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"content": "\u003cp>\u003c!-- Creative Commons Attribution-NonCommercial-NoDerivatives https://creativecommons.org/licenses/by-nc-nd/4.0/ -->\u003c/p>\n\u003cp>\u003cem>This story was originally published by \u003ca href=\"https://calmatters.org/\">CalMatters\u003c/a>. \u003ca href=\"https://calmatters.org/subscribe-to-calmatters/\">Sign up\u003c/a> for their newsletters.\u003c/em>\u003c/p>\n\u003cp>A debate over roads may cost Glenn County its only emergency room.\u003c/p>\n\u003cp>Glenn Medical Center, a 25-bed hospital in the rural agricultural town of Willows, north of Sacramento, is about to lose its “critical access” title. Without it, administrators say the hospital couldn’t afford to stay open because it would lose its increased Medicare reimbursements and regulatory flexibilities.\u003c/p>\n\u003cp>Glenn Medical Center received a letter in April from the U.S. Centers for Medicare and Medicaid Services notifying the hospital that it was no longer in compliance with the distance requirement to qualify as “critical access.” That requirement states that hospitals must be more than a 35-mile drive on primary roads — or a 15-mile drive on mountainous or secondary roads — from the next nearest hospital.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The next closest hospital is Colusa Medical Center, which the federal Medicare and Medicaid agency places at 32 miles south of Glenn Medical Center. That makes Glenn County’s hospital three miles short of the qualifying distance for the critical access title. But local health officials and the Willows Fire Department say ambulances and most patients take the “more reliable” route of I-5 and Highway 20, which makes the distance between the hospitals 35.7 miles — far enough to qualify.\u003c/p>\n\u003cp>About 40% of Glenn County’s 30,000 residents rely on public health insurance programs — Medicaid and Medicare — and 12% live under the poverty line.\u003c/p>\n\u003cp>“We treat and see and care for a lot of people who are unseen in the community. A lot of behavioral health crises, a lot of justice-involved folks, a lot of elderly, a lot of people without transportation. And we are truly a lifeline for those folks,” said Lauren Still, chief administrative officer at Glenn Medical Center.\u003c/p>\n\u003cfigure id=\"attachment_12045105\" class=\"wp-caption aligncenter\" style=\"max-width: 2500px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12045105\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/06/Side-by-side-Downpage-2.jpg\" alt=\"\" width=\"2500\" height=\"833\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/06/Side-by-side-Downpage-2.jpg 2500w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/06/Side-by-side-Downpage-2-2000x666.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/06/Side-by-side-Downpage-2-160x53.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/06/Side-by-side-Downpage-2-1536x512.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/06/Side-by-side-Downpage-2-2048x682.jpg 2048w\" sizes=\"auto, (max-width: 2500px) 100vw, 2500px\">\u003cfigcaption class=\"wp-caption-text\">Left: An ambulance parked at Glenn Medical Center in Willows. Right: Emergency medicine physician Dr. Salah Sherif (center) talks with Bradley Ford (right) assistant ER manager, and registered nurse Rebecca Vranich (left). \u003ccite>(Chris Kaufman for CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Closing the only hospital in this Sacramento Valley county would mean residents would have to travel farther for emergency care and ambulances would take longer responding to 911 calls.\u003c/p>\n\u003cp>Dr. Jared Garrison, Glenn County’s health officer, said losing the hospital would be a devastating blow to the community. Garrison worries about the elderly who may be afraid to drive at night and people who don’t have transportation to make it out of the county. Heart attacks, strokes, traumatic injuries and overdoses can become more deadly when hospital treatment is delayed.\u003c/p>\n\u003cp>“If Glenn Medical Center closes, it’s not just a health crisis — it’s an economic and social crisis,” Garrison said. “We’ll see longer emergency response times, job losses, declining local businesses, and worsening health outcomes for our most vulnerable neighbors.”\u003c/p>\n\u003ch2>\u003cstrong>‘This is not the road people would take’\u003c/strong>\u003c/h2>\n\u003cp>Both hospitals, Colusa and Glenn, have been at the same location since their construction decades ago. In 2001, Glenn Medical Center was first approved to participate in the federal \u003ca href=\"https://www.cms.gov/medicare/health-safety-standards/certification-compliance/critical-access-hospitals\">Critical Access Hospital Program\u003c/a> under the same distance rule. Hospital and county health officials say geographically nothing has changed.\u003c/p>\n\u003cp>“We tried to send some emails back and forth and say, ‘Hey, this is not the road people would take. This is not the road the ambulance takes. This is just not accurate,’” Garrison said. The “shorter” route, he explained, actually takes longer because it includes a county road that often floods and is primarily used by farm equipment.\u003c/p>\n\u003cp>The hospital’s appeals to the federal agency have been unsuccessful. Still said she is clinging to one last hope that U.S. Rep. Doug LaMalfa, a Richvale Republican, can make the hospital’s case.\u003c/p>\n\u003cp>Mark Spannagel, chief of staff at LaMalfa’s office, told CalMatters that no resolution has been reached yet, but that conversations with the federal agency continue and that the hospital’s situation is under “heightened review.”\u003c/p>\n\u003cp>The federal Medicare and Medicaid agency is supposed to review critical access hospitals’ eligibility periodically. This review started last year and the issue seems to be a reclassification of roads, Spannagel said.\u003c/p>\n\u003cp>The federal agency did not respond to a CalMatters request for comment about why it changed its decision on the roads.\u003c/p>\n\u003cfigure>\u003cimg decoding=\"async\" src=\"https://calmatters.org/wp-content/uploads/2025/06/061325_Glenn-Medical-Center_CK_26-1024x682.jpg\" alt=\"\">\u003cfigcaption>At left, Glenn County public health officer Dr. Jared Garrison and Lauren Still, chief administrative officer, worry that the hospital may have to close. \u003cem>Chris Kaufman for CalMatters\u003c/em>\u003c/figcaption>\u003c/figure>\n\u003cp>Peggy Wheeler, vice president of policy at the California Hospital Association, said she is aware of four critical access hospitals in California that received a similar letter. Two of them, Bear Valley Community Hospital in Big Bear Lake and George L. Mee Memorial in Monterey County, have since resolved their cases and will be allowed to keep their “critical access” designation.\u003c/p>\n\u003cp>A third, Santa Ynez Valley Cottage Hospital in Solvang is also working with the federal agency and considering its options, Wheeler said. The Cottage Health system declined an interview request from CalMatters.\u003c/p>\n\u003cp>Wheeler explained that hospitals that lose their “critical access” designation may have to apply for other classifications, such as a “low volume provider” or “sole community hospital,” which also provide enhanced Medicare payments.\u003c/p>\n\u003cp>In its letter, the federal agency told Glenn Medical Center that it has until April 23, 2026 to reclassify as another type of hospital to continue participating in the Medicare program.\u003c/p>\n\u003ch2>\u003cstrong>A financial buffer for ‘critical access’ hospitals\u003c/strong>\u003c/h2>\n\u003cp>The Clinton administration created the Critical Access Program in 1997 as a way to support rural hospitals. The goal of the program is to make sure that remote areas far from cities have adequate medical care.\u003c/p>\n\u003cp>“Our hospital was on the brink of closure back in 2001. We got this designation and have kept our doors open for the next 24 years,” said Still at Glenn Medical Center. The hospital is owned by American Advanced Management, the same group that \u003ca href=\"https://calmatters.org/health/2024/02/madera-hospital-reopen/\">recently purchased and reopened Madera Community Hospital\u003c/a>.[aside postID=forum_2010101909199 hero='https://cdn.kqed.org/wp-content/uploads/sites/43/2025/03/iStock-921681588-1-1020x574.jpg']The program gives the hospital a bit of a financial buffer through higher-than-average Medicare reimbursement. Medicare pays critical access hospitals 101% of costs for most inpatient and outpatient services; for comparison, Medicare reimburses \u003ca href=\"https://www.aha.org/2024-01-10-infographic-medicare-significantly-underpays-hospitals-cost-patient-care\">most other hospitals 82% of costs\u003c/a>, according to the American Hospital Association.\u003c/p>\n\u003cp>The designation also allows rural hospitals to stay open even if they don’t meet certain standards required of most other general acute hospitals. For example, Glenn Medical Center does not have a serviceable operating room, and bringing it up to required standards is financially prohibitive, Still said.\u003c/p>\n\u003cp>The financial burden of losing its critical access designation would be such that the hospital would likely have to close its inpatient services by next spring, Still said. Outpatient services, such as clinics and labs, would remain open.\u003c/p>\n\u003cp>Like hospitals across the country, Glenn Medical Center is also bracing for a separate financial blow in the form of potential Medicaid cuts that are currently being debated in Congress. Hospitals could see decreased federal funding and increased costs because of uncompensated care from people who lose their Medicaid coverage. The American Hospital Association has estimated that \u003ca href=\"https://www.aha.org/news/headline/2025-06-16-analysis-highlights-impact-proposed-medicaid-cuts-rural-patients-and-hospitals\">rural hospitals across the country could lose about $50 billion\u003c/a> altogether in federal Medicaid spending by 2034, if President Donald Trump’s “One Big Beautiful Bill” were to pass as currently drafted.\u003c/p>\n\u003cp>Last month, all of California’s Republican House members \u003ca href=\"https://lamalfa.house.gov/media-center/press-releases/lamalfa-applauds-house-passage-budget-reconciliation-package\">voted in support \u003c/a>of the budget bill, including LaMalfa, who represents the area. The Senate is now deliberating on its own version of the bill.\u003c/p>\n\u003cp>To raise awareness of the hospital’s looming loss of its critical access status, Glenn Medical Center \u003ca href=\"https://saveglennmedical.com/\">recently launched a campaign\u003c/a> urging residents to write testimonials and letters in support.\u003c/p>\n\u003cp>Without a local hospital, the county’s two ambulances would have to travel farther, to Enloe Medical Center in Chico, about 36 miles north. Garrison explained that ambulances would probably choose Enloe over Colusa Medical Center because it is the larger of the two and has a trauma center.\u003c/p>\n\u003cp>The vast central-north region between Mendocino and Plumas National Forests is already down a hospital after Adventist’s Feather River Hospital was damaged in the 2018 Camp Fire and did not reopen.\u003c/p>\n\u003cp>If ambulances have to drive 45 minutes out of the county instead of the five to ten minutes to their local hospital, that will affect the ability of Emergency Medical Services to respond to 911 calls, Garrison said.\u003c/p>\n\u003cp>“I was talking to an administrator at Enloe and they estimated that this could increase their wait times by up to two hours,” Garrison said.\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>\u003cem>This article was \u003ca href=\"https://calmatters.org/health/2025/06/california-glenn-county-hospital-critical-access-closure-medicaid/\">originally published on CalMatters\u003c/a> and was republished under the \u003ca href=\"https://creativecommons.org/licenses/by-nc-nd/4.0/\">Creative Commons Attribution-NonCommercial-NoDerivatives\u003c/a> license.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The next closest hospital is Colusa Medical Center, which the federal Medicare and Medicaid agency places at 32 miles south of Glenn Medical Center. That makes Glenn County’s hospital three miles short of the qualifying distance for the critical access title. But local health officials and the Willows Fire Department say ambulances and most patients take the “more reliable” route of I-5 and Highway 20, which makes the distance between the hospitals 35.7 miles — far enough to qualify.\u003c/p>\n\u003cp>About 40% of Glenn County’s 30,000 residents rely on public health insurance programs — Medicaid and Medicare — and 12% live under the poverty line.\u003c/p>\n\u003cp>“We treat and see and care for a lot of people who are unseen in the community. A lot of behavioral health crises, a lot of justice-involved folks, a lot of elderly, a lot of people without transportation. And we are truly a lifeline for those folks,” said Lauren Still, chief administrative officer at Glenn Medical Center.\u003c/p>\n\u003cfigure id=\"attachment_12045105\" class=\"wp-caption aligncenter\" style=\"max-width: 2500px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12045105\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/06/Side-by-side-Downpage-2.jpg\" alt=\"\" width=\"2500\" height=\"833\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/06/Side-by-side-Downpage-2.jpg 2500w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/06/Side-by-side-Downpage-2-2000x666.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/06/Side-by-side-Downpage-2-160x53.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/06/Side-by-side-Downpage-2-1536x512.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/06/Side-by-side-Downpage-2-2048x682.jpg 2048w\" sizes=\"auto, (max-width: 2500px) 100vw, 2500px\">\u003cfigcaption class=\"wp-caption-text\">Left: An ambulance parked at Glenn Medical Center in Willows. Right: Emergency medicine physician Dr. Salah Sherif (center) talks with Bradley Ford (right) assistant ER manager, and registered nurse Rebecca Vranich (left). \u003ccite>(Chris Kaufman for CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Closing the only hospital in this Sacramento Valley county would mean residents would have to travel farther for emergency care and ambulances would take longer responding to 911 calls.\u003c/p>\n\u003cp>Dr. Jared Garrison, Glenn County’s health officer, said losing the hospital would be a devastating blow to the community. Garrison worries about the elderly who may be afraid to drive at night and people who don’t have transportation to make it out of the county. Heart attacks, strokes, traumatic injuries and overdoses can become more deadly when hospital treatment is delayed.\u003c/p>\n\u003cp>“If Glenn Medical Center closes, it’s not just a health crisis — it’s an economic and social crisis,” Garrison said. “We’ll see longer emergency response times, job losses, declining local businesses, and worsening health outcomes for our most vulnerable neighbors.”\u003c/p>\n\u003ch2>\u003cstrong>‘This is not the road people would take’\u003c/strong>\u003c/h2>\n\u003cp>Both hospitals, Colusa and Glenn, have been at the same location since their construction decades ago. In 2001, Glenn Medical Center was first approved to participate in the federal \u003ca href=\"https://www.cms.gov/medicare/health-safety-standards/certification-compliance/critical-access-hospitals\">Critical Access Hospital Program\u003c/a> under the same distance rule. Hospital and county health officials say geographically nothing has changed.