.org/documents/25597409-nbc-march-2025-poll/?q=stick&mode=document#document/p16\">recent NBC poll\u003c/a> found that 20% of Democratic voters have negative views of the party. Unlike in 2017, when most Democratic voters hoped their party would pursue compromise and consensus in Congress, the survey found 65% of Democratic voters want House Democrats to stick to their positions, even if it leads to gridlock in Washington.\u003c/p>\n\u003cp>“That’s what we want to see,” said Mitch Carillo, pointing to Khanna as he paced the makeshift stage answering questions. “They were mentioning the old guard in the Democratic Party, and they’ve done some really great things, but it’s time to step aside and let’s let this younger generation come in and see what they can do.”\u003c/p>\n\u003cp>“Because the Republicans aren’t playing fair, they’re not playing by the rule book, I mean, whatever it takes to win, they’ll do,” Carillo added. “The Democrats don’t have an answer for that. I think people like Ro Khanna do have an answer.”\u003c/p>\n\u003cfigure id=\"attachment_12032696\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12032696\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/250323-DEM-TOWN-HALLS-MD-14-KQED-1.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/250323-DEM-TOWN-HALLS-MD-14-KQED-1.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/250323-DEM-TOWN-HALLS-MD-14-KQED-1-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/250323-DEM-TOWN-HALLS-MD-14-KQED-1-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/250323-DEM-TOWN-HALLS-MD-14-KQED-1-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/250323-DEM-TOWN-HALLS-MD-14-KQED-1-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/250323-DEM-TOWN-HALLS-MD-14-KQED-1-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">(From center right) Connie Wright, Sally MacGuire and Ali Ramirez applaud and cheer at a town hall meeting with Rep. Ro Khanna at the MLK Community Center in Bakersfield on March 23, 2025. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In the short-term, Khanna is hoping strategic organizing efforts can strong-arm the Republican votes needed to block potential cuts to Medicaid, which covers health care for Americans with low incomes, disabilities or who live in nursing homes. His choice of the 22nd District was no accident: Two-thirds of residents receive health coverage through Medicaid, according to the California Budget & Policy Center.\u003c/p>\n\u003cp>“We need three Republicans — three Republicans — to prevent the cuts to Medicaid,” Khanna told the crowd on Sunday.\u003c/p>\n\u003cp>The district’s representative, David Valadao, said in a speech on the House floor last month that he has heard from many constituents “who tell me the only way they can afford health care is through programs like Medicaid.”\u003c/p>\n\u003cp>“I will not support a final reconciliation bill that risks leaving them behind,” he said.\u003c/p>\n\u003cfigure id=\"attachment_12032695\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-12032695 size-full\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/250323-DEM-TOWN-HALLS-MD-13-KQED-1.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/250323-DEM-TOWN-HALLS-MD-13-KQED-1.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/250323-DEM-TOWN-HALLS-MD-13-KQED-1-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/250323-DEM-TOWN-HALLS-MD-13-KQED-1-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/250323-DEM-TOWN-HALLS-MD-13-KQED-1-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/250323-DEM-TOWN-HALLS-MD-13-KQED-1-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/250323-DEM-TOWN-HALLS-MD-13-KQED-1-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Dawna Sodders-Simpson holds a sign at a town hall meeting with Rep. Ro Khanna at the MLK Community Center in Bakersfield on March 23, 2025. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>As part of a budget roadmap that will allow the party to renew their 2017 tax cut law, Republicans set a target of $880 billion in cuts to programs under the House Committee on Energy and Commerce. An \u003ca href=\"https://www.cbo.gov/system/files/2025-03/61235-Boyle-Pallone.pdf\">analysis released\u003c/a> by the nonpartisan Congressional Budget Office found that it would be impossible for Republicans to achieve that benchmark without cutting Medicaid, which accounts for $8.2 trillion of the $8.8 trillion in spending under that committee’s jurisdiction.\u003c/p>\n\u003cp>Russell Paul, a doctor in Bakersfield, said it would be heartbreaking if cuts led to patients being unable to afford care.\u003c/p>\n\u003cp>Paul, who was invited to the town hall by a coworker, heaped his own share of criticism on the Democratic Party.\u003c/p>\n\u003cp>“When we get young people like [Alexandria Ocasio-Cortez] or very progressive people like Bernie Sanders speaking truth to power, we try to marginalize them so we seem more mainstream,” he said. “This is sort of my start in becoming more active and trying to push back against what’s going on in our country.”\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>BAKERSFIELD — Erlinda Carrillo is already exhausted by the first two months of \u003ca href=\"https://www.kqed.org/news/tag/donald-trump\">President Donald Trump’s\u003c/a> second term.\u003c/p>\n\u003cp>Her daughter lost her job at a scientific research institute after the Trump administration canceled its government contract. She’s worried layoffs at the Department of Veterans Affairs will \u003ca href=\"https://www.kqed.org/news/12031166/federal-judge-in-sf-orders-trump-administration-to-reverse-mass-firings-at-6-agencies\">affect care for her brother\u003c/a>, a Vietnam War veteran. And she’s concerned about her Social Security benefits \u003ca href=\"https://www.npr.org/2025/03/22/nx-s1-5320263/social-security-administration-changes-identity-office\">amid cost-cutting\u003c/a> at the Social Security Administration.\u003c/p>\n\u003cp>“I’m tired of all of the backlash that we’re actually getting due to Donald Trump,” she said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Carillo and her husband, Mitch, went looking for inspiration in the gym of a Bakersfield community center, \u003ca href=\"https://www.kqed.org/news/12032453/rep-ro-khanna-on-how-democrats-should-fight-back\">where Rep. Ro Khanna\u003c/a> held a town hall meeting on Sunday — hundreds of miles from his Silicon Valley district.\u003c/p>\n\u003cp>It was part of a day-long barnstorming tour of meetings in three districts represented by California Republicans for Khanna, a Democrat. Khanna mocked Republicans for not holding in-person town halls and denounced the GOP budget framework that could set the table for cuts to Medicaid.\u003c/p>\n\u003cfigure id=\"attachment_12032694\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-12032694 size-full\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/250323-DEM-TOWN-HALLS-MD-12-KQED-1.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/250323-DEM-TOWN-HALLS-MD-12-KQED-1.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/250323-DEM-TOWN-HALLS-MD-12-KQED-1-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/250323-DEM-TOWN-HALLS-MD-12-KQED-1-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/250323-DEM-TOWN-HALLS-MD-12-KQED-1-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/250323-DEM-TOWN-HALLS-MD-12-KQED-1-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/250323-DEM-TOWN-HALLS-MD-12-KQED-1-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Audrey Chavez (center) listens at a town hall meeting with Rep. Ro Khanna at the MLK Community Center in Bakersfield on March 23, 2025. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>He also got a taste of the rising frustration among Democratic voters who have criticized party leaders for lacking vitality and vision in their response to Trump.\u003c/p>\n\u003cp>Dispirited Democrats made up much of the crowd in Bakersfield. They \u003ca href=\"https://www.npr.org/2025/03/13/nx-s1-5327600/house-democrats-outrage-spending\">reserved particular criticism\u003c/a> for Senate Minority Leader Chuck Schumer, who led nine Democrats in voting for a Republican-authored budget resolution to avoid a government shutdown earlier this month.\u003c/p>\n\u003cp>“When is the Democratic Party going to set aside its peacetime leaders and bring up some wartime leaders?” Darren Bly asked Khanna. “Because that’s what we need.”\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Khanna reiterated his stance that the party’s “old guard needs to step aside,” and said, “If the party is letting us down, it’s time to rebuild the party.”\u003c/p>\n\u003cp>“If you are not fighting and marching and organizing, then you don’t understand the moment,” he continued. “We need Democratic leaders who are going to be with the people in the fight.”\u003c/p>\n\u003cp>A \u003ca href=\"https://www.documentcloud.org/documents/25597409-nbc-march-2025-poll/?q=stick&mode=document#document/p16\">recent NBC poll\u003c/a> found that 20% of Democratic voters have negative views of the party. Unlike in 2017, when most Democratic voters hoped their party would pursue compromise and consensus in Congress, the survey found 65% of Democratic voters want House Democrats to stick to their positions, even if it leads to gridlock in Washington.\u003c/p>\n\u003cp>“That’s what we want to see,” said Mitch Carillo, pointing to Khanna as he paced the makeshift stage answering questions. “They were mentioning the old guard in the Democratic Party, and they’ve done some really great things, but it’s time to step aside and let’s let this younger generation come in and see what they can do.”\u003c/p>\n\u003cp>“Because the Republicans aren’t playing fair, they’re not playing by the rule book, I mean, whatever it takes to win, they’ll do,” Carillo added. “The Democrats don’t have an answer for that. I think people like Ro Khanna do have an answer.”\u003c/p>\n\u003cfigure id=\"attachment_12032696\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12032696\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/250323-DEM-TOWN-HALLS-MD-14-KQED-1.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/250323-DEM-TOWN-HALLS-MD-14-KQED-1.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/250323-DEM-TOWN-HALLS-MD-14-KQED-1-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/250323-DEM-TOWN-HALLS-MD-14-KQED-1-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/250323-DEM-TOWN-HALLS-MD-14-KQED-1-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/250323-DEM-TOWN-HALLS-MD-14-KQED-1-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/250323-DEM-TOWN-HALLS-MD-14-KQED-1-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">(From center right) Connie Wright, Sally MacGuire and Ali Ramirez applaud and cheer at a town hall meeting with Rep. Ro Khanna at the MLK Community Center in Bakersfield on March 23, 2025. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In the short-term, Khanna is hoping strategic organizing efforts can strong-arm the Republican votes needed to block potential cuts to Medicaid, which covers health care for Americans with low incomes, disabilities or who live in nursing homes. His choice of the 22nd District was no accident: Two-thirds of residents receive health coverage through Medicaid, according to the California Budget & Policy Center.\u003c/p>\n\u003cp>“We need three Republicans — three Republicans — to prevent the cuts to Medicaid,” Khanna told the crowd on Sunday.\u003c/p>\n\u003cp>The district’s representative, David Valadao, said in a speech on the House floor last month that he has heard from many constituents “who tell me the only way they can afford health care is through programs like Medicaid.”\u003c/p>\n\u003cp>“I will not support a final reconciliation bill that risks leaving them behind,” he said.\u003c/p>\n\u003cfigure id=\"attachment_12032695\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-12032695 size-full\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/250323-DEM-TOWN-HALLS-MD-13-KQED-1.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/250323-DEM-TOWN-HALLS-MD-13-KQED-1.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/250323-DEM-TOWN-HALLS-MD-13-KQED-1-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/250323-DEM-TOWN-HALLS-MD-13-KQED-1-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/250323-DEM-TOWN-HALLS-MD-13-KQED-1-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/250323-DEM-TOWN-HALLS-MD-13-KQED-1-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/250323-DEM-TOWN-HALLS-MD-13-KQED-1-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Dawna Sodders-Simpson holds a sign at a town hall meeting with Rep. Ro Khanna at the MLK Community Center in Bakersfield on March 23, 2025. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>As part of a budget roadmap that will allow the party to renew their 2017 tax cut law, Republicans set a target of $880 billion in cuts to programs under the House Committee on Energy and Commerce. An \u003ca href=\"https://www.cbo.gov/system/files/2025-03/61235-Boyle-Pallone.pdf\">analysis released\u003c/a> by the nonpartisan Congressional Budget Office found that it would be impossible for Republicans to achieve that benchmark without cutting Medicaid, which accounts for $8.2 trillion of the $8.8 trillion in spending under that committee’s jurisdiction.\u003c/p>\n\u003cp>Russell Paul, a doctor in Bakersfield, said it would be heartbreaking if cuts led to patients being unable to afford care.\u003c/p>\n\u003cp>Paul, who was invited to the town hall by a coworker, heaped his own share of criticism on the Democratic Party.\u003c/p>\n\u003cp>“When we get young people like [Alexandria Ocasio-Cortez] or very progressive people like Bernie Sanders speaking truth to power, we try to marginalize them so we seem more mainstream,” he said. “This is sort of my start in becoming more active and trying to push back against what’s going on in our country.”\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"title": "California’s Medi-Cal Shortfall Hits $6.2 billion With ‘Unprecedented’ Cost Increases",