\u003c/p>\n\u003cp>“We tried to send some emails back and forth and say, ‘Hey, this is not the road people would take. This is not the road the ambulance takes. This is just not accurate,’” Garrison said. The “shorter” route, he explained, actually takes longer because it includes a county road that often floods and is primarily used by farm equipment.\u003c/p>\n\u003cp>The hospital’s appeals to the federal agency have been unsuccessful. Still said she is clinging to one last hope that U.S. Rep. Doug LaMalfa, a Richvale Republican, can make the hospital’s case.\u003c/p>\n\u003cp>Mark Spannagel, chief of staff at LaMalfa’s office, told CalMatters that no resolution has been reached yet, but that conversations with the federal agency continue and that the hospital’s situation is under “heightened review.”\u003c/p>\n\u003cp>The federal Medicare and Medicaid agency is supposed to review critical access hospitals’ eligibility periodically. This review started last year and the issue seems to be a reclassification of roads, Spannagel said.\u003c/p>\n\u003cp>The federal agency did not respond to a CalMatters request for comment about why it changed its decision on the roads.\u003c/p>\n\u003cfigure>\u003cimg decoding=\"async\" src=\"https://calmatters.org/wp-content/uploads/2025/06/061325_Glenn-Medical-Center_CK_26-1024x682.jpg\" alt=\"\">\u003cfigcaption>At left, Glenn County public health officer Dr. Jared Garrison and Lauren Still, chief administrative officer, worry that the hospital may have to close. \u003cem>Chris Kaufman for CalMatters\u003c/em>\u003c/figcaption>\u003c/figure>\n\u003cp>Peggy Wheeler, vice president of policy at the California Hospital Association, said she is aware of four critical access hospitals in California that received a similar letter. Two of them, Bear Valley Community Hospital in Big Bear Lake and George L. Mee Memorial in Monterey County, have since resolved their cases and will be allowed to keep their “critical access” designation.\u003c/p>\n\u003cp>A third, Santa Ynez Valley Cottage Hospital in Solvang is also working with the federal agency and considering its options, Wheeler said. The Cottage Health system declined an interview request from CalMatters.\u003c/p>\n\u003cp>Wheeler explained that hospitals that lose their “critical access” designation may have to apply for other classifications, such as a “low volume provider” or “sole community hospital,” which also provide enhanced Medicare payments.\u003c/p>\n\u003cp>In its letter, the federal agency told Glenn Medical Center that it has until April 23, 2026 to reclassify as another type of hospital to continue participating in the Medicare program.\u003c/p>\n\u003ch2>\u003cstrong>A financial buffer for ‘critical access’ hospitals\u003c/strong>\u003c/h2>\n\u003cp>The Clinton administration created the Critical Access Program in 1997 as a way to support rural hospitals. The goal of the program is to make sure that remote areas far from cities have adequate medical care.\u003c/p>\n\u003cp>“Our hospital was on the brink of closure back in 2001. We got this designation and have kept our doors open for the next 24 years,” said Still at Glenn Medical Center. The hospital is owned by American Advanced Management, the same group that \u003ca href=\"https://calmatters.org/health/2024/02/madera-hospital-reopen/\">recently purchased and reopened Madera Community Hospital\u003c/a>.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The program gives the hospital a bit of a financial buffer through higher-than-average Medicare reimbursement. Medicare pays critical access hospitals 101% of costs for most inpatient and outpatient services; for comparison, Medicare reimburses \u003ca href=\"https://www.aha.org/2024-01-10-infographic-medicare-significantly-underpays-hospitals-cost-patient-care\">most other hospitals 82% of costs\u003c/a>, according to the American Hospital Association.\u003c/p>\n\u003cp>The designation also allows rural hospitals to stay open even if they don’t meet certain standards required of most other general acute hospitals. For example, Glenn Medical Center does not have a serviceable operating room, and bringing it up to required standards is financially prohibitive, Still said.\u003c/p>\n\u003cp>The financial burden of losing its critical access designation would be such that the hospital would likely have to close its inpatient services by next spring, Still said. Outpatient services, such as clinics and labs, would remain open.\u003c/p>\n\u003cp>Like hospitals across the country, Glenn Medical Center is also bracing for a separate financial blow in the form of potential Medicaid cuts that are currently being debated in Congress. Hospitals could see decreased federal funding and increased costs because of uncompensated care from people who lose their Medicaid coverage. The American Hospital Association has estimated that \u003ca href=\"https://www.aha.org/news/headline/2025-06-16-analysis-highlights-impact-proposed-medicaid-cuts-rural-patients-and-hospitals\">rural hospitals across the country could lose about $50 billion\u003c/a> altogether in federal Medicaid spending by 2034, if President Donald Trump’s “One Big Beautiful Bill” were to pass as currently drafted.\u003c/p>\n\u003cp>Last month, all of California’s Republican House members \u003ca href=\"https://lamalfa.house.gov/media-center/press-releases/lamalfa-applauds-house-passage-budget-reconciliation-package\">voted in support \u003c/a>of the budget bill, including LaMalfa, who represents the area. The Senate is now deliberating on its own version of the bill.\u003c/p>\n\u003cp>To raise awareness of the hospital’s looming loss of its critical access status, Glenn Medical Center \u003ca href=\"https://saveglennmedical.com/\">recently launched a campaign\u003c/a> urging residents to write testimonials and letters in support.\u003c/p>\n\u003cp>Without a local hospital, the county’s two ambulances would have to travel farther, to Enloe Medical Center in Chico, about 36 miles north. Garrison explained that ambulances would probably choose Enloe over Colusa Medical Center because it is the larger of the two and has a trauma center.\u003c/p>\n\u003cp>The vast central-north region between Mendocino and Plumas National Forests is already down a hospital after Adventist’s Feather River Hospital was damaged in the 2018 Camp Fire and did not reopen.\u003c/p>\n\u003cp>If ambulances have to drive 45 minutes out of the county instead of the five to ten minutes to their local hospital, that will affect the ability of Emergency Medical Services to respond to 911 calls, Garrison said.\u003c/p>\n\u003cp>“I was talking to an administrator at Enloe and they estimated that this could increase their wait times by up to two hours,” Garrison said.\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>\u003cem>This article was \u003ca href=\"https://calmatters.org/health/2025/06/california-glenn-county-hospital-critical-access-closure-medicaid/\">originally published on CalMatters\u003c/a> and was republished under the \u003ca href=\"https://creativecommons.org/licenses/by-nc-nd/4.0/\">Creative Commons Attribution-NonCommercial-NoDerivatives\u003c/a> license.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"slug": "medicaid-work-rules-could-leave-a-million-californians-with-no-health-insurance",
"title": "Medicaid Work Rules Could Leave a Million Californians With No Health Insurance",
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"headTitle": "Medicaid Work Rules Could Leave a Million Californians With No Health Insurance | KQED",
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"content": "\u003cp>\u003c!-- Creative Commons Attribution-NonCommercial-NoDerivatives https://creativecommons.org/licenses/by-nc-nd/4.0/ -->\u003c/p>\n\u003cp>\u003cem>This story was originally published by \u003ca href=\"https://calmatters.org/\">CalMatters\u003c/a>. \u003ca href=\"https://calmatters.org/subscribe-to-calmatters/\">Sign up\u003c/a> for their newsletters.\u003c/em>\u003c/p>\n\u003cp>If Congress moves forward with a controversial \u003ca href=\"https://www.nytimes.com/2025/05/22/upshot/medicaid-republicans-work-requirement.html\">proposal to require people to report work hours\u003c/a> to keep Medicaid, more than a million of California’s poorest residents could lose their health insurance.\u003c/p>\n\u003cp>The budget bill that the U.S. House advanced last week includes a requirement that certain adults — largely those under 65 without children or a disability — meet work reporting rules. In California, about a third of them could lose their health coverage, according to an analysis by the research group Urban Institute. Based on 2026 enrollment projections, that’s \u003ca href=\"https://www.urban.org/research/publication/expanding-federal-work-requirements-medicaid-expansion-coverage-age-64-would\">between 1.2 and 1.4 million\u003c/a> Californians.\u003c/p>\n\u003cp>As Congress looks at Medicaid for ways to help offset the cost of extending President Donald Trump’s 2017 tax cuts, imposing work requirements has increasingly been deemed as one of the most feasible and significant cost-savings actions. House Speaker Mike Johnson \u003ca href=\"https://www.cbsnews.com/news/mike-johnson-house-speaker-trump-bill-medicaid-work-requirements/\">told CBS that work requirements\u003c/a> have a “moral component” and that people who don’t work are “defrauding the system.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>But health policy researchers and advocates point to New Hampshire and Arkansas, where state-imposed work requirements failed in recent years. Their \u003ca href=\"https://www.healthaffairs.org/doi/10.1377/hlthaff.2020.00538\">policies didn’t actually boost employment\u003c/a>; they did, however, leave thousands of eligible people without health insurance within a matter of months. Both states have since canceled their work policies. Georgia is the only state that currently has work requirements.\u003c/p>\n\u003cp>Nationwide and in California, about two-thirds of Medicaid enrollees work, according to the health research firm KFF. Another 29% care for children, attend school or have a disability that would exempt them. But health advocates say the additional red tape to prove employment could be so cumbersome that many eligible people would fall out of the health insurance program.\u003c/p>\n\u003cp>“You might say you’re combating waste, fraud and abuse,” said Katherine Hempstead, a senior policy officer at the Robert Wood Johnson Foundation, a nonprofit health advocacy organization that funds policy research. But “the way you’re going to save money is by people inadvertently or accidentally losing their coverage. The program saves money through mistakes. And that’s not a good way to run social insurance or to run policy.”\u003c/p>\n\u003cp>Medi-Cal — the California version of Medicaid — provides health insurance to almost 15 million people.\u003c/p>\n\u003cp>Diana Alfaro, associate executive director of Central City Neighborhood Partners, a nonprofit that helps people enroll in public benefits and services, says some of her low-income clients in Los Angeles who rely on Medi-Cal are employed — but not always in “typical” paying jobs. They are housekeepers, gardeners, construction workers and others who don’t have a regular paycheck or a single employer.\u003c/p>\n\u003cfigure>\u003cimg decoding=\"async\" src=\"https://calmatters.org/wp-content/uploads/2025/05/052825_WorkRequirements_JC_CM_16-819x1024.jpg\" alt=\"A person with long, wavy dark hair smiles while leaning on a podium decorated with various organizational logos. They wear a navy blouse with white trim and black pants, standing against a bright blue background. The overall mood is confident and welcoming.\">\u003cfigcaption>Diana Alfaro, shown at the Central City Neighborhood Partners office in Los Angeles, worries about people who will have trouble documenting work requirements if Congress’ proposal is enacted. Many are housekeepers, gardeners or others without a single employer and pay stubs. \u003cem>Jill Connelly for CalMatters\u003c/em>\u003c/figcaption>\u003c/figure>\n\u003cp>So far, it’s unclear exactly what documentation enrollees would need to show if a work requirement is enacted. But Alfaro is concerned that it could be especially challenging for people whose schedules fluctuate or who are paid in cash and don’t receive a pay stub that shows their hours worked. Some enrollees use a copy of their taxes, a letter from their employer or in some cases self-attestation to verify income eligibility when first applying for Medi-Cal.\u003c/p>\n\u003cp>“Some of them are doing those jobs of gardening or being a nanny or a housekeeper, and so they’re already going to have a hard time getting a letter that certifies the amount of hours that they’re doing if this were to pass,” Alfaro said.\u003c/p>\n\u003ch2>House proposal requires 80 hours a month of work or school\u003c/h2>\n\u003cp>The work requirement proposal is part of President Donald Trump’s “big beautiful bill,” which the U.S. House passed last week and is now in the hands of the Senate. All nine of California’s House Republicans voted in favor of the bill, while all Democrats voted against it.[aside postID=news_12039465 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/250323-DEM-TOWN-HALLS-MD-13-KQED-1-1020x680.jpg']The current version requires certain adults to log at least 80 hours a month of “community engagement,” which could be employment, school or volunteer work. As proposed, the rule would pertain specifically to adults ages 19 to 64 who qualify for Medicaid as part of an expansion under the Affordable Care Act. Pregnant women, parents and caregivers of young children, and people with mental and physical disabilities would be exempt.\u003c/p>\n\u003cp>Rep. David Valadao, a California Republican who represents portions of the San Joaquin Valley that have some of the highest Medicaid enrollment, \u003ca href=\"https://www.youtube.com/watch?v=mBNAOogpqGs\">told ABC’s Bakersfield affiliate\u003c/a> that work requirements are a fair ask.\u003c/p>\n\u003cp>“For those who are able-bodied with no dependents and you choose not to try to make that effort to go get a job, go to school or volunteer, do something in your community, yeah you’re probably going to be affected by this, but the average person who is working really hard to provide for their family thinks that’s the right thing to do,” Valadao said.\u003c/p>\n\u003cp>But Rep. Laura Friedman, a California Democrat representing Los Angeles, said it is the responsibility of the government to help people stay safe and healthy, but work requirements would do the opposite.\u003c/p>\n\u003cp>“They want to make it so hard for you and your family to access care with these onerous work requirements that you say ‘I’m not even going to bother, I’ll just try not to get sick,’” Friedman said during a press conference this week.\u003c/p>\n\u003cp>Friedman said the proposed cuts and requirements in the House bill would lead to more uncompensated care costs for clinics and hospitals, which ultimately could lead to reduced services for entire communities.\u003c/p>\n\u003cfigure>\u003cimg decoding=\"async\" src=\"https://calmatters.org/wp-content/uploads/2025/05/052825_WorkRequirements_JC_CM_02-1024x683.jpg\" alt=\"Two people sit across from each other at a white table in a brightly lit community center. One person, wearing a blue blazer, types on a laptop and speaks while holding a pen. The other person listens attentively, seated with hands on the table. Papers, folders, and a red wallet are spread out between them. The background includes folding chairs, a table with flowers, and yellow walls.