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"content": "\u003cp>The hole in California’s \u003ca href=\"https://calmatters.org/tag/medi-cal/\">Medi-Cal\u003c/a> budget seems to be bigger than what state officials reported just last week.\u003c/p>\n\u003cp>California health care officials told the Legislature on Monday that the state will need another $2.8 billion to be able to pay Medi-Cal providers through the end of the fiscal year.\u003c/p>\n\u003cp>That’s on top of a $3.4 billion loan that the administration told lawmakers last week it needed to make \u003ca href=\"https://calmatters.org/health/2025/03/medi-cal-budget-shortfall/\">“critical” payments for Medi-Cal\u003c/a>, the state-federal health insurance program for people with low income.\u003c/p>\n\u003cp>Combined, that’s $6.2 billion in spending above what was projected in the budget Gov. Gavin Newsom signed last summer. Almost 15 million Californians have health care coverage through Medi-Cal, also known as Medicaid.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“With the loan and these additional funds, the administration anticipates being able to manage expenditures for the remainder of the current year,” said Michelle Bass, director of the Department of Health Care Services, which oversees Medi-Cal.\u003c/p>\n\u003cp>Bass told legislators in a budget hearing that several factors are contributing to the higher-than-anticipated spending, including an increase in pharmacy costs, but also more growth in enrollment than the state projected. For one, the state underestimated the \u003ca href=\"https://calmatters.org/health/2023/12/undocumented-health-insurance-new-california-laws-2024/\">number of immigrants without legal status\u003c/a> who would sign up to the program in the last year.\u003c/p>\n\u003cp>Bass said the department had about one month of data regarding new policies before it had to make projections for the budget Newsom signed.\u003c/p>\n\u003cp>“These changes were unprecedented, and all happened at once,” Bass said.\u003c/p>\n\u003cp>The developments include:\u003c/p>\n\u003cul class=\"wp-block-list\">\n\u003cli>More immigrants without legal status enrolled in the program than expected. Over the last 10 years, California has \u003ca href=\"https://calmatters.org/explainers/california-health-care-coverage/\">expanded Medi-Cal coverage\u003c/a> to undocumented people in different age groups. The final group, adults ages 26 to 49, were allowed to apply for Medi-Cal starting Jan. 1, 2024. In January, Bass’ department estimated California would be spending \u003ca href=\"https://www.dhcs.ca.gov/Documents/Budget-Highlights/DHCS-FY-2025-26-Governors-Budget-Highlights.pdf\">$2.7 billion beyond what it budgeted (PDF)\u003c/a> due to the cost of covering care and prescriptions for newly enrolled immigrants. According to updated estimates from the administration, it costs the state about $8.5 billion from the general fund to cover immigrants who are in the country without legal authorization.\u003c/li>\n\u003cli>Also starting on Jan. 1, 2024, more seniors were able to sign up for Medi-Cal after the state stopped counting certain assets, such as cars, homes and savings when considering someone’s eligibility. Now, like everyone else, seniors’ eligibility is based on their income.\u003c/li>\n\u003cli>The program has seen higher overall enrollment due to pandemic-related flexibilities. California’s overall Medi-Cal population ballooned during the COVID-19 pandemic when the federal government temporarily suspended income eligibility checks to keep people insured during the national emergency. The number of people who dropped off the program after the pandemic was smaller than the department assumed.\u003c/li>\n\u003c/ul>\n\u003cp>Bass said other states are also going over budget, noting health care spending in general is increasing across the U.S.\u003c/p>\n\u003cp>Going over budget has vexed some state Republicans who say the governor and Democrats over-promised when they decided to expand Medi-Cal services to all immigrants with low income. Democrats have come out in defense of the expansion and the state’s efforts to keep people covered during the pandemic.[aside postID=news_12022068 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2024/11/GettyImages-536950177-1020x680.jpg']“The things that you’re talking about means that we have been successful,” Assemblymember Pilar Schiavo, a Santa Clarita Democrat, told Bass during Monday’s hearing. “We have been successful about keeping people covered, about making sure that they have access to health care.”\u003c/p>\n\u003cp>Schiavo added that California’s current shortfall is solvable, but less so are the potential cuts to Medicaid that Congress is currently weighing.\u003c/p>\n\u003cp>House Republicans recently voted to advance a proposal that could result in cuts of\u003ca href=\"https://calmatters.org/health/2025/02/medicaid-medi-cal-trump-cuts/\"> $880 billion to a group of programs\u003c/a>, largely Medicaid, over the next 10 years. According to some estimates, that could translate into annual losses of \u003ca href=\"https://calbudgetcenter.org/resources/california-at-risk-proposed-federal-funding-cuts-jeopardize-key-services/\">$10 billion to $20 billion a year\u003c/a> for California, an amount that state officials have said the state would not be able to backfill.\u003c/p>\n\u003cp>\u003cem>Supported by the California Health Care Foundation (CHCF), which works to ensure that people have access to the care they need, when they need it, at a price they can afford. Visit www.chcf.org to learn more.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n",
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"excerpt": "California is spending billions more than planned for Medi-Cal. Some of the cost drivers include higher enrollment among immigrants without legal status as well as pharmacy costs.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The hole in California’s \u003ca href=\"https://calmatters.org/tag/medi-cal/\">Medi-Cal\u003c/a> budget seems to be bigger than what state officials reported just last week.\u003c/p>\n\u003cp>California health care officials told the Legislature on Monday that the state will need another $2.8 billion to be able to pay Medi-Cal providers through the end of the fiscal year.\u003c/p>\n\u003cp>That’s on top of a $3.4 billion loan that the administration told lawmakers last week it needed to make \u003ca href=\"https://calmatters.org/health/2025/03/medi-cal-budget-shortfall/\">“critical” payments for Medi-Cal\u003c/a>, the state-federal health insurance program for people with low income.\u003c/p>\n\u003cp>Combined, that’s $6.2 billion in spending above what was projected in the budget Gov. Gavin Newsom signed last summer. Almost 15 million Californians have health care coverage through Medi-Cal, also known as Medicaid.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“With the loan and these additional funds, the administration anticipates being able to manage expenditures for the remainder of the current year,” said Michelle Bass, director of the Department of Health Care Services, which oversees Medi-Cal.\u003c/p>\n\u003cp>Bass told legislators in a budget hearing that several factors are contributing to the higher-than-anticipated spending, including an increase in pharmacy costs, but also more growth in enrollment than the state projected. For one, the state underestimated the \u003ca href=\"https://calmatters.org/health/2023/12/undocumented-health-insurance-new-california-laws-2024/\">number of immigrants without legal status\u003c/a> who would sign up to the program in the last year.\u003c/p>\n\u003cp>Bass said the department had about one month of data regarding new policies before it had to make projections for the budget Newsom signed.\u003c/p>\n\u003cp>“These changes were unprecedented, and all happened at once,” Bass said.