\">\u003cfigcaption>Health navigator Elba Medina, right, works with Carmen Umana to apply for Medi-Cal. \u003cem>Jill Connelly for CalMatters\u003c/em>\u003c/figcaption>\u003c/figure>\n\u003cp>As currently drafted in the House bill, work requirements would kick in on Dec. 31, 2026. States would have the option to start earlier.\u003c/p>\n\u003cp>In addition to the work rules, the House budget bill proposes several other changes, including requiring these enrollees to verify their income every six months, rather than once a year. A separate measure seeks to financially penalize states that offer non-emergency Medicaid coverage to undocumented people, even if it’s with state-only funds, as California does. And less federal funding may force states to reduce benefits or enrollment.\u003c/p>\n\u003cp>The federal proposals are on top of changes that Gov. Gavin Newsom is already eyeing that could also force people to lose their health insurance. In his most recent budget proposal, Newsom proposed \u003ca href=\"https://calmatters.org/health/2025/05/newsom-freeze-medi-cal-undocumented-immigrants/\">benefit reductions, a premium charge and enrollment freezes\u003c/a> for undocumented residents as the state deals with a projected $12 billion shortfall.\u003c/p>\n\u003cp>All of the proposals at the federal and state level are bound to result in confusion and disruption for patients, Alfaro said.\u003c/p>\n\u003cp>“Last year we were doing a bunch of promotion around how easier it is to get health insurance,” she said. “And it seems like now we’re going a step backwards.”\u003c/p>\n\u003ch2>The Arkansas and New Hampshire experience\u003c/h2>\n\u003cp>Currently about 5 million Californians with Medi-Cal are eligible because of the Affordable Care Act’s Medicaid expansion. The 2010 health law allowed states to add adults without children or a disability to their rolls. It’s this group of enrollees that would be subject to the work requirements.\u003c/p>\n\u003cp>The Urban Institute’s estimate of more than a million of them losing coverage in 2026 is based on multiple factors, including trends and experiences observed in Arkansas and New Hampshire.\u003c/p>\n\u003cp>In 2018, Arkansas became the first state to implement work rules as a condition for Medicaid coverage. The rule applied to adults ages 30 to 49 who had to show 80 hours of work a month. Within six months, 18,000 adults had lost their coverage. In 2019, \u003ca href=\"https://www.npr.org/2019/03/27/707425729/federal-judge-strikes-down-medicaid-work-requirements-in-arkansas-and-kentucky\">a federal judge struck down\u003c/a> the state’s work requirement.\u003c/p>\n\u003cp>State lawmakers in New Hampshire said they’d do a better job than Arkansas in rolling out their own 2019 work requirement, but they faced similar challenges. The state had \u003ca href=\"https://www.unionleader.com/news/health/spreading-the-word-on-medicaid-work-requirement-proves-challenging/article_740b99e7-9f48-52d4-b2d8-030167e66af8.html\">a difficult time reaching enrollees\u003c/a> and notifying them about the changes, news reports at the time show. On track to lose thousands of people more than anticipated, the state suspended its rule.\u003c/p>\n\u003cp>“Based on the experience of other states, even if you spend a ton of energy on outreach, a lot of people just don’t realize what they have to do,” said Nari Rhee, director of the Retirement Security Program at the UC Berkeley Labor Center. “People have a bunch of questions: ‘Am I exempt? What do I have to do?’\u003c/p>\n\u003cp>“Even in New Hampshire, where they thought they were being gentle about the rollout, people had a hard time getting through (phone lines) to ask questions,” Rhee said. “So you can expect a pretty large percentage of people who could meet the requirements just fine, basically falling through the cracks and losing coverage because they just didn’t know or couldn’t get the information they needed.”\u003c/p>\n\u003cp>\u003cem>This article was \u003ca href=\"https://calmatters.org/health/2025/05/medicaid-work-requirement-california-congress/\">originally published on CalMatters\u003c/a> and was republished under the \u003ca href=\"https://creativecommons.org/licenses/by-nc-nd/4.0/\">Creative Commons Attribution-NonCommercial-NoDerivatives\u003c/a> license.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"excerpt": "A proposal in Congress would require some adults to document 80 hours a month of work or school. Experts say the red tape and paperwork is so cumbersome that even people who work will lose their health insurance.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003c!-- Creative Commons Attribution-NonCommercial-NoDerivatives https://creativecommons.org/licenses/by-nc-nd/4.0/ -->\u003c/p>\n\u003cp>\u003cem>This story was originally published by \u003ca href=\"https://calmatters.org/\">CalMatters\u003c/a>. \u003ca href=\"https://calmatters.org/subscribe-to-calmatters/\">Sign up\u003c/a> for their newsletters.\u003c/em>\u003c/p>\n\u003cp>If Congress moves forward with a controversial \u003ca href=\"https://www.nytimes.com/2025/05/22/upshot/medicaid-republicans-work-requirement.html\">proposal to require people to report work hours\u003c/a> to keep Medicaid, more than a million of California’s poorest residents could lose their health insurance.\u003c/p>\n\u003cp>The budget bill that the U.S. House advanced last week includes a requirement that certain adults — largely those under 65 without children or a disability — meet work reporting rules. In California, about a third of them could lose their health coverage, according to an analysis by the research group Urban Institute. Based on 2026 enrollment projections, that’s \u003ca href=\"https://www.urban.org/research/publication/expanding-federal-work-requirements-medicaid-expansion-coverage-age-64-would\">between 1.2 and 1.4 million\u003c/a> Californians.\u003c/p>\n\u003cp>As Congress looks at Medicaid for ways to help offset the cost of extending President Donald Trump’s 2017 tax cuts, imposing work requirements has increasingly been deemed as one of the most feasible and significant cost-savings actions. House Speaker Mike Johnson \u003ca href=\"https://www.cbsnews.com/news/mike-johnson-house-speaker-trump-bill-medicaid-work-requirements/\">told CBS that work requirements\u003c/a> have a “moral component” and that people who don’t work are “defrauding the system.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But health policy researchers and advocates point to New Hampshire and Arkansas, where state-imposed work requirements failed in recent years. Their \u003ca href=\"https://www.healthaffairs.org/doi/10.1377/hlthaff.2020.00538\">policies didn’t actually boost employment\u003c/a>; they did, however, leave thousands of eligible people without health insurance within a matter of months. Both states have since canceled their work policies. Georgia is the only state that currently has work requirements.\u003c/p>\n\u003cp>Nationwide and in California, about two-thirds of Medicaid enrollees work, according to the health research firm KFF. Another 29% care for children, attend school or have a disability that would exempt them. But health advocates say the additional red tape to prove employment could be so cumbersome that many eligible people would fall out of the health insurance program.\u003c/p>\n\u003cp>“You might say you’re combating waste, fraud and abuse,” said Katherine Hempstead, a senior policy officer at the Robert Wood Johnson Foundation, a nonprofit health advocacy organization that funds policy research. But “the way you’re going to save money is by people inadvertently or accidentally losing their coverage. The program saves money through mistakes. And that’s not a good way to run social insurance or to run policy.”\u003c/p>\n\u003cp>Medi-Cal — the California version of Medicaid — provides health insurance to almost 15 million people.\u003c/p>\n\u003cp>Diana Alfaro, associate executive director of Central City Neighborhood Partners, a nonprofit that helps people enroll in public benefits and services, says some of her low-income clients in Los Angeles who rely on Medi-Cal are employed — but not always in “typical” paying jobs. They are housekeepers, gardeners, construction workers and others who don’t have a regular paycheck or a single employer.\u003c/p>\n\u003cfigure>\u003cimg decoding=\"async\" src=\"https://calmatters.org/wp-content/uploads/2025/05/052825_WorkRequirements_JC_CM_16-819x1024.jpg\" alt=\"A person with long, wavy dark hair smiles while leaning on a podium decorated with various organizational logos. They wear a navy blouse with white trim and black pants, standing against a bright blue background. The overall mood is confident and welcoming.\">\u003cfigcaption>Diana Alfaro, shown at the Central City Neighborhood Partners office in Los Angeles, worries about people who will have trouble documenting work requirements if Congress’ proposal is enacted. Many are housekeepers, gardeners or others without a single employer and pay stubs. \u003cem>Jill Connelly for CalMatters\u003c/em>\u003c/figcaption>\u003c/figure>\n\u003cp>So far, it’s unclear exactly what documentation enrollees would need to show if a work requirement is enacted. But Alfaro is concerned that it could be especially challenging for people whose schedules fluctuate or who are paid in cash and don’t receive a pay stub that shows their hours worked. Some enrollees use a copy of their taxes, a letter from their employer or in some cases self-attestation to verify income eligibility when first applying for Medi-Cal.\u003c/p>\n\u003cp>“Some of them are doing those jobs of gardening or being a nanny or a housekeeper, and so they’re already going to have a hard time getting a letter that certifies the amount of hours that they’re doing if this were to pass,” Alfaro said.\u003c/p>\n\u003ch2>House proposal requires 80 hours a month of work or school\u003c/h2>\n\u003cp>The work requirement proposal is part of President Donald Trump’s “big beautiful bill,” which the U.S. House passed last week and is now in the hands of the Senate. All nine of California’s House Republicans voted in favor of the bill, while all Democrats voted against it.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The current version requires certain adults to log at least 80 hours a month of “community engagement,” which could be employment, school or volunteer work. As proposed, the rule would pertain specifically to adults ages 19 to 64 who qualify for Medicaid as part of an expansion under the Affordable Care Act. Pregnant women, parents and caregivers of young children, and people with mental and physical disabilities would be exempt.\u003c/p>\n\u003cp>Rep. David Valadao, a California Republican who represents portions of the San Joaquin Valley that have some of the highest Medicaid enrollment, \u003ca href=\"https://www.youtube.com/watch?v=mBNAOogpqGs\">told ABC’s Bakersfield affiliate\u003c/a> that work requirements are a fair ask.\u003c/p>\n\u003cp>“For those who are able-bodied with no dependents and you choose not to try to make that effort to go get a job, go to school or volunteer, do something in your community, yeah you’re probably going to be affected by this, but the average person who is working really hard to provide for their family thinks that’s the right thing to do,” Valadao said.\u003c/p>\n\u003cp>But Rep. Laura Friedman, a California Democrat representing Los Angeles, said it is the responsibility of the government to help people stay safe and healthy, but work requirements would do the opposite.\u003c/p>\n\u003cp>“They want to make it so hard for you and your family to access care with these onerous work requirements that you say ‘I’m not even going to bother, I’ll just try not to get sick,’” Friedman said during a press conference this week.\u003c/p>\n\u003cp>Friedman said the proposed cuts and requirements in the House bill would lead to more uncompensated care costs for clinics and hospitals, which ultimately could lead to reduced services for entire communities.\u003c/p>\n\u003cfigure>\u003cimg decoding=\"async\" src=\"https://calmatters.org/wp-content/uploads/2025/05/052825_WorkRequirements_JC_CM_02-1024x683.jpg\" alt=\"Two people sit across from each other at a white table in a brightly lit community center. One person, wearing a blue blazer, types on a laptop and speaks while holding a pen. The other person listens attentively, seated with hands on the table. Papers, folders, and a red wallet are spread out between them. The background includes folding chairs, a table with flowers, and yellow walls.\">\u003cfigcaption>Health navigator Elba Medina, right, works with Carmen Umana to apply for Medi-Cal. \u003cem>Jill Connelly for CalMatters\u003c/em>\u003c/figcaption>\u003c/figure>\n\u003cp>As currently drafted in the House bill, work requirements would kick in on Dec. 31, 2026. States would have the option to start earlier.\u003c/p>\n\u003cp>In addition to the work rules, the House budget bill proposes several other changes, including requiring these enrollees to verify their income every six months, rather than once a year. A separate measure seeks to financially penalize states that offer non-emergency Medicaid coverage to undocumented people, even if it’s with state-only funds, as California does. And less federal funding may force states to reduce benefits or enrollment.\u003c/p>\n\u003cp>The federal proposals are on top of changes that Gov. Gavin Newsom is already eyeing that could also force people to lose their health insurance. In his most recent budget proposal, Newsom proposed \u003ca href=\"https://calmatters.org/health/2025/05/newsom-freeze-medi-cal-undocumented-immigrants/\">benefit reductions, a premium charge and enrollment freezes\u003c/a> for undocumented residents as the state deals with a projected $12 billion shortfall.\u003c/p>\n\u003cp>All of the proposals at the federal and state level are bound to result in confusion and disruption for patients, Alfaro said.\u003c/p>\n\u003cp>“Last year we were doing a bunch of promotion around how easier it is to get health insurance,” she said. “And it seems like now we’re going a step backwards.”\u003c/p>\n\u003ch2>The Arkansas and New Hampshire experience\u003c/h2>\n\u003cp>Currently about 5 million Californians with Medi-Cal are eligible because of the Affordable Care Act’s Medicaid expansion. The 2010 health law allowed states to add adults without children or a disability to their rolls. It’s this group of enrollees that would be subject to the work requirements.\u003c/p>\n\u003cp>The Urban Institute’s estimate of more than a million of them losing coverage in 2026 is based on multiple factors, including trends and experiences observed in Arkansas and New Hampshire.\u003c/p>\n\u003cp>In 2018, Arkansas became the first state to implement work rules as a condition for Medicaid coverage. The rule applied to adults ages 30 to 49 who had to show 80 hours of work a month. Within six months, 18,000 adults had lost their coverage. In 2019, \u003ca href=\"https://www.npr.org/2019/03/27/707425729/federal-judge-strikes-down-medicaid-work-requirements-in-arkansas-and-kentucky\">a federal judge struck down\u003c/a> the state’s work requirement.\u003c/p>\n\u003cp>State lawmakers in New Hampshire said they’d do a better job than Arkansas in rolling out their own 2019 work requirement, but they faced similar challenges. The state had \u003ca href=\"https://www.unionleader.com/news/health/spreading-the-word-on-medicaid-work-requirement-proves-challenging/article_740b99e7-9f48-52d4-b2d8-030167e66af8.html\">a difficult time reaching enrollees\u003c/a> and notifying them about the changes, news reports at the time show. On track to lose thousands of people more than anticipated, the state suspended its rule.