\u003c/p>\n\u003cp>The developments include:\u003c/p>\n\u003cul class=\"wp-block-list\">\n\u003cli>More immigrants without legal status enrolled in the program than expected. Over the last 10 years, California has \u003ca href=\"https://calmatters.org/explainers/california-health-care-coverage/\">expanded Medi-Cal coverage\u003c/a> to undocumented people in different age groups. The final group, adults ages 26 to 49, were allowed to apply for Medi-Cal starting Jan. 1, 2024. In January, Bass’ department estimated California would be spending \u003ca href=\"https://www.dhcs.ca.gov/Documents/Budget-Highlights/DHCS-FY-2025-26-Governors-Budget-Highlights.pdf\">$2.7 billion beyond what it budgeted (PDF)\u003c/a> due to the cost of covering care and prescriptions for newly enrolled immigrants. According to updated estimates from the administration, it costs the state about $8.5 billion from the general fund to cover immigrants who are in the country without legal authorization.\u003c/li>\n\u003cli>Also starting on Jan. 1, 2024, more seniors were able to sign up for Medi-Cal after the state stopped counting certain assets, such as cars, homes and savings when considering someone’s eligibility. Now, like everyone else, seniors’ eligibility is based on their income.\u003c/li>\n\u003cli>The program has seen higher overall enrollment due to pandemic-related flexibilities. California’s overall Medi-Cal population ballooned during the COVID-19 pandemic when the federal government temporarily suspended income eligibility checks to keep people insured during the national emergency. The number of people who dropped off the program after the pandemic was smaller than the department assumed.\u003c/li>\n\u003c/ul>\n\u003cp>Bass said other states are also going over budget, noting health care spending in general is increasing across the U.S.\u003c/p>\n\u003cp>Going over budget has vexed some state Republicans who say the governor and Democrats over-promised when they decided to expand Medi-Cal services to all immigrants with low income. Democrats have come out in defense of the expansion and the state’s efforts to keep people covered during the pandemic.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“The things that you’re talking about means that we have been successful,” Assemblymember Pilar Schiavo, a Santa Clarita Democrat, told Bass during Monday’s hearing. “We have been successful about keeping people covered, about making sure that they have access to health care.”\u003c/p>\n\u003cp>Schiavo added that California’s current shortfall is solvable, but less so are the potential cuts to Medicaid that Congress is currently weighing.\u003c/p>\n\u003cp>House Republicans recently voted to advance a proposal that could result in cuts of\u003ca href=\"https://calmatters.org/health/2025/02/medicaid-medi-cal-trump-cuts/\"> $880 billion to a group of programs\u003c/a>, largely Medicaid, over the next 10 years. According to some estimates, that could translate into annual losses of \u003ca href=\"https://calbudgetcenter.org/resources/california-at-risk-proposed-federal-funding-cuts-jeopardize-key-services/\">$10 billion to $20 billion a year\u003c/a> for California, an amount that state officials have said the state would not be able to backfill.\u003c/p>\n\u003cp>\u003cem>Supported by the California Health Care Foundation (CHCF), which works to ensure that people have access to the care they need, when they need it, at a price they can afford. Visit www.chcf.org to learn more.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"slug": "california-has-a-lot-to-lose-if-trump-slashes-medicaid-seniors-kids-could-face-coverage-cuts",
"title": "California Has a Lot to Lose if Trump Slashes Medicaid. Seniors, Kids Could Face Coverage Cuts",
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"content": "\u003cp>Perhaps no state has more to lose than California in the federal budget proposal House Republicans passed this week.\u003c/p>\n\u003cp>That spending plan sets up significant cuts to Medicaid, the health insurance program for people with low income. California has taken just about every route and opportunity to expand the Medicaid program. Today, 14.9 million Californians are enrolled in it, and federal funding cuts would almost certainly roll back services and coverage for some of them.\u003c/p>\n\u003cp>Looking for a way to offset the cost of extending President Donald Trump’s 2017 tax cuts, the House advanced a bill Tuesday that directs the Energy and Commerce Committee to find $880 billion in spending cuts over the next 10 years. Those cuts, budget and health policy experts say, would largely have to come from Medicaid, also known as \u003ca href=\"https://calmatters.org/tag/medi-cal/\">Medi-Cal in California\u003c/a>.\u003c/p>\n\u003cp>The Senate voted for its own, narrower budget bill last week. Next, both chambers have to work out their differences and agree on one budget.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>At this point, it’s not clear which Medicaid services would be cut or how many people exactly would lose coverage because lawmakers can hit the spending reductions in a number of ways.\u003c/p>\n\u003cp>Still, enrollees, health advocates and providers in California and across the country are now grappling with what the cuts would mean for them and the people they care for. In press conferences and online meetings, they’ve called the proposed cuts a “five-alarm fire” and Republicans’ vote “the ultimate betrayal” of their constituents.\u003c/p>\n\u003cp>Their outcries echo the first Trump administration, when in 2017 House Republicans voted to repeal the Affordable Care Act. The law ultimately survived, but that health care vote \u003ca href=\"https://calmatters.org/politics/2018/11/hidden-dem-shifts-beneath-blue-wave-california/\">helped stir up the “blue wave”\u003c/a> that flipped Republican House seats in the 2018 election.\u003c/p>\n\u003cp>“These cuts would rip care away from children, seniors, disabled Californians, and more while raising costs for everyone, all to give tax breaks to the ultra-wealthy,” Amanda McAllister-Wallner, interim executive director of Health Access California, a health consumer advocacy group, said in a statement following the House vote. “This is just the beginning — we will be pushing our California congress members at every turn to put the health of their constituents first.”\u003c/p>\n\u003cp>Medicaid is the backbone of California’s social safety net. It covers half of all children and 40% of all births. It \u003ca href=\"https://www.medicare.gov/coverage/long-term-care\">also covers long-term care\u003c/a> services for seniors and disabled people.\u003c/p>\n\u003cp>Since 2014, the state \u003ca href=\"https://calmatters.org/explainers/california-health-care-coverage/\">has expanded the program big time\u003c/a> — first to more adults allowed in the Medicaid expansion under the Affordable Care Act, and gradually to low-income immigrants, regardless of their legal status. Cuts to the scale that Republicans in Congress are proposing, advocates and providers say, would be harmful across the board.\u003c/p>\n\u003cp>Hospitals, doctors and \u003ca href=\"https://news.santaclaracounty.gov/statement-county-executive-james-r-williams-impact-proposed-federal-funding-cuts-santa-clara-county\">county officials\u003c/a> are also speaking out against the proposed cuts because Medicaid is a key payer, especially for those located in rural areas or communities with high poverty rates. If these facilities can’t keep their doors open, entire communities, not just people enrolled in Medicaid, could lose access.\u003c/p>\n\u003cp>House Speaker Mike Johnson, a Louisiana Republican, has said savings could be accomplished through eliminating Medicaid fraud and waste — although that would only get Republicans so far. \u003ca href=\"https://www.washingtonpost.com/politics/2025/02/26/republicans-could-be-touching-third-rail-medicaid/\">Johnson has cited about $50 billion in alleged fraud\u003c/a>, a small slice of the GOP’s goal total, the Washington Post reports.\u003c/p>\n\u003ch2>Cuts would leave big budget hole for state\u003c/h2>\n\u003cp>Medicaid accounts for a significant portion of states’ budgets. The program is jointly funded by the federal government and states, meaning federal cuts would leave major budget gaps that would force reductions in services and enrollment, and also could trigger cuts to other state programs. California’s budget includes \u003ca href=\"https://ebudget.ca.gov/2024-25/pdf/Enacted/BudgetSummary/HealthandHumanServices.pdf\">$161 billion for Medi-Cal (PDF)\u003c/a>, of which more than half is paid for with federal funds.\u003c/p>\n\u003cp>Based on proposals that Republicans in Congress are considering, \u003ca href=\"https://calbudgetcenter.org/resources/california-at-risk-proposed-federal-funding-cuts-jeopardize-key-services/\">California could lose $10 billion to $20 billion a year\u003c/a>, the California Budget Policy Center estimates.\u003c/p>\n\u003cfigure id=\"attachment_12029304\" class=\"wp-caption aligncenter\" style=\"max-width: 1568px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12029304\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/022625-Mike-Johnson-REUTERS-CM-01-copy.jpg\" alt=\"\" width=\"1568\" height=\"1045\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/022625-Mike-Johnson-REUTERS-CM-01-copy.jpg 1568w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/022625-Mike-Johnson-REUTERS-CM-01-copy-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/022625-Mike-Johnson-REUTERS-CM-01-copy-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/022625-Mike-Johnson-REUTERS-CM-01-copy-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/022625-Mike-Johnson-REUTERS-CM-01-copy-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1568px) 100vw, 1568px\">\u003cfigcaption class=\"wp-caption-text\">Speaker of the House Mike Johnson speaks at the Conservative Political Action Conference (CPAC) at the Gaylord National Resort and Convention Center in National Harbor, Maryland on Feb. 20, 2025. \u003ccite>(Jack Gruber/USA TODAY via Reuters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>A big question mark is how exactly Congress will meet its savings goal — Republican lawmakers have floated a number of proposals, but it’s unclear yet what could stick.\u003c/p>\n\u003cp>They’ve proposed imposing work requirements, for example. The idea behind that is enrollment would drop as people who don’t meet the requirements get kicked off the program. But the spending reductions from such a policy would not get Republicans all the way to their target, said Edwin Park, a research professor at the Georgetown University McCourt School of Public Policy.\u003c/p>\n\u003cp>A second proposal would require restructuring the program so that instead of the federal government paying states a fixed percentage of Medicaid costs, it could set a spending cap per enrollee.\u003c/p>\n\u003cp>Under the Affordable Care Act, California opened up its Medi-Cal roll to low-income adults who had previously not been covered. The federal government pays California 90% of the cost for this expansion group — \u003ca href=\"https://www.kff.org/medicaid/state-indicator/federal-matching-rate-and-multiplier/?currentTimeframe=2&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D\">that’s up from the state’s 50% regular match rate\u003c/a>. Republicans may also choose to eliminate the increased match rate for adults covered under this expansion.\u003c/p>\n\u003cp>“One reason that these types of cuts are popular among federal policy makers is because…it really allows the blame to be placed on governors and state legislatures,” Park said. “The federal government is cutting federal funding, making it harder for states to finance their share of the cost of Medicaid, but it’s not actually saying ‘You have to cut eligibility in this way or cut provider rates in this way.’”\u003c/p>\n\u003cp>“It’s really, ‘States, you figure it out, you have to balance your budget,’” Park added. “And you know, there’s only three choices: higher taxes, cutting the rest of the budget, which is primarily education in California, and then, most likely, really dramatically cutting Medi-Cal in the state.”\u003c/p>\n\u003ch2>Coverage for seniors and people with disabilities\u003c/h2>\n\u003cp>President Trump and Republicans have promised to not touch seniors’ Medicare, but millions of seniors also rely on Medicaid. In California, about 2.2 million seniors and people with disabilities are enrolled in Medi-Cal, according to data from the state’s Department of Health Care Services.\u003c/p>\n\u003cp>Traditional Medicare does not cover services including dental, vision and hearing benefits. Seniors typically have to buy into a Medicare Advantage plan to get that covered. Low-income seniors in California can access those services with no or at a low-cost through Medi-Cal.[aside label=\"Related Stories\" postID=\"news_12022068,forum_2010101908967,news_12028454\"]\u003cbr>\nNursing home stays and in-home care are also largely covered by Medicaid. Nationally, \u003ca href=\"https://www.kff.org/medicaid/issue-brief/a-look-at-nursing-facility-characteristics/\">about 6 in 10 nursing home residents\u003c/a> are covered by Medicaid, according to an analysis by KFF, a health polling and research organization.\u003c/p>\n\u003cp>“Medicare has huge gaps in coverage and Medicare is really expensive,” said Amber Christ, managing director of health advocacy at Justice in Aging, which advocates on behalf of older adults. “It is Medicaid, not Medicare, that is the primary payer of long-term care in this country.”\u003c/p>\n\u003cp>Because of their high needs, seniors and people with disabilities are the most costly population. In California, they make up about \u003ca href=\"https://www.dhcs.ca.gov/provgovpart/Documents/SPD-Final-Evaluation-Report.pdf\">15% of the people enrolled in Medi-Cal (PDF)\u003c/a>, but account for roughly half of all the program’s spending.\u003c/p>\n\u003cp>“So if the state wants to go where the money is, that’s seniors and people with disabilities. That’s long-term care, nursing home care, community-based services,” said Park. To protect the coverage of this population, he said, the state would have to consider potentially making larger cuts for other groups of people.\u003c/p>\n\u003ch2>A safety net for California kids\u003c/h2>\n\u003cp>More than 5 million kids in California are insured through Medi-Cal and the accompanying \u003ca href=\"https://www.medicaid.gov/chip/index.html\">Children’s Health Insurance Program\u003c/a>. It pays for their preventive care, such as immunizations and screenings, but it also covers support services, such as counseling and therapy. For about 160,000 children in the foster care system and who have been adopted, it also pays for an array of social services.