\u003c/p>\n\u003cp>“Based on the experience of other states, even if you spend a ton of energy on outreach, a lot of people just don’t realize what they have to do,” said Nari Rhee, director of the Retirement Security Program at the UC Berkeley Labor Center. “People have a bunch of questions: ‘Am I exempt? What do I have to do?’\u003c/p>\n\u003cp>“Even in New Hampshire, where they thought they were being gentle about the rollout, people had a hard time getting through (phone lines) to ask questions,” Rhee said. “So you can expect a pretty large percentage of people who could meet the requirements just fine, basically falling through the cracks and losing coverage because they just didn’t know or couldn’t get the information they needed.”\u003c/p>\n\u003cp>\u003cem>This article was \u003ca href=\"https://calmatters.org/health/2025/05/medicaid-work-requirement-california-congress/\">originally published on CalMatters\u003c/a> and was republished under the \u003ca href=\"https://creativecommons.org/licenses/by-nc-nd/4.0/\">Creative Commons Attribution-NonCommercial-NoDerivatives\u003c/a> license.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>In the face of a $12 billion state deficit, Gov. Gavin Newsom’s revised budget plan has sparked a wave of \u003ca href=\"https://www.kqed.org/news/12041584/health-advocates-say-newsoms-medi-cal-budget-could-cripple-womens-reproductive-care\">backlash\u003c/a> among acupuncture advocates across the state.\u003c/p>\n\u003cp>A coalition of San Francisco health care providers and patients gathered in Chinatown on Tuesday to slam Newsom’s exclusion of acupuncture from state-subsidized Medi-Cal services from the proposal, released earlier this month.\u003c/p>\n\u003cp>Michael Bozier, a San Francisco resident, said acupuncture is the only treatment that has relieved his debilitating and chronic pain from a car accident 40 years ago.\u003c/p>\n\u003cp>“As we look to vote to fund or defund acupuncture, remember … there is a face and a name to suffering,” Bozier said. “Help when the opportunity calls — save the acupuncture.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Eliminating the benefit would result in an estimated saving of $5.4 million from the state’s general fund this year, and “$13.1 million ongoing,” according to the state’s revised Department of Health Care Services budget.\u003c/p>\n\u003cp>In a statement, Newsom’s staff attributed the cuts to tough choices the Trump administration has forced upon the state.\u003c/p>\n\u003cp>“Because of the $16 billion Trump Slump and higher-than-expected health care utilization, the state must take difficult but necessary steps to ensure fiscal stability and preserve the long-term viability of Medi-Cal for all Californians,” a spokesperson said by email.\u003c/p>\n\u003cfigure id=\"attachment_12041726\" class=\"wp-caption aligncenter\" style=\"max-width: 2560px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-12041726 size-full\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/IMG_8129-scaled.jpg\" alt=\"\" width=\"2560\" height=\"1920\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/IMG_8129-scaled.jpg 2560w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/IMG_8129-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/IMG_8129-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/IMG_8129-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/IMG_8129-1536x1152.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/IMG_8129-2048x1536.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/IMG_8129-1920x1440.jpg 1920w\" sizes=\"auto, (max-width: 2560px) 100vw, 2560px\">\u003cfigcaption class=\"wp-caption-text\">Acupuncture advocates and health care providers rally in San Francisco’s Chinatown on Tuesday to protest Gov. Gavin Newsom’s revised budget plan, which excludes acupuncture from Medi-Cal coverage amid a $12 billion state deficit. \u003ccite>(Gilare Zada/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Last year, Newsom also attempted to slash the traditional Chinese treatment from Medi-Cal, the state’s health insurance for low-income residents.\u003c/p>\n\u003cp>But the AAPI legislative caucus, state Sen. Scott Wiener and other legislative leadership were able to restore acupuncture in the budget, said Kenneth Wilkerson, a spokesperson for North East Medical Services, a nonprofit community health center.\u003c/p>\n\u003cp>“Here we are again,” Wilkerson told KQED in an email, “trying to restore this critical benefit again this year.”\u003c/p>\n\u003cp>Of the 20,000 patient visits to NEMS since 2017, 90% “were funded by Medi-Cal,” state Assemblymember Matt Haney said at the protest.\u003c/p>\n\u003cp>If the cuts go through, those who won’t be able to afford it out of pocket “will be forced into much more expensive, sometimes addictive medications, and higher cost, riskier treatments,” Haney added.[aside postID=news_12041305 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/GettyImages-2201320740-1020x680.jpg']At the press conference, retired acupuncturist Han Shulin carried a book of scrolls, bound by leather ties and filled with loose-leaf parchment that frayed at the corners.\u003c/p>\n\u003cp>The book bears ancient Chinese instructions for acupuncture treatment, Shulin said at the event, referring to the book as “a kind of acupuncture bible.”\u003c/p>\n\u003cp>\u003cstrong>“\u003c/strong>Our job is to inherit, to achieve acupunctures, to let acupunctions travel the world, to let them travel the whole family,” Shulin said, the book’s yellowed pages wrestling with light gusts of wind.\u003c/p>\n\u003cp>In a major \u003ca href=\"https://pubmed.ncbi.nlm.nih.gov/39384145/\">study —\u003c/a> in which Veterans Affairs Healthcare of Connecticut and Yale University researchers followed nearly 2 million veterans suffering from musculoskeletal disorders from 2005 to 2017 — researchers found that for over 270,000 veterans who used acupuncture services, opioid prescriptions “dropped significantly after these approaches were integrated.”\u003c/p>\n\u003cp>After these results, the VA widely adopted acupuncture as part of its holistic health model, “because it works and it reduces long-term costs,” Lin Yang, vice-president of the California Acupuncture Coalition, said at the event.\u003c/p>\n\u003cp>Speaking at the event, District 3 Supervisor Danny Sauter recalled that a year earlier, his campaign trail led him to Chinatown’s Portsmouth Square, where the budget cut protest was located. He had asked a senior citizen what was most important to her, expecting her response to involve housing affordability or public safety.\u003c/p>\n\u003cp>But he said he was surprised when she responded: ‘Zom Gao,’ or acupuncture, in Mandarin.\u003c/p>\n\u003cp>“She grabbed my hand and showed [me] where she gets acupuncture,” Sauter said. “She said, ‘Zom-Gao.’ She said acupuncture is the most important thing to her.”\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>In the face of a $12 billion state deficit, Gov. Gavin Newsom’s revised budget plan has sparked a wave of \u003ca href=\"https://www.kqed.org/news/12041584/health-advocates-say-newsoms-medi-cal-budget-could-cripple-womens-reproductive-care\">backlash\u003c/a> among acupuncture advocates across the state.\u003c/p>\n\u003cp>A coalition of San Francisco health care providers and patients gathered in Chinatown on Tuesday to slam Newsom’s exclusion of acupuncture from state-subsidized Medi-Cal services from the proposal, released earlier this month.\u003c/p>\n\u003cp>Michael Bozier, a San Francisco resident, said acupuncture is the only treatment that has relieved his debilitating and chronic pain from a car accident 40 years ago.\u003c/p>\n\u003cp>“As we look to vote to fund or defund acupuncture, remember … there is a face and a name to suffering,” Bozier said. “Help when the opportunity calls — save the acupuncture.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Eliminating the benefit would result in an estimated saving of $5.4 million from the state’s general fund this year, and “$13.1 million ongoing,” according to the state’s revised Department of Health Care Services budget.\u003c/p>\n\u003cp>In a statement, Newsom’s staff attributed the cuts to tough choices the Trump administration has forced upon the state.\u003c/p>\n\u003cp>“Because of the $16 billion Trump Slump and higher-than-expected health care utilization, the state must take difficult but necessary steps to ensure fiscal stability and preserve the long-term viability of Medi-Cal for all Californians,” a spokesperson said by email.\u003c/p>\n\u003cfigure id=\"attachment_12041726\" class=\"wp-caption aligncenter\" style=\"max-width: 2560px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-12041726 size-full\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/IMG_8129-scaled.jpg\" alt=\"\" width=\"2560\" height=\"1920\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/IMG_8129-scaled.jpg 2560w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/IMG_8129-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/IMG_8129-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/IMG_8129-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/IMG_8129-1536x1152.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/IMG_8129-2048x1536.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/IMG_8129-1920x1440.jpg 1920w\" sizes=\"auto, (max-width: 2560px) 100vw, 2560px\">\u003cfigcaption class=\"wp-caption-text\">Acupuncture advocates and health care providers rally in San Francisco’s Chinatown on Tuesday to protest Gov. Gavin Newsom’s revised budget plan, which excludes acupuncture from Medi-Cal coverage amid a $12 billion state deficit. \u003ccite>(Gilare Zada/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Last year, Newsom also attempted to slash the traditional Chinese treatment from Medi-Cal, the state’s health insurance for low-income residents.\u003c/p>\n\u003cp>But the AAPI legislative caucus, state Sen. Scott Wiener and other legislative leadership were able to restore acupuncture in the budget, said Kenneth Wilkerson, a spokesperson for North East Medical Services, a nonprofit community health center.\u003c/p>\n\u003cp>“Here we are again,” Wilkerson told KQED in an email, “trying to restore this critical benefit again this year.”\u003c/p>\n\u003cp>Of the 20,000 patient visits to NEMS since 2017, 90% “were funded by Medi-Cal,” state Assemblymember Matt Haney said at the protest.\u003c/p>\n\u003cp>If the cuts go through, those who won’t be able to afford it out of pocket “will be forced into much more expensive, sometimes addictive medications, and higher cost, riskier treatments,” Haney added.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>At the press conference, retired acupuncturist Han Shulin carried a book of scrolls, bound by leather ties and filled with loose-leaf parchment that frayed at the corners.\u003c/p>\n\u003cp>The book bears ancient Chinese instructions for acupuncture treatment, Shulin said at the event, referring to the book as “a kind of acupuncture bible.”\u003c/p>\n\u003cp>\u003cstrong>“\u003c/strong>Our job is to inherit, to achieve acupunctures, to let acupunctions travel the world, to let them travel the whole family,” Shulin said, the book’s yellowed pages wrestling with light gusts of wind.\u003c/p>\n\u003cp>In a major \u003ca href=\"https://pubmed.ncbi.nlm.nih.gov/39384145/\">study —\u003c/a> in which Veterans Affairs Healthcare of Connecticut and Yale University researchers followed nearly 2 million veterans suffering from musculoskeletal disorders from 2005 to 2017 — researchers found that for over 270,000 veterans who used acupuncture services, opioid prescriptions “dropped significantly after these approaches were integrated.”\u003c/p>\n\u003cp>After these results, the VA widely adopted acupuncture as part of its holistic health model, “because it works and it reduces long-term costs,” Lin Yang, vice-president of the California Acupuncture Coalition, said at the event.\u003c/p>\n\u003cp>Speaking at the event, District 3 Supervisor Danny Sauter recalled that a year earlier, his campaign trail led him to Chinatown’s Portsmouth Square, where the budget cut protest was located. He had asked a senior citizen what was most important to her, expecting her response to involve housing affordability or public safety.\u003c/p>\n\u003cp>But he said he was surprised when she responded: ‘Zom Gao,’ or acupuncture, in Mandarin.\u003c/p>\n\u003cp>“She grabbed my hand and showed [me] where she gets acupuncture,” Sauter said. “She said, ‘Zom-Gao.’ She said acupuncture is the most important thing to her.”\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"content": "\u003cp>California’s congressional delegation split along party lines early Thursday morning, as the U.S. House of Representatives passed a sweeping budget plan on a \u003ca href=\"https://clerk.house.gov/Votes/2025145\">narrow\u003c/a> 215–214 vote.\u003c/p>\n\u003cp>The One Big Beautiful Act contains much of President Donald Trump’s legislative agenda, including an extension of the 2017 tax cuts, which are partially offset by cuts to health care, food assistance and clean energy programs. Key pieces of the bill will have an outsized impact on California — such as \u003ca href=\"https://www.kqed.org/news/12039102/californians-worried-about-medi-cal-congressional-republicans-consider-cuts\">cuts to Medicaid\u003c/a> and the expansion of the state and local tax deduction — and will likely feature prominently in next year’s midterm congressional campaigns.\u003c/p>\n\u003cp>California is home to a dozen congressional districts deemed “competitive” by the Cook Political Report — more than any other state — putting a microscope on the vote of many swing-district members. In the end, all 43 California Democrats in the House voted against the bill, while the state’s nine Republican representatives voted in support. The legislation now heads to the U.S. Senate, where it can pass with a simple majority vote under budget reconciliation rules.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Republicans in California touted the bill’s extension of income tax cuts that are set to expire at the end of the year, in addition to new tax breaks on tips and overtime, and increased funding for border security.\u003c/p>\n\u003cp>“By this time next year, Americans could be experiencing one of the most explosive periods of growth in our history,” Rep. Tom McClintock, a Republican from the Sierra foothills, said early Thursday on the House floor. “All of that means secure borders, safer communities, lower taxes, abundant energy, more and better jobs, a higher standard of living and a better quality of life.”\u003c/p>\n\u003cp>Democrats focused much of their criticism on the bill’s cuts to Medicaid, which provides healthcare coverage for Americans with low incomes and disabilities, as well as covering nursing home costs. Los Angeles Democratic Rep. Sydney Kamlager-Dove called the legislation a “backstabbing billionaire bill” during the House debate.\u003c/p>\n\u003cfigure id=\"attachment_12041312\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12041312\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/Sydney-Kamlager-Dove-Getty.jpg\" alt=\"\" width=\"2000\" height=\"1600\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/Sydney-Kamlager-Dove-Getty.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/Sydney-Kamlager-Dove-Getty-800x640.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/Sydney-Kamlager-Dove-Getty-1020x816.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/Sydney-Kamlager-Dove-Getty-160x128.