\u003c/p>\n\u003cp>Getting kids insured has long been a priority for California. When the state began expanding Medi-Cal to undocumented people in 2016, children were first in line.\u003c/p>\n\u003cp>Perhaps less known is that Medi-Cal is also a big player in services provided at schools. It helps fund services and equipment for students with disabilities, such as hearing aids and specialty transportation. It reimburses school districts for certain providers, including psychologists and social workers, for example. Across the state, some districts also provide physical and mental health care to children and their families through school-based health centers that also draw down on Medi-Cal funding.\u003c/p>\n\u003cp>“The rates of depression and anxiety among youth are rising at alarming rates, and for many, Medi-Cal services are their only option for care,” said Michele Cantwell-Copher, the Fresno County Superintendent of Schools, on a media call with advocates and parents on Thursday. “Ensuring that children have access to the mental health support they need is critical to their well-being and their success in schools.”\u003c/p>\n\u003cp>Medi-Cal is a keystone program for many kids but also for their birthing parent — it pays for about 40% of the state’s births. California offers coverage for pregnant people at slightly higher income levels than the regular cut-off, allowing more to qualify. It provides coverage during their pregnancy and 12 months postpartum, paying for standard obstetric visits, prescriptions, laboratory services, doula services and hospital care.\u003c/p>\n\u003cp>“If we want kids to have a healthy start, that means making sure that their birthing parent has access to health care,” said Mike Odeh, health policy director at Children Now. “Those early years really are important for both babies and parents. There are a lot of services in that time period that really are critical, and any reduction in those services could have very bad effects.”\u003c/p>\n\u003cp>\u003cem>Supported by the California Health Care Foundation (CHCF), which works to ensure that people have access to the care they need, when they need it, at a price they can afford. Visit www.chcf.org to learn more.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"excerpt": "Almost 15 million Californians have health care coverage through Medi-Cal, a program that stands to lose billions of dollars if Republicans follow through on proposed cuts.",
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"title": "California Has a Lot to Lose if Trump Slashes Medicaid. Seniors, Kids Could Face Coverage Cuts | KQED",
"description": "Almost 15 million Californians have health care coverage through Medi-Cal, a program that stands to lose billions of dollars if Republicans follow through on proposed cuts.",
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"headline": "California Has a Lot to Lose if Trump Slashes Medicaid. Seniors, Kids Could Face Coverage Cuts",
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"nprByline": "\u003ca href=\"https://calmatters.org/author/anaibarra/\">Ana B. Ibarra\u003c/a>, CalMatters",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Perhaps no state has more to lose than California in the federal budget proposal House Republicans passed this week.\u003c/p>\n\u003cp>That spending plan sets up significant cuts to Medicaid, the health insurance program for people with low income. California has taken just about every route and opportunity to expand the Medicaid program. Today, 14.9 million Californians are enrolled in it, and federal funding cuts would almost certainly roll back services and coverage for some of them.\u003c/p>\n\u003cp>Looking for a way to offset the cost of extending President Donald Trump’s 2017 tax cuts, the House advanced a bill Tuesday that directs the Energy and Commerce Committee to find $880 billion in spending cuts over the next 10 years. Those cuts, budget and health policy experts say, would largely have to come from Medicaid, also known as \u003ca href=\"https://calmatters.org/tag/medi-cal/\">Medi-Cal in California\u003c/a>.\u003c/p>\n\u003cp>The Senate voted for its own, narrower budget bill last week. Next, both chambers have to work out their differences and agree on one budget.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>At this point, it’s not clear which Medicaid services would be cut or how many people exactly would lose coverage because lawmakers can hit the spending reductions in a number of ways.\u003c/p>\n\u003cp>Still, enrollees, health advocates and providers in California and across the country are now grappling with what the cuts would mean for them and the people they care for. In press conferences and online meetings, they’ve called the proposed cuts a “five-alarm fire” and Republicans’ vote “the ultimate betrayal” of their constituents.\u003c/p>\n\u003cp>Their outcries echo the first Trump administration, when in 2017 House Republicans voted to repeal the Affordable Care Act. The law ultimately survived, but that health care vote \u003ca href=\"https://calmatters.org/politics/2018/11/hidden-dem-shifts-beneath-blue-wave-california/\">helped stir up the “blue wave”\u003c/a> that flipped Republican House seats in the 2018 election.\u003c/p>\n\u003cp>“These cuts would rip care away from children, seniors, disabled Californians, and more while raising costs for everyone, all to give tax breaks to the ultra-wealthy,” Amanda McAllister-Wallner, interim executive director of Health Access California, a health consumer advocacy group, said in a statement following the House vote. “This is just the beginning — we will be pushing our California congress members at every turn to put the health of their constituents first.”\u003c/p>\n\u003cp>Medicaid is the backbone of California’s social safety net. It covers half of all children and 40% of all births. It \u003ca href=\"https://www.medicare.gov/coverage/long-term-care\">also covers long-term care\u003c/a> services for seniors and disabled people.\u003c/p>\n\u003cp>Since 2014, the state \u003ca href=\"https://calmatters.org/explainers/california-health-care-coverage/\">has expanded the program big time\u003c/a> — first to more adults allowed in the Medicaid expansion under the Affordable Care Act, and gradually to low-income immigrants, regardless of their legal status. Cuts to the scale that Republicans in Congress are proposing, advocates and providers say, would be harmful across the board.\u003c/p>\n\u003cp>Hospitals, doctors and \u003ca href=\"https://news.santaclaracounty.gov/statement-county-executive-james-r-williams-impact-proposed-federal-funding-cuts-santa-clara-county\">county officials\u003c/a> are also speaking out against the proposed cuts because Medicaid is a key payer, especially for those located in rural areas or communities with high poverty rates. If these facilities can’t keep their doors open, entire communities, not just people enrolled in Medicaid, could lose access.\u003c/p>\n\u003cp>House Speaker Mike Johnson, a Louisiana Republican, has said savings could be accomplished through eliminating Medicaid fraud and waste — although that would only get Republicans so far. \u003ca href=\"https://www.washingtonpost.com/politics/2025/02/26/republicans-could-be-touching-third-rail-medicaid/\">Johnson has cited about $50 billion in alleged fraud\u003c/a>, a small slice of the GOP’s goal total, the Washington Post reports.\u003c/p>\n\u003ch2>Cuts would leave big budget hole for state\u003c/h2>\n\u003cp>Medicaid accounts for a significant portion of states’ budgets. The program is jointly funded by the federal government and states, meaning federal cuts would leave major budget gaps that would force reductions in services and enrollment, and also could trigger cuts to other state programs. California’s budget includes \u003ca href=\"https://ebudget.ca.gov/2024-25/pdf/Enacted/BudgetSummary/HealthandHumanServices.pdf\">$161 billion for Medi-Cal (PDF)\u003c/a>, of which more than half is paid for with federal funds.\u003c/p>\n\u003cp>Based on proposals that Republicans in Congress are considering, \u003ca href=\"https://calbudgetcenter.org/resources/california-at-risk-proposed-federal-funding-cuts-jeopardize-key-services/\">California could lose $10 billion to $20 billion a year\u003c/a>, the California Budget Policy Center estimates.\u003c/p>\n\u003cfigure id=\"attachment_12029304\" class=\"wp-caption aligncenter\" style=\"max-width: 1568px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12029304\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/022625-Mike-Johnson-REUTERS-CM-01-copy.jpg\" alt=\"\" width=\"1568\" height=\"1045\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/022625-Mike-Johnson-REUTERS-CM-01-copy.jpg 1568w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/022625-Mike-Johnson-REUTERS-CM-01-copy-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/022625-Mike-Johnson-REUTERS-CM-01-copy-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/022625-Mike-Johnson-REUTERS-CM-01-copy-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/022625-Mike-Johnson-REUTERS-CM-01-copy-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1568px) 100vw, 1568px\">\u003cfigcaption class=\"wp-caption-text\">Speaker of the House Mike Johnson speaks at the Conservative Political Action Conference (CPAC) at the Gaylord National Resort and Convention Center in National Harbor, Maryland on Feb. 20, 2025. \u003ccite>(Jack Gruber/USA TODAY via Reuters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>A big question mark is how exactly Congress will meet its savings goal — Republican lawmakers have floated a number of proposals, but it’s unclear yet what could stick.\u003c/p>\n\u003cp>They’ve proposed imposing work requirements, for example. The idea behind that is enrollment would drop as people who don’t meet the requirements get kicked off the program. But the spending reductions from such a policy would not get Republicans all the way to their target, said Edwin Park, a research professor at the Georgetown University McCourt School of Public Policy.\u003c/p>\n\u003cp>A second proposal would require restructuring the program so that instead of the federal government paying states a fixed percentage of Medicaid costs, it could set a spending cap per enrollee.\u003c/p>\n\u003cp>Under the Affordable Care Act, California opened up its Medi-Cal roll to low-income adults who had previously not been covered. The federal government pays California 90% of the cost for this expansion group — \u003ca href=\"https://www.kff.org/medicaid/state-indicator/federal-matching-rate-and-multiplier/?currentTimeframe=2&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D\">that’s up from the state’s 50% regular match rate\u003c/a>. Republicans may also choose to eliminate the increased match rate for adults covered under this expansion.\u003c/p>\n\u003cp>“One reason that these types of cuts are popular among federal policy makers is because…it really allows the blame to be placed on governors and state legislatures,” Park said. “The federal government is cutting federal funding, making it harder for states to finance their share of the cost of Medicaid, but it’s not actually saying ‘You have to cut eligibility in this way or cut provider rates in this way.’”\u003c/p>\n\u003cp>“It’s really, ‘States, you figure it out, you have to balance your budget,’” Park added. “And you know, there’s only three choices: higher taxes, cutting the rest of the budget, which is primarily education in California, and then, most likely, really dramatically cutting Medi-Cal in the state.”\u003c/p>\n\u003ch2>Coverage for seniors and people with disabilities\u003c/h2>\n\u003cp>President Trump and Republicans have promised to not touch seniors’ Medicare, but millions of seniors also rely on Medicaid. In California, about 2.2 million seniors and people with disabilities are enrolled in Medi-Cal, according to data from the state’s Department of Health Care Services.\u003c/p>\n\u003cp>Traditional Medicare does not cover services including dental, vision and hearing benefits. Seniors typically have to buy into a Medicare Advantage plan to get that covered. Low-income seniors in California can access those services with no or at a low-cost through Medi-Cal.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cbr>\nNursing home stays and in-home care are also largely covered by Medicaid. Nationally, \u003ca href=\"https://www.kff.org/medicaid/issue-brief/a-look-at-nursing-facility-characteristics/\">about 6 in 10 nursing home residents\u003c/a> are covered by Medicaid, according to an analysis by KFF, a health polling and research organization.\u003c/p>\n\u003cp>“Medicare has huge gaps in coverage and Medicare is really expensive,” said Amber Christ, managing director of health advocacy at Justice in Aging, which advocates on behalf of older adults. “It is Medicaid, not Medicare, that is the primary payer of long-term care in this country.”\u003c/p>\n\u003cp>Because of their high needs, seniors and people with disabilities are the most costly population. In California, they make up about \u003ca href=\"https://www.dhcs.ca.gov/provgovpart/Documents/SPD-Final-Evaluation-Report.pdf\">15% of the people enrolled in Medi-Cal (PDF)\u003c/a>, but account for roughly half of all the program’s spending.\u003c/p>\n\u003cp>“So if the state wants to go where the money is, that’s seniors and people with disabilities. That’s long-term care, nursing home care, community-based services,” said Park. To protect the coverage of this population, he said, the state would have to consider potentially making larger cuts for other groups of people.\u003c/p>\n\u003ch2>A safety net for California kids\u003c/h2>\n\u003cp>More than 5 million kids in California are insured through Medi-Cal and the accompanying \u003ca href=\"https://www.medicaid.gov/chip/index.html\">Children’s Health Insurance Program\u003c/a>. It pays for their preventive care, such as immunizations and screenings, but it also covers support services, such as counseling and therapy. For about 160,000 children in the foster care system and who have been adopted, it also pays for an array of social services.\u003c/p>\n\u003cp>Getting kids insured has long been a priority for California. When the state began expanding Medi-Cal to undocumented people in 2016, children were first in line.\u003c/p>\n\u003cp>Perhaps less known is that Medi-Cal is also a big player in services provided at schools. It helps fund services and equipment for students with disabilities, such as hearing aids and specialty transportation. It reimburses school districts for certain providers, including psychologists and social workers, for example. Across the state, some districts also provide physical and mental health care to children and their families through school-based health centers that also draw down on Medi-Cal funding.