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/Sydney-Kamlager-Dove-Getty-1536x1229.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/Sydney-Kamlager-Dove-Getty-1920x1536.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">U.S. Representative Sydney Kamlager-Dove, D-CA, speaks as bipartisan lawmakers mark the end of Second Chance Month with Federal Clean Slate Legislation on April 30, 2025, in Washington, D.C. \u003ccite>(Shannon Finney/Getty Images for The Clean Slate Initiative)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“My constituents call my office asking me to protect their Medicaid,” she said. “They don’t ask that their life-saving benefits be taken away and given to the 1%.”\u003c/p>\n\u003cp>The largest cuts to Medicaid spending, known as Medi-Cal in California, will come through the implementation of new requirements that adults ages 19–64 document 80 hours of monthly work, volunteering or education in order to receive health care coverage. People with disabilities, pregnant women and caregivers will be exempted from the requirements.\u003c/p>\n\u003cp>The Center on Budget on Policy Priorities \u003ca href=\"https://www.cbpp.org/research/health/harsh-work-requirements-in-house-republican-bill-would-take-away-medicaid-coverage\">estimated\u003c/a> that the new documentation requirements could lead to health care coverage loss for between 2.2 million and 3.4 million Californians, depending on how strictly the state implements the law.[aside postID=news_12040842 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/npr.brightspotcdn-1020x680.jpg']Their study found that “much of the coverage loss due to work requirements would occur among people who work or should qualify for an exemption but nevertheless would lose coverage due to red tape.”\u003c/p>\n\u003cp>Another provision of the bill would punish California more directly by reducing federal payments to states that allow undocumented residents to enroll in Medicaid or have expanded health coverage to children and pregnant women who have green cards. California has expanded Medi-Cal coverage eligibility to all residents, regardless of immigration status, and does so with state funds. The Center on Budget on Policy Priorities found the penalty could \u003ca href=\"https://www.cbpp.org/research/health/house-republican-bill-grows-even-harsher-cutting-medicaid-funding-to-states-that\">cost California\u003c/a> $27 billion between 2028 and 2034.\u003c/p>\n\u003cp>“Our constituents lose, our hospitals and our clinics close, our veterans’ communities lose — this is a bad bill,” said Rep. Mike Thompson, a Democrat from Napa.\u003c/p>\n\u003cp>The cuts to Medi-Cal could be a particularly vulnerable issue for Republicans in California. A \u003ca href=\"https://www.kqed.org/news/12033802/how-cuts-medicaid-republican-gains-california\">KQED analysis\u003c/a> found that the congressional districts that moved the most toward President Trump in last year’s election also rely disproportionately on Medi-Cal.\u003c/p>\n\u003cp>While the health care cuts will have an outsized impact in working-class political battlegrounds, including many communities in the Central Valley, the GOP will likely tout a provision of the budget bill that expands the state and local tax (SALT) deduction limit — a boon to residents in competitive suburban districts.\u003c/p>\n\u003cp>The SALT deduction allows taxpayers to subtract what they owe in state and local taxes, such as property taxes, from their federal tax bill. The legislation passed by the House raises the limit on that deduction from $10,000 to $40,000. In 2022, 15% of California taxpayers \u003ca href=\"https://bipartisanpolicy.org/explainer/which-states-benefit-most-from-the-salt-deduction/\">utilized\u003c/a> the SALT deduction, the second-highest share of any state, according to the Bipartisan Policy Center.\u003c/p>\n\u003cp>“Increasing the SALT cap means bringing vital tax relief for hardworking, middle-class families I represent who face double taxation,” Orange County Republican Rep. Young Kim wrote on the social media platform X on Wednesday.\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>California’s congressional delegation split along party lines early Thursday morning, as the U.S. House of Representatives passed a sweeping budget plan on a \u003ca href=\"https://clerk.house.gov/Votes/2025145\">narrow\u003c/a> 215–214 vote.\u003c/p>\n\u003cp>The One Big Beautiful Act contains much of President Donald Trump’s legislative agenda, including an extension of the 2017 tax cuts, which are partially offset by cuts to health care, food assistance and clean energy programs. Key pieces of the bill will have an outsized impact on California — such as \u003ca href=\"https://www.kqed.org/news/12039102/californians-worried-about-medi-cal-congressional-republicans-consider-cuts\">cuts to Medicaid\u003c/a> and the expansion of the state and local tax deduction — and will likely feature prominently in next year’s midterm congressional campaigns.\u003c/p>\n\u003cp>California is home to a dozen congressional districts deemed “competitive” by the Cook Political Report — more than any other state — putting a microscope on the vote of many swing-district members. In the end, all 43 California Democrats in the House voted against the bill, while the state’s nine Republican representatives voted in support. The legislation now heads to the U.S. Senate, where it can pass with a simple majority vote under budget reconciliation rules.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Republicans in California touted the bill’s extension of income tax cuts that are set to expire at the end of the year, in addition to new tax breaks on tips and overtime, and increased funding for border security.\u003c/p>\n\u003cp>“By this time next year, Americans could be experiencing one of the most explosive periods of growth in our history,” Rep. Tom McClintock, a Republican from the Sierra foothills, said early Thursday on the House floor. “All of that means secure borders, safer communities, lower taxes, abundant energy, more and better jobs, a higher standard of living and a better quality of life.”\u003c/p>\n\u003cp>Democrats focused much of their criticism on the bill’s cuts to Medicaid, which provides healthcare coverage for Americans with low incomes and disabilities, as well as covering nursing home costs. Los Angeles Democratic Rep. Sydney Kamlager-Dove called the legislation a “backstabbing billionaire bill” during the House debate.\u003c/p>\n\u003cfigure id=\"attachment_12041312\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12041312\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/Sydney-Kamlager-Dove-Getty.jpg\" alt=\"\" width=\"2000\" height=\"1600\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/Sydney-Kamlager-Dove-Getty.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/Sydney-Kamlager-Dove-Getty-800x640.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/Sydney-Kamlager-Dove-Getty-1020x816.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/Sydney-Kamlager-Dove-Getty-160x128.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/Sydney-Kamlager-Dove-Getty-1536x1229.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/Sydney-Kamlager-Dove-Getty-1920x1536.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">U.S. Representative Sydney Kamlager-Dove, D-CA, speaks as bipartisan lawmakers mark the end of Second Chance Month with Federal Clean Slate Legislation on April 30, 2025, in Washington, D.C. \u003ccite>(Shannon Finney/Getty Images for The Clean Slate Initiative)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“My constituents call my office asking me to protect their Medicaid,” she said. “They don’t ask that their life-saving benefits be taken away and given to the 1%.”\u003c/p>\n\u003cp>The largest cuts to Medicaid spending, known as Medi-Cal in California, will come through the implementation of new requirements that adults ages 19–64 document 80 hours of monthly work, volunteering or education in order to receive health care coverage. People with disabilities, pregnant women and caregivers will be exempted from the requirements.\u003c/p>\n\u003cp>The Center on Budget on Policy Priorities \u003ca href=\"https://www.cbpp.org/research/health/harsh-work-requirements-in-house-republican-bill-would-take-away-medicaid-coverage\">estimated\u003c/a> that the new documentation requirements could lead to health care coverage loss for between 2.2 million and 3.4 million Californians, depending on how strictly the state implements the law.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Their study found that “much of the coverage loss due to work requirements would occur among people who work or should qualify for an exemption but nevertheless would lose coverage due to red tape.”\u003c/p>\n\u003cp>Another provision of the bill would punish California more directly by reducing federal payments to states that allow undocumented residents to enroll in Medicaid or have expanded health coverage to children and pregnant women who have green cards. California has expanded Medi-Cal coverage eligibility to all residents, regardless of immigration status, and does so with state funds. The Center on Budget on Policy Priorities found the penalty could \u003ca href=\"https://www.cbpp.org/research/health/house-republican-bill-grows-even-harsher-cutting-medicaid-funding-to-states-that\">cost California\u003c/a> $27 billion between 2028 and 2034.\u003c/p>\n\u003cp>“Our constituents lose, our hospitals and our clinics close, our veterans’ communities lose — this is a bad bill,” said Rep. Mike Thompson, a Democrat from Napa.\u003c/p>\n\u003cp>The cuts to Medi-Cal could be a particularly vulnerable issue for Republicans in California. A \u003ca href=\"https://www.kqed.org/news/12033802/how-cuts-medicaid-republican-gains-california\">KQED analysis\u003c/a> found that the congressional districts that moved the most toward President Trump in last year’s election also rely disproportionately on Medi-Cal.\u003c/p>\n\u003cp>While the health care cuts will have an outsized impact in working-class political battlegrounds, including many communities in the Central Valley, the GOP will likely tout a provision of the budget bill that expands the state and local tax (SALT) deduction limit — a boon to residents in competitive suburban districts.\u003c/p>\n\u003cp>The SALT deduction allows taxpayers to subtract what they owe in state and local taxes, such as property taxes, from their federal tax bill. The legislation passed by the House raises the limit on that deduction from $10,000 to $40,000. In 2022, 15% of California taxpayers \u003ca href=\"https://bipartisanpolicy.org/explainer/which-states-benefit-most-from-the-salt-deduction/\">utilized\u003c/a> the SALT deduction, the second-highest share of any state, according to the Bipartisan Policy Center.\u003c/p>\n\u003cp>“Increasing the SALT cap means bringing vital tax relief for hardworking, middle-class families I represent who face double taxation,” Orange County Republican Rep. Young Kim wrote on the social media platform X on Wednesday.\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"content": "\u003cp>\u003cb>Here are the morning’s top stories on Tuesday, May 20, 2025…\u003c/b>\u003c/p>\n\u003cul>\n\u003cli>California legislators are considering a bill that would allow ranchers to compost livestock carcasses. AB411, introduced in February of this year, would enable ranchers to compost as much as 100 cubic yards of organic material onsite, including livestock remains. Ranchers in California currently have limited options for disposal.\u003c/li>\n\u003cli>\u003cspan data-slate-fragment=\"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\">Part of President Trump’s self-described “big, beautiful” bill includes congressional Republicans’ plans to change Medicaid. The proposal would cut billions from the safety net program. Many Republican lawmakers see this as a needed savings to slash what they see as waste in the system. Recent estimates show millions of Americans stand to lose their health insurance, including in Republican health districts like Kern County.\u003c/span>\u003c/li>\n\u003c/ul>\n\u003ch2>\u003ca href=\"https://legiscan.com/CA/text/AB411/id/3199717\">A Proposed Bill Would Allow Ranchers In California To Compost Livestock \u003c/a>\u003c/h2>\n\u003cp>Lawmakers in Sacramento are mulling over a proposed bill that would give California ranchers another option for livestock carcass disposal– composting.\u003c/p>\n\u003cp>As it stands, California ranchers can either send livestock carcasses to a small handful of rendering facilities or create open air pits for carcass decomposition, which attracts predators. Vice President of the California Cattlemen’s Association Kirk Wilbur sees AB 411 as a promising alternative.\u003c/p>\n\u003cp>“There are 42 other states that currently allow cattle carcass composting throughout the country,” Wilbur said. “So, California is not reinventing the wheel here.” The bill would allow ranchers to compost up to 100 cubic yards of organic material onsite, including the livestock remains. Wilbur says that equates to about six to eight cattle carcasses.\u003c/p>\n\u003ch2>\u003ca href=\"https://www.kvpr.org/government-politics/2025-05-16/medicaid-recipients-in-key-california-gop-district-express-concerns\"> Kern County Residents Protest Proposed Cuts to Medicaid\u003c/a>\u003c/h2>\n\u003cp>A large crowd of protesters gathered outside Kern Medical Hospital in Bakersfield, California to protest potential cuts to Medicaid from the Trump Administration. Some sat in wheelchairs. Others wore lab coats. All agreed that meaningful cuts to Medicaid would be a disaster for the region. The hospital sits in a swing district held by Republican Congressman David Valadao, and his stretch of the rural Central Valley also has the highest number of Medicaid patients represented by a House Republican – nearly two-thirds of residents here, according to research by UC Berkeley.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Resident doctor Megan Haugland is in her second year at the hospital. She said the patients here are among the sickest she’s seen during her training. “The thought that our already marginalized population could lose access to that very basic resource is frightening for me,” she said. “It worries me that these already sick patients are not going to have the care that they need to be able to take care of themselves.” Haugland said a whopping 90 percent of her patients are enrolled in Medicaid.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The proposed cuts are apart of President Trump’s self-described “big, beautiful” bill that Republican lawmakers see as a way to cut down on financial waste in the system and would take away billions of dollars from the program.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cb>Here are the morning’s top stories on Tuesday, May 20, 2025…\u003c/b>\u003c/p>\n\u003cul>\n\u003cli>California legislators are considering a bill that would allow ranchers to compost livestock carcasses. AB411, introduced in February of this year, would enable ranchers to compost as much as 100 cubic yards of organic material onsite, including livestock remains. Ranchers in California currently have limited options for disposal.\u003c/li>\n\u003cli>\u003cspan data-slate-fragment=\"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\">Part of President Trump’s self-described “big, beautiful” bill includes congressional Republicans’ plans to change Medicaid. The proposal would cut billions from the safety net program. Many Republican lawmakers see this as a needed savings to slash what they see as waste in the system. Recent estimates show millions of Americans stand to lose their health insurance, including in Republican health districts like Kern County.\u003c/span>\u003c/li>\n\u003c/ul>\n\u003ch2>\u003ca href=\"https://legiscan.com/CA/text/AB411/id/3199717\">A Proposed Bill Would Allow Ranchers In California To Compost Livestock \u003c/a>\u003c/h2>\n\u003cp>Lawmakers in Sacramento are mulling over a proposed bill that would give California ranchers another option for livestock carcass disposal– composting.\u003c/p>\n\u003cp>As it stands, California ranchers can either send livestock carcasses to a small handful of rendering facilities or create open air pits for carcass decomposition, which attracts predators. Vice President of the California Cattlemen’s Association Kirk Wilbur sees AB 411 as a promising alternative.\u003c/p>\n\u003cp>“There are 42 other states that currently allow cattle carcass composting throughout the country,” Wilbur said. “So, California is not reinventing the wheel here.” The bill would allow ranchers to compost up to 100 cubic yards of organic material onsite, including the livestock remains. Wilbur says that equates to about six to eight cattle carcasses.\u003c/p>\n\u003ch2>\u003ca href=\"https://www.kvpr.org/government-politics/2025-05-16/medicaid-recipients-in-key-california-gop-district-express-concerns\"> Kern County Residents Protest Proposed Cuts to Medicaid\u003c/a>\u003c/h2>\n\u003cp>A large crowd of protesters gathered outside Kern Medical Hospital in Bakersfield, California to protest potential cuts to Medicaid from the Trump Administration. Some sat in wheelchairs. Others wore lab coats. All agreed that meaningful cuts to Medicaid would be a disaster for the region. The hospital sits in a swing district held by Republican Congressman David Valadao, and his stretch of the rural Central Valley also has the highest number of Medicaid patients represented by a House Republican – nearly two-thirds of residents here, according to research by UC Berkeley.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Resident doctor Megan Haugland is in her second year at the hospital. She said the patients here are among the sickest she’s seen during her training. “The thought that our already marginalized population could lose access to that very basic resource is frightening for me,” she said. “It worries me that these already sick patients are not going to have the care that they need to be able to take care of themselves.” Haugland said a whopping 90 percent of her patients are enrolled in Medicaid.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The proposed cuts are apart of President Trump’s self-described “big, beautiful” bill that Republican lawmakers see as a way to cut down on financial waste in the system and would take away billions of dollars from the program.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"slug": "newsom-blames-trump-california-budget-deficit-aims-cap-undocumented-health-care",
"title": "Citing ‘Trump Slump,’ Newsom Unveils Budget Gap, Aims to Cap Undocumented Health Care",
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"headTitle": "Citing ‘Trump Slump,’ Newsom Unveils Budget Gap, Aims to Cap Undocumented Health Care | KQED",
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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",
"description": "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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"headline": "Citing ‘Trump Slump,’ Newsom Unveils Budget Gap, Aims to Cap Undocumented Health Care",
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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": "medicaid-cuts-divide-california-house-members-as-budget-deadline-looms",
"title": "Medicaid Cuts Divide California House Members as Budget Deadline Looms",
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"headTitle": "Medicaid Cuts Divide California House Members as Budget Deadline Looms | KQED",
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"content": "\u003cp>Washington, D.C. — As Republicans in Congress debate how to cut as much as $880 billion over the next 10 years from Medicaid, which provides health coverage to about 72 million Americans who are low-income or disabled, the proposed cuts are \u003ca href=\"https://www.kqed.org/news/12033802/how-cuts-medicaid-republican-gains-california\">putting swing district Republicans in a tough spot\u003c/a>.\u003c/p>\n\u003cp>That’s not the case for their colleagues in safe seats on both sides of the aisle, who are doubling down on their respective party’s positions.\u003c/p>\n\u003cp>Given the partisan divide over nearly every policy issue at this moment, those positions shouldn’t be surprising. Case in point: A \u003ca href=\"https://escholarship.org/uc/igs_poll\">series of polls\u003c/a> released this week from the UC Berkeley Institute for Governmental Studies found partisanship influencing voter views on virtually every policy area, including Medicaid — or as it’s known in California, Medi-Cal. About 15 million Californians are covered by Medi-Cal.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>According to \u003ca href=\"https://escholarship.org/uc/item/1nd0h87z\">one IGS poll\u003c/a>, more than half — 56% — of California voters believe Republicans’ proposed changes to Medi-Cal will negatively impact the state, while 21% think it will be positive. The number concerned about negative impacts skyrockets to 78% with Democrats, while 47% of GOP voters say the changes could have a positive effect.[aside postID=news_12039102 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/033023_Hollister-Hospital_LV_CM_21-copy.jpg']\u003c/p>\n\u003cp>Nearly half of voters say \u003ca href=\"https://www.kqed.org/news/12039102/californians-worried-about-medi-cal-congressional-republicans-consider-cuts\">they are worried about their own health insurance coverage\u003c/a> under President Donald Trump, though those views also break along party lines: Just 18% of Republicans are worried compared to 66% of Democrats, while no party preference voters are pretty evenly split on the question. Medi-Cal recipients are most worried, with more than two-thirds expressing concern.\u003c/p>\n\u003cp>“Voters, especially the Democrats, are very, very fearful of what’s going down in Washington, and I think this poll just pretty much verifies that,” said IGS poll director Mark DiCamillo. “Republicans seem to be rather blasé about it in terms of the impacts on the state.”\u003c/p>\n\u003cp>DiCamillo called the partisan divide on policy issues “extreme.”\u003c/p>\n\u003cp>“Republicans have very, very different views than Democrats on just about everything,” he said.\u003c/p>\n\u003cfigure id=\"attachment_12029302\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12029302\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/072820-Doctor-Pediatrician-Kid-GETTY-CM-01-copy.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/072820-Doctor-Pediatrician-Kid-GETTY-CM-01-copy.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/072820-Doctor-Pediatrician-Kid-GETTY-CM-01-copy-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/072820-Doctor-Pediatrician-Kid-GETTY-CM-01-copy-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/072820-Doctor-Pediatrician-Kid-GETTY-CM-01-copy-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/072820-Doctor-Pediatrician-Kid-GETTY-CM-01-copy-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/072820-Doctor-Pediatrician-Kid-GETTY-CM-01-copy-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">House Republicans this week passed a budget proposal that sets up cuts to Medicaid, the program that provides health insurance to lower-income households. Many Californians rely on the program, which is known as Medi-Cal in the state. \u003ccite>(Paul Bersebach/Orange County Register via Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Those divergent views explain why Rep. Kevin Kiley, a Republican who won his Northern California district by a comfortable 10-point margin last year, supports his party’s plan to make deep cuts to Medicaid. Though the GOP hasn’t finalized which areas to cut, one idea involves tying Medicaid to work requirements.\u003c/p>\n\u003cp>“Work requirements, I think, absolutely make sense,” Kiley told \u003ca href=\"https://www.kqed.org/podcasts/politicalbreakdown\">KQED’s \u003cem>Political Breakdown\u003c/em> podcast\u003c/a> this week.\u003c/p>\n\u003cp>Studies show most Medicaid recipients who can work already do. Advocates for people with lower incomes warn that new work requirements are just a way to boot people off their health insurance. The California Budget and Policy Center estimates that more than 8 million Californians, or half of Medi-Cal recipients, \u003ca href=\"https://calbudgetcenter.org/resources/republicans-are-pushing-medicaid-cuts-heres-how-theyd-affect-california/\">could lose healthcare\u003c/a> if work requirements are imposed, despite most adults enrolled in Medi-Cal already being employed.\u003c/p>\n\u003cp>An \u003ca href=\"https://publichealth.gwu.edu/new-state-state-report-medicaid-work-requirements-threaten-half-million-jobs-and-could-drain-state\">analysis\u003c/a> by the Commonwealth Fund and Milken Institute of Public Health at George Washington University finds that work requirements don’t increase employment, they simply lead to coverage losses.\u003c/p>\n\u003cp>“They push people out of Medicaid not because they aren’t working, but because they can’t navigate complex paperwork and reporting rules,” said Sara R. Collins, a senior scholar and vice president for health care coverage and access at the Commonwealth Fund. “The result is more uninsured Americans and greater strain on families and the doctors, clinics and hospitals they depend on.”\u003c/p>\n\u003cp>Kiley also wants to prohibit undocumented immigrants from accessing Medi-Cal, even though their coverage is funded by the state rather than federal money. He noted that covering undocumented immigrants \u003ca href=\"https://www.kqed.org/news/12031544/providing-health-care-for-immigrants-is-costing-california-more-than-expected-is-coverage-at-risk\">costs more than California officials expected\u003c/a>, and argued that the funds could be used to cover citizens if federal Medi-Cal dollars decline under the GOP plan.\u003c/p>\n\u003cp>“Let’s say you extend that over the next 10 years,” he said. “That’s hundreds of billions of dollars potentially that could be going to supporting access to care for our own residents, but is instead being used as essentially an incentive for further illegal immigration.”\u003c/p>\n\u003cfigure id=\"attachment_12039256\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12039256\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/FTG02453_qed.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/FTG02453_qed.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/FTG02453_qed-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/FTG02453_qed-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/FTG02453_qed-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/FTG02453_qed-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/FTG02453_qed-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Rep. Pete Aguilar, the third-ranking Democrat in the House, represents portions of California’s Inland Empire. He spoke with KQED’s Scott Shafer and Marisa Lagos in his Washington, D.C. office on May 7, 2025. \u003ccite>(Izzy Bloom/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>California Democrats are unapologetic about their support for Medi-Cal and say Republicans in Congress and Trump are making a political miscalculation by supporting cuts.\u003c/p>\n\u003cp>“There is not this magic bucket of waste, fraud, and abuse that Republicans are going to unlock and all the savings are going to emerge,” said Democratic Rep. Pete Aguilar. He added that even in his more centrist Inland Empire district, Medi-Cal is incredibly popular.\u003c/p>\n\u003cp>Aguilar warned that the cuts, if realized, wouldn’t just hurt individuals who lose their insurance but could have a ripple effect on the entire hospital and healthcare system, especially in more rural districts like Kiley’s.\u003c/p>\n\u003cp>“These are essential services that are being provided by the federal government,” he said.\u003c/p>\n\u003cp>That potential pain may be why two vulnerable House Republicans from California joined 10 other swing-state GOP members of Congress in \u003ca href=\"https://www.politico.com/news/2025/05/01/the-key-republican-warning-about-a-megabill-medicaid-fallout-00322377\">sounding the alarm\u003c/a> to House leadership over the proposed cuts.\u003c/p>\n\u003cfigure id=\"attachment_12010091\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12010091\" 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 pictured in 2022. \u003ccite>(Irfan Khan/Los Angeles Times via Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>California Reps. David Valadao (R-Hanford) and Young Kim (R-Anaheim Hills) recently \u003ca href=\"https://bresnahan.house.gov/sites/evo-subsites/bresnahan.house.gov/files/evo-media-document/letter-to-leadership-on-medicaid.pdf\">signed a letter\u003c/a> to Speaker Mike Johnson that said ”we cannot and will not support a final reconciliation bill that includes any reduction in Medicaid coverage for vulnerable populations.”\u003c/p>\n\u003cp>In Valadao’s Central Valley district, \u003ca href=\"https://www.kqed.org/news/12033802/how-cuts-medicaid-republican-gains-california\">which has the highest percentage\u003c/a> of Medicaid recipients, 67% of residents rely on the public program for their health insurance. In Kim’s Orange County district, one-fifth of residents are enrolled in the program, \u003ca href=\"https://www.chcf.org/publication/how-many-congressional-district-get-medi-cal-premium-subsidy-through-covered-california/#related-links-and-downloads\">according to data\u003c/a> from the California Health Care Foundation.\u003c/p>\n\u003cp>“Communities like ours won us the majority, and we have a responsibility to deliver on the promises we made,” the letter stated. “Balancing the federal budget must not come at the expense of those who depend on these benefits for their health and economic security.”\u003c/p>\n\u003cp>GOP leaders are still looking for a way to cut spending while assuaging the concerns of Republican members like Valadao and Kim. But they’ll need those swing district members to pass a budget by Memorial Day because House Republicans hold a slim majority and cannot afford to lose more than a few votes.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Washington, D.C. — As Republicans in Congress debate how to cut as much as $880 billion over the next 10 years from Medicaid, which provides health coverage to about 72 million Americans who are low-income or disabled, the proposed cuts are \u003ca href=\"https://www.kqed.org/news/12033802/how-cuts-medicaid-republican-gains-california\">putting swing district Republicans in a tough spot\u003c/a>.\u003c/p>\n\u003cp>That’s not the case for their colleagues in safe seats on both sides of the aisle, who are doubling down on their respective party’s positions.\u003c/p>\n\u003cp>Given the partisan divide over nearly every policy issue at this moment, those positions shouldn’t be surprising. Case in point: A \u003ca href=\"https://escholarship.org/uc/igs_poll\">series of polls\u003c/a> released this week from the UC Berkeley Institute for Governmental Studies found partisanship influencing voter views on virtually every policy area, including Medicaid — or as it’s known in California, Medi-Cal. About 15 million Californians are covered by Medi-Cal.