\u003c/p>\n\u003cp>“The rates of depression and anxiety among youth are rising at alarming rates, and for many, Medi-Cal services are their only option for care,” said Michele Cantwell-Copher, the Fresno County Superintendent of Schools, on a media call with advocates and parents on Thursday. “Ensuring that children have access to the mental health support they need is critical to their well-being and their success in schools.”\u003c/p>\n\u003cp>Medi-Cal is a keystone program for many kids but also for their birthing parent — it pays for about 40% of the state’s births. California offers coverage for pregnant people at slightly higher income levels than the regular cut-off, allowing more to qualify. It provides coverage during their pregnancy and 12 months postpartum, paying for standard obstetric visits, prescriptions, laboratory services, doula services and hospital care.\u003c/p>\n\u003cp>“If we want kids to have a healthy start, that means making sure that their birthing parent has access to health care,” said Mike Odeh, health policy director at Children Now. “Those early years really are important for both babies and parents. There are a lot of services in that time period that really are critical, and any reduction in those services could have very bad effects.”\u003c/p>\n\u003cp>\u003cem>Supported by the California Health Care Foundation (CHCF), which works to ensure that people have access to the care they need, when they need it, at a price they can afford. Visit www.chcf.org to learn more.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"tagline": "Where conversation and cultura meet",
"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
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"info": "The Political Mind of Jerry Brown brings listeners the wisdom of the former Governor, Mayor, and presidential candidate. Scott Shafer interviewed Brown for more than 40 hours, covering the former governor's life and half-century in the political game – and Brown has some lessons he'd like to share. ",
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"marketplace": {
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"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
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"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
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"order": 12
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"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
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"info": "Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. For one hour a week, the show tries to lift the veil from the process of \"making media,\" especially news media, because it's through that lens that we see the world and the world sees us",
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"planet-money": {
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"info": "The economy explained. Imagine you could call up a friend and say, Meet me at the bar and tell me what's going on with the economy. Now imagine that's actually a fun evening.",
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"politicalbreakdown": {
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"title": "Political Breakdown",
"tagline": "Politics from a personal perspective",
"info": "Political Breakdown is a new series that explores the political intersection of California and the nation. Each week hosts Scott Shafer and Marisa Lagos are joined with a new special guest to unpack politics -- with personality — and offer an insider’s glimpse at how politics happens.",
"airtime": "THU 6:30pm-7pm",
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"possible": {
"id": "possible",
"title": "Possible",
"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
"airtime": "SUN 2pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Possible-Podcast-Tile-360x360-1.jpg",
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"pri-the-world": {
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"title": "PRI's The World: Latest Edition",
"info": "Each weekday, host Marco Werman and his team of producers bring you the world's most interesting stories in an hour of radio that reminds us just how small our planet really is.",
"airtime": "MON-FRI 2pm-3pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-World-Podcast-Tile-360x360-1.jpg",
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},
"radiolab": {
"id": "radiolab",
"title": "Radiolab",
"info": "A two-time Peabody Award-winner, Radiolab is an investigation told through sounds and stories, and centered around one big idea. In the Radiolab world, information sounds like music and science and culture collide. Hosted by Jad Abumrad and Robert Krulwich, the show is designed for listeners who demand skepticism, but appreciate wonder. WNYC Studios is the producer of other leading podcasts including Freakonomics Radio, Death, Sex & Money, On the Media and many more.",
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},
"reveal": {
"id": "reveal",
"title": "Reveal",
"info": "Created by The Center for Investigative Reporting and PRX, Reveal is public radios first one-hour weekly radio show and podcast dedicated to investigative reporting. Credible, fact based and without a partisan agenda, Reveal combines the power and artistry of driveway moment storytelling with data-rich reporting on critically important issues. The result is stories that inform and inspire, arming our listeners with information to right injustices, hold the powerful accountable and improve lives.Reveal is hosted by Al Letson and showcases the award-winning work of CIR and newsrooms large and small across the nation. In a radio and podcast market crowded with choices, Reveal focuses on important and often surprising stories that illuminate the world for our listeners.",
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"officialWebsiteLink": "https://www.revealnews.org/episodes/",
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},
"rightnowish": {
"id": "rightnowish",
"title": "Rightnowish",
"tagline": "Art is where you find it",
"info": "Rightnowish digs into life in the Bay Area right now… ish. Journalist Pendarvis Harshaw takes us to galleries painted on the sides of liquor stores in West Oakland. We'll dance in warehouses in the Bayview, make smoothies with kids in South Berkeley, and listen to classical music in a 1984 Cutlass Supreme in Richmond. Every week, Pen talks to movers and shakers about how the Bay Area shapes what they create, and how they shape the place we call home.",
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"source": "kqed",
"order": 16
},
"link": "/podcasts/rightnowish",
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},
"science-friday": {
"id": "science-friday",
"title": "Science Friday",
"info": "Science Friday is a weekly science talk show, broadcast live over public radio stations nationwide. Each week, the show focuses on science topics that are in the news and tries to bring an educated, balanced discussion to bear on the scientific issues at hand. Panels of expert guests join host Ira Flatow, a veteran science journalist, to discuss science and to take questions from listeners during the call-in portion of the program.",
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},
"snap-judgment": {
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