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>According to \u003ca href=\"https://escholarship.org/uc/item/1nd0h87z\">one IGS poll\u003c/a>, more than half — 56% — of California voters believe Republicans’ proposed changes to Medi-Cal will negatively impact the state, while 21% think it will be positive. The number concerned about negative impacts skyrockets to 78% with Democrats, while 47% of GOP voters say the changes could have a positive effect.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Nearly half of voters say \u003ca href=\"https://www.kqed.org/news/12039102/californians-worried-about-medi-cal-congressional-republicans-consider-cuts\">they are worried about their own health insurance coverage\u003c/a> under President Donald Trump, though those views also break along party lines: Just 18% of Republicans are worried compared to 66% of Democrats, while no party preference voters are pretty evenly split on the question. Medi-Cal recipients are most worried, with more than two-thirds expressing concern.\u003c/p>\n\u003cp>“Voters, especially the Democrats, are very, very fearful of what’s going down in Washington, and I think this poll just pretty much verifies that,” said IGS poll director Mark DiCamillo. “Republicans seem to be rather blasé about it in terms of the impacts on the state.”\u003c/p>\n\u003cp>DiCamillo called the partisan divide on policy issues “extreme.”\u003c/p>\n\u003cp>“Republicans have very, very different views than Democrats on just about everything,” he said.\u003c/p>\n\u003cfigure id=\"attachment_12029302\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12029302\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/072820-Doctor-Pediatrician-Kid-GETTY-CM-01-copy.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/072820-Doctor-Pediatrician-Kid-GETTY-CM-01-copy.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/072820-Doctor-Pediatrician-Kid-GETTY-CM-01-copy-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/072820-Doctor-Pediatrician-Kid-GETTY-CM-01-copy-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/072820-Doctor-Pediatrician-Kid-GETTY-CM-01-copy-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/072820-Doctor-Pediatrician-Kid-GETTY-CM-01-copy-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/03/072820-Doctor-Pediatrician-Kid-GETTY-CM-01-copy-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">House Republicans this week passed a budget proposal that sets up cuts to Medicaid, the program that provides health insurance to lower-income households. Many Californians rely on the program, which is known as Medi-Cal in the state. \u003ccite>(Paul Bersebach/Orange County Register via Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Those divergent views explain why Rep. Kevin Kiley, a Republican who won his Northern California district by a comfortable 10-point margin last year, supports his party’s plan to make deep cuts to Medicaid. Though the GOP hasn’t finalized which areas to cut, one idea involves tying Medicaid to work requirements.\u003c/p>\n\u003cp>“Work requirements, I think, absolutely make sense,” Kiley told \u003ca href=\"https://www.kqed.org/podcasts/politicalbreakdown\">KQED’s \u003cem>Political Breakdown\u003c/em> podcast\u003c/a> this week.\u003c/p>\n\u003cp>Studies show most Medicaid recipients who can work already do. Advocates for people with lower incomes warn that new work requirements are just a way to boot people off their health insurance. The California Budget and Policy Center estimates that more than 8 million Californians, or half of Medi-Cal recipients, \u003ca href=\"https://calbudgetcenter.org/resources/republicans-are-pushing-medicaid-cuts-heres-how-theyd-affect-california/\">could lose healthcare\u003c/a> if work requirements are imposed, despite most adults enrolled in Medi-Cal already being employed.\u003c/p>\n\u003cp>An \u003ca href=\"https://publichealth.gwu.edu/new-state-state-report-medicaid-work-requirements-threaten-half-million-jobs-and-could-drain-state\">analysis\u003c/a> by the Commonwealth Fund and Milken Institute of Public Health at George Washington University finds that work requirements don’t increase employment, they simply lead to coverage losses.\u003c/p>\n\u003cp>“They push people out of Medicaid not because they aren’t working, but because they can’t navigate complex paperwork and reporting rules,” said Sara R. Collins, a senior scholar and vice president for health care coverage and access at the Commonwealth Fund. “The result is more uninsured Americans and greater strain on families and the doctors, clinics and hospitals they depend on.”\u003c/p>\n\u003cp>Kiley also wants to prohibit undocumented immigrants from accessing Medi-Cal, even though their coverage is funded by the state rather than federal money. He noted that covering undocumented immigrants \u003ca href=\"https://www.kqed.org/news/12031544/providing-health-care-for-immigrants-is-costing-california-more-than-expected-is-coverage-at-risk\">costs more than California officials expected\u003c/a>, and argued that the funds could be used to cover citizens if federal Medi-Cal dollars decline under the GOP plan.\u003c/p>\n\u003cp>“Let’s say you extend that over the next 10 years,” he said. “That’s hundreds of billions of dollars potentially that could be going to supporting access to care for our own residents, but is instead being used as essentially an incentive for further illegal immigration.”\u003c/p>\n\u003cfigure id=\"attachment_12039256\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12039256\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/FTG02453_qed.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/FTG02453_qed.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/FTG02453_qed-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/FTG02453_qed-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/FTG02453_qed-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/FTG02453_qed-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/05/FTG02453_qed-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Rep. Pete Aguilar, the third-ranking Democrat in the House, represents portions of California’s Inland Empire. He spoke with KQED’s Scott Shafer and Marisa Lagos in his Washington, D.C. office on May 7, 2025. \u003ccite>(Izzy Bloom/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>California Democrats are unapologetic about their support for Medi-Cal and say Republicans in Congress and Trump are making a political miscalculation by supporting cuts.\u003c/p>\n\u003cp>“There is not this magic bucket of waste, fraud, and abuse that Republicans are going to unlock and all the savings are going to emerge,” said Democratic Rep. Pete Aguilar. He added that even in his more centrist Inland Empire district, Medi-Cal is incredibly popular.\u003c/p>\n\u003cp>Aguilar warned that the cuts, if realized, wouldn’t just hurt individuals who lose their insurance but could have a ripple effect on the entire hospital and healthcare system, especially in more rural districts like Kiley’s.\u003c/p>\n\u003cp>“These are essential services that are being provided by the federal government,” he said.\u003c/p>\n\u003cp>That potential pain may be why two vulnerable House Republicans from California joined 10 other swing-state GOP members of Congress in \u003ca href=\"https://www.politico.com/news/2025/05/01/the-key-republican-warning-about-a-megabill-medicaid-fallout-00322377\">sounding the alarm\u003c/a> to House leadership over the proposed cuts.\u003c/p>\n\u003cfigure id=\"attachment_12010091\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12010091\" 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 pictured in 2022. \u003ccite>(Irfan Khan/Los Angeles Times via Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>California Reps. David Valadao (R-Hanford) and Young Kim (R-Anaheim Hills) recently \u003ca href=\"https://bresnahan.house.gov/sites/evo-subsites/bresnahan.house.gov/files/evo-media-document/letter-to-leadership-on-medicaid.pdf\">signed a letter\u003c/a> to Speaker Mike Johnson that said ”we cannot and will not support a final reconciliation bill that includes any reduction in Medicaid coverage for vulnerable populations.”\u003c/p>\n\u003cp>In Valadao’s Central Valley district, \u003ca href=\"https://www.kqed.org/news/12033802/how-cuts-medicaid-republican-gains-california\">which has the highest percentage\u003c/a> of Medicaid recipients, 67% of residents rely on the public program for their health insurance. In Kim’s Orange County district, one-fifth of residents are enrolled in the program, \u003ca href=\"https://www.chcf.org/publication/how-many-congressional-district-get-medi-cal-premium-subsidy-through-covered-california/#related-links-and-downloads\">according to data\u003c/a> from the California Health Care Foundation.\u003c/p>\n\u003cp>“Communities like ours won us the majority, and we have a responsibility to deliver on the promises we made,” the letter stated. “Balancing the federal budget must not come at the expense of those who depend on these benefits for their health and economic security.”\u003c/p>\n\u003cp>GOP leaders are still looking for a way to cut spending while assuaging the concerns of Republican members like Valadao and Kim. But they’ll need those swing district members to pass a budget by Memorial Day because House Republicans hold a slim majority and cannot afford to lose more than a few votes.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"slug": "most-california-republican-voters-still-confident-in-trump-administration",
"title": "Most California Republican Voters Still Confident In Trump Administration",
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"headTitle": "Most California Republican Voters Still Confident In Trump Administration | KQED",
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"content": "\u003cp>\u003cb>Here are the morning’s top stories on Thursday, May 1, 2025…\u003c/b>\u003c/p>\n\u003cul>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Nearly 40% of Californians voted for President Donald Trump in the 2024 election. Now, \u003c/span>\u003ca href=\"https://www.npr.org/2025/04/30/nx-s1-5379594/trump-100-days\">\u003cspan style=\"font-weight: 400\">100 days into his second term\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">, how do they feel? \u003c/span>\u003c/li>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">In San Francisco \u003c/span>\u003ca href=\"https://www.npr.org/2025/04/30/nx-s1-5382563/kamala-harris-first-speech-trump\">\u003cspan style=\"font-weight: 400\">Wednesday night\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">, former Vice President Kamala Harris laid into President Donald Trump at the 100 day mark of his presidency.\u003c/span>\u003c/li>\n\u003cli>As Congress reconvenes this week, Republicans are proposing $880 billion in Medicaid cuts over the next decade. A \u003ca href=\"https://laborcenter.berkeley.edu/california-could-lose-up-to-217000-jobs-if-congress-cuts-medicaid/\">new UC Berkeley Labor Center report\u003c/a> warns the move would not only jeopardize healthcare for 15 million Californians, but could cost the state up to 217,000 jobs.\u003c/li>\n\u003c/ul>\n\u003ch2>\u003cstrong>100 Days In, Most California Trump Voters Still Back The President\u003c/strong>\u003c/h2>\n\u003cp>So much has happened in the first 100 days of President Trump’s second term. On Day 1, he signed a \u003ca href=\"https://www.npr.org/2025/01/20/g-s1-43698/trump-inauguration-executive-orders-2025-day-1\" target=\"_blank\" rel=\"noopener\">slew of executive orders\u003c/a> aimed at, among other things, creating DOGE, his government-slashing informal Department of Government Efficiency, erasing diversity, equity and inclusion efforts, getting rid of \u003ca href=\"https://www.npr.org/2025/01/23/nx-s1-5270572/birthright-citizenship-trump-executive-order\" target=\"_blank\" rel=\"noopener\">birthright citizenship\u003c/a> for people born in the U.S. to parents without permanent legal status, \u003ca href=\"https://www.npr.org/2025/01/20/g-s1-43650/trump-inauguration-day-one-immigration\" target=\"_blank\" rel=\"noopener\">declaring an emergency\u003c/a> at the southern border and recognizing only \u003ca href=\"https://www.npr.org/2025/01/20/g-s1-43955/trumps-anti-transgender-order-defines-male-and-female\" target=\"_blank\" rel=\"noopener\">“two sexes – male and female.”\u003c/a>\u003c/p>\n\u003cp>He’s also moved aggressively to implement tariffs on imported goods, restructure the federal government and tighten his grip on power, carry out deportations, reposition the United States on the world stage, and punish perceived political enemies.\u003c/p>\n\u003cp>In California, nearly 40% of voters backed President Trump in the 2024 election. And most remain fully behind him. Ben Pino was a lifelong Democrat, before voting for Trump in 2020 and again last year. “It’s kind of funny because I was like all these people that are losing their minds right now over this guy, going crazy and losing sleep,” he said. Pino said he supports most of the president’s policies, including on the economy and immigration. But he does have one criticism — President’s Trump’s rhetoric on transgender issues. His friend recently transitioned and Pino thinks Trump hurts the entire Republican Party when he disparages the transgender community.\u003c/p>\n\u003cp>Of the two dozen Trump voters we interviewed for this story, only one expressed buyer’s remorse. Emerson Green from El Dorado County initially liked Trump’s pledge to shrink the federal workforce. But he didn’t think that would include an across-the-board hiring freeze. Green’s mom had just landed a job at the IRS when her offer was rescinded. “And I just think that’s a really big sort of middle finger to the American working class,” Green said. If he had to do it all over again, Green said he likely would not have voted for either candidate in 2024.\u003c/p>\n\u003ch2>\u003ca href=\"https://www.npr.org/2025/04/30/nx-s1-5382563/kamala-harris-first-speech-trump\">Kamala Harris Slams Trump Tariffs In Her First Major Speech Since He Took Office\u003c/a>\u003c/h2>\n\u003cp>Former Vice President Kamala Harris, in her first major public remarks since leaving the White House, criticized President Trump’s \u003ca href=\"https://www.npr.org/2025/04/09/nx-s1-5357645/trump-tariffs-paused\" target=\"_blank\" rel=\"noopener\">\u003cu>tariff policies\u003c/u>\u003c/a> as “reckless,” saying they pose the risk of taking the country into recession.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“Some people are describing what’s been happening in recent months as absolute chaos. And of course I understand why. It’s certainly true of those tariffs. Tariffs that — as I predicted — are clearly inviting a recession,” Harris said.\u003c/p>\n\u003cp>She called it the “greatest man-made economic crisis in modern presidential history” and applauded Americans who are rallying against the tariffs, saying they will increase everyday costs and impact retirement accounts and small businesses.\u003c/p>\n\u003cp>The former vice president who failed in her race against Trump last year was speaking in San Francisco at a gala event for the organization Emerge America, which helps women run for office. Her comments come as Trump hits the \u003ca href=\"https://www.npr.org/2025/04/30/nx-s1-5379594/trump-100-days\" target=\"_blank\" rel=\"noopener\">\u003cu>100-day\u003c/u>\u003c/a> mark of his second term, and as reports show the U.S. economy is \u003ca href=\"https://www.npr.org/2025/04/30/nx-s1-5380204/trump-economy-gdp-tariffs-recession-consumers\" target=\"_blank\" rel=\"noopener\">\u003cu>contracting.\u003c/u>\u003c/a>\u003c/p>\n\u003ch2>\u003cstrong>UC Berkeley Report Paints Bleak Picture If Medicaid Cuts Are Approved \u003c/strong>\u003c/h2>\n\u003cp>\u003cspan style=\"font-weight: 400\">Republicans in Congress are weighing steep cuts to Medicaid as part of \u003ca href=\"https://www.npr.org/2025/04/28/g-s1-62678/trump-needs-unity-among-republicans-to-pass-his-budget-bill-can-he-get-it\">a wide-ranging budget package\u003c/a>. Medicaid is \u003c/span>\u003cspan style=\"font-weight: 400\">the federal-state \u003c/span>\u003ca href=\"https://www.npr.org/2025/04/14/g-s1-59261/medicaid-cuts-long-term-care-caregivers\">\u003cspan style=\"font-weight: 400\">health insurance program for people with disabilities and low-income adults\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">. The House instructed the Energy and Commerce Committee, which has jurisdiction over the program, to find $880 billion in savings over the next 10 years.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">There is some GOP opposition. A dozen House Republicans recently wrote a letter to the chairman of the Energy and Commerce Committee along with House leadership, warning they won’t support a bill that includes “any reduction in Medicaid coverage for vulnerable populations.”\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>In California, any cuts to Medicaid would have huge impacts. \u003ca href=\"https://laborcenter.berkeley.edu/california-could-lose-up-to-217000-jobs-if-congress-cuts-medicaid/\">New analysis\u003c/a> from the UC Berkeley Labor Center found that California could expect to see between $10 billion and $20 billion fewer federal dollars per year coming to Medi-Cal, the state’s Medicaid program. And that in turn would lead to major job losses — in the range of 100,000-200,000 jobs. About two-thirds of the job losses would be in the health care sector.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cb>Here are the morning’s top stories on Thursday, May 1, 2025…\u003c/b>\u003c/p>\n\u003cul>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Nearly 40% of Californians voted for President Donald Trump in the 2024 election. Now, \u003c/span>\u003ca href=\"https://www.npr.org/2025/04/30/nx-s1-5379594/trump-100-days\">\u003cspan style=\"font-weight: 400\">100 days into his second term\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">, how do they feel? \u003c/span>\u003c/li>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">In San Francisco \u003c/span>\u003ca href=\"https://www.npr.org/2025/04/30/nx-s1-5382563/kamala-harris-first-speech-trump\">\u003cspan style=\"font-weight: 400\">Wednesday night\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">, former Vice President Kamala Harris laid into President Donald Trump at the 100 day mark of his presidency.\u003c/span>\u003c/li>\n\u003cli>As Congress reconvenes this week, Republicans are proposing $880 billion in Medicaid cuts over the next decade. A \u003ca href=\"https://laborcenter.berkeley.edu/california-could-lose-up-to-217000-jobs-if-congress-cuts-medicaid/\">new UC Berkeley Labor Center report\u003c/a> warns the move would not only jeopardize healthcare for 15 million Californians, but could cost the state up to 217,000 jobs.\u003c/li>\n\u003c/ul>\n\u003ch2>\u003cstrong>100 Days In, Most California Trump Voters Still Back The President\u003c/strong>\u003c/h2>\n\u003cp>So much has happened in the first 100 days of President Trump’s second term. On Day 1, he signed a \u003ca href=\"https://www.npr.org/2025/01/20/g-s1-43698/trump-inauguration-executive-orders-2025-day-1\" target=\"_blank\" rel=\"noopener\">slew of executive orders\u003c/a> aimed at, among other things, creating DOGE, his government-slashing informal Department of Government Efficiency, erasing diversity, equity and inclusion efforts, getting rid of \u003ca href=\"https://www.npr.org/2025/01/23/nx-s1-5270572/birthright-citizenship-trump-executive-order\" target=\"_blank\" rel=\"noopener\">birthright citizenship\u003c/a> for people born in the U.S. to parents without permanent legal status, \u003ca href=\"https://www.npr.org/2025/01/20/g-s1-43650/trump-inauguration-day-one-immigration\" target=\"_blank\" rel=\"noopener\">declaring an emergency\u003c/a> at the southern border and recognizing only \u003ca href=\"https://www.npr.org/2025/01/20/g-s1-43955/trumps-anti-transgender-order-defines-male-and-female\" target=\"_blank\" rel=\"noopener\">“two sexes – male and female.”\u003c/a>\u003c/p>\n\u003cp>He’s also moved aggressively to implement tariffs on imported goods, restructure the federal government and tighten his grip on power, carry out deportations, reposition the United States on the world stage, and punish perceived political enemies.\u003c/p>\n\u003cp>In California, nearly 40% of voters backed President Trump in the 2024 election. And most remain fully behind him. Ben Pino was a lifelong Democrat, before voting for Trump in 2020 and again last year. “It’s kind of funny because I was like all these people that are losing their minds right now over this guy, going crazy and losing sleep,” he said. Pino said he supports most of the president’s policies, including on the economy and immigration. But he does have one criticism — President’s Trump’s rhetoric on transgender issues. His friend recently transitioned and Pino thinks Trump hurts the entire Republican Party when he disparages the transgender community.\u003c/p>\n\u003cp>Of the two dozen Trump voters we interviewed for this story, only one expressed buyer’s remorse. Emerson Green from El Dorado County initially liked Trump’s pledge to shrink the federal workforce. But he didn’t think that would include an across-the-board hiring freeze. Green’s mom had just landed a job at the IRS when her offer was rescinded. “And I just think that’s a really big sort of middle finger to the American working class,” Green said. If he had to do it all over again, Green said he likely would not have voted for either candidate in 2024.\u003c/p>\n\u003ch2>\u003ca href=\"https://www.npr.org/2025/04/30/nx-s1-5382563/kamala-harris-first-speech-trump\">Kamala Harris Slams Trump Tariffs In Her First Major Speech Since He Took Office\u003c/a>\u003c/h2>\n\u003cp>Former Vice President Kamala Harris, in her first major public remarks since leaving the White House, criticized President Trump’s \u003ca href=\"https://www.npr.org/2025/04/09/nx-s1-5357645/trump-tariffs-paused\" target=\"_blank\" rel=\"noopener\">\u003cu>tariff policies\u003c/u>\u003c/a> as “reckless,” saying they pose the risk of taking the country into recession.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“Some people are describing what’s been happening in recent months as absolute chaos. And of course I understand why. It’s certainly true of those tariffs. Tariffs that — as I predicted — are clearly inviting a recession,” Harris said.\u003c/p>\n\u003cp>She called it the “greatest man-made economic crisis in modern presidential history” and applauded Americans who are rallying against the tariffs, saying they will increase everyday costs and impact retirement accounts and small businesses.\u003c/p>\n\u003cp>The former vice president who failed in her race against Trump last year was speaking in San Francisco at a gala event for the organization Emerge America, which helps women run for office. Her comments come as Trump hits the \u003ca href=\"https://www.npr.org/2025/04/30/nx-s1-5379594/trump-100-days\" target=\"_blank\" rel=\"noopener\">\u003cu>100-day\u003c/u>\u003c/a> mark of his second term, and as reports show the U.S. economy is \u003ca href=\"https://www.npr.org/2025/04/30/nx-s1-5380204/trump-economy-gdp-tariffs-recession-consumers\" target=\"_blank\" rel=\"noopener\">\u003cu>contracting.\u003c/u>\u003c/a>\u003c/p>\n\u003ch2>\u003cstrong>UC Berkeley Report Paints Bleak Picture If Medicaid Cuts Are Approved \u003c/strong>\u003c/h2>\n\u003cp>\u003cspan style=\"font-weight: 400\">Republicans in Congress are weighing steep cuts to Medicaid as part of \u003ca href=\"https://www.npr.org/2025/04/28/g-s1-62678/trump-needs-unity-among-republicans-to-pass-his-budget-bill-can-he-get-it\">a wide-ranging budget package\u003c/a>. Medicaid is \u003c/span>\u003cspan style=\"font-weight: 400\">the federal-state \u003c/span>\u003ca href=\"https://www.npr.org/2025/04/14/g-s1-59261/medicaid-cuts-long-term-care-caregivers\">\u003cspan style=\"font-weight: 400\">health insurance program for people with disabilities and low-income adults\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">. The House instructed the Energy and Commerce Committee, which has jurisdiction over the program, to find $880 billion in savings over the next 10 years.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">There is some GOP opposition. A dozen House Republicans recently wrote a letter to the chairman of the Energy and Commerce Committee along with House leadership, warning they won’t support a bill that includes “any reduction in Medicaid coverage for vulnerable populations.”\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>In California, any cuts to Medicaid would have huge impacts. \u003ca href=\"https://laborcenter.berkeley.edu/california-could-lose-up-to-217000-jobs-if-congress-cuts-medicaid/\">New analysis\u003c/a> from the UC Berkeley Labor Center found that California could expect to see between $10 billion and $20 billion fewer federal dollars per year coming to Medi-Cal, the state’s Medicaid program. And that in turn would lead to major job losses — in the range of 100,000-200,000 jobs. About two-thirds of the job losses would be in the health care sector.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"title": "Biden Let California Get Creative With Medicaid Spending. Trump Is Signaling That May End",
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"content": "\u003cp>\u003cem>This story was originally published by \u003ca href=\"https://calmatters.org/\">CalMatters\u003c/a>. \u003ca href=\"https://calmatters.org/subscribe-to-calmatters/\">Sign up\u003c/a> for their newsletters.\u003c/em>\u003c/p>\n\u003cp>In 2022, California made sweeping changes to its \u003ca href=\"https://calmatters.org/tag/medi-cal/\">Medi-Cal\u003c/a> program that reimagined what health care could look like for some of the state’s poorest and sickest residents by covering services from housing to healthy food. But the future of that program, known as \u003ca href=\"https://calmatters.org/health/2022/02/california-medi-cal-reform/\">CalAIM\u003c/a>, could be at risk under the Trump administration.\u003c/p>\n\u003cp>In recent weeks, federal officials have signaled that support for creative uses of Medi-Cal funding is waning, particularly uses that California has invested in such as rent assistance and medically tailored meals. Medi-Cal is California’s name for Medicaid.\u003c/p>\n\u003cp>The moves align with a narrower vision of Medicaid espoused by newly confirmed \u003ca href=\"https://www.youtube.com/watch?v=66PQk_npFm0\">Centers for Medicare and Medicaid Services head Dr. Mehmet Oz\u003c/a>, who said during his swearing-in ceremony that Medicaid spending was crowding out spending on education and other services in states with the federal government “paying most of the bill.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“This one really bothers me. There are states who are using Medicaid — Medicaid dollars for people who are vulnerable — for services that are not medical,” Oz said.\u003c/p>\n\u003cp>It also fits with broader GOP calls to slim down the federal government. \u003ca href=\"https://calmatters.org/health/2025/03/medicaid-cuts-republican-districts/\">Medicaid is under scrutiny as part of a GOP-led budget process\u003c/a> in the House of Representatives that calls for $880 billion in cuts over 10 years to programs including Medicaid.\u003c/p>\n\u003cp>“The messaging that we want to go back to the basics of Medicaid puts all of these waiver programs in jeopardy,” said John Baackes, former chief executive of L.A. Care, the state’s largest Medi-Cal health insurer.\u003c/p>\n\u003cp>[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']\u003c/p>\n\u003cp>CalAIM is authorized under a federal waiver that allows states to experiment with their Medicaid programs to try to save money and improve health outcomes. Under the waiver, California added extra benefits for high-cost users to help with food insecurity, \u003ca href=\"https://calmatters.org/housing/homelessness/2024/12/calaim-federal-waivers/\">housing instability\u003c/a>, \u003ca href=\"https://calmatters.org/health/mental-health/2025/04/medicaid-cuts-behavioral-health/\">substance use and behavioral health challenges\u003c/a>.\u003c/p>\n\u003cp>Roughly \u003ca href=\"https://www.dhcs.ca.gov/CalAIM/Documents/CalAIM-ECM-a11y.pdf\">half of all Medi-Cal spending\u003c/a> can be attributed to 5% of high-cost users, according to state documents.\u003c/p>\n\u003cp>But in March, the federal government \u003ca href=\"https://www.medicaid.gov/federal-policy-guidance/downloads/cib03042025.pdf\">rescinded guidelines supporting Medi-Cal spending for social services\u003c/a>. It also sent states a letter in April indicating that the Centers for Medicare and Medicaid Services would no longer approve a \u003ca href=\"https://www.cms.gov/newsroom/press-releases/cms-refocuses-its-core-mission-and-preserving-state-federal-medicaid-partnership\">funding mechanism that helps support CalAIM\u003c/a>, although that money will continue until 2026.\u003c/p>\n\u003cp>Together, these moves should worry states that operate programs like CalAIM, said Kathy Hempstead, senior policy officer at the Robert Wood Johnson Foundation.\u003c/p>\n\u003cp>“Under the Biden administration states were encouraged to experiment with things like that: To prescribe people prescriptions to get healthy food, to refer people to community-based services,” Hempstead said. “This administration is not receptive at all to … that vision of the Medicaid program.”\u003c/p>\n\u003cp>In a press release, CMS said it is putting an end to spending that isn’t “directly tied to health care services.”\u003c/p>\n\u003cfigure>\u003cimg decoding=\"async\" src=\"https://calmatters.org/wp-content/uploads/2023/07/070523-Street-Medicine-Project-LV-CM_36-1024x682.jpg\" alt=\"Physician assistant Brett Feldman checks his patient, Carla Bolen’s, blood pressure while in her encampment at the Figueroa St. Viaduct above Highway 110 in Elysian Valley Park in Los Angeles on Nov. 18, 2022. Photo by Larry Valenzuela, CalMatters/CatchLight Local\">\u003cfigcaption>Physician assistant Brett Feldman checks his patient, Carla Bolen’s, blood pressure while in her encampment at the Figueroa St. Viaduct above Highway 110 in Elysian Valley Park in Los Angeles on Nov. 18, 2022. \u003cem>Larry Valenzuela/CalMatters/CatchLight Local\u003c/em>\u003c/figcaption>\u003c/figure>\n\u003cp>“Mounting expenditures, such as covering housekeeping for individuals who are not eligible for Medicaid or high-speed internet for rural healthcare providers, distracts from the core mission of Medicaid, and in some instances, serves as an overly-creative financing mechanism to skirt state budget responsibilities,” the press release states.\u003c/p>\n\u003cp>These signals from the federal government apply to future applications for Medicaid changes, and do not change California’s current programs or funding. The state’s CalAIM waiver expires at the end of 2026, and another similar waiver that supports \u003ca href=\"https://calmatters.org/health/mental-health/2023/02/medi-cal-mental-health/\">California’s efforts to improve behavioral health care\u003c/a> expires in 2029.\u003c/p>\n\u003cp>According to a statement from the Department of Health Care Services, the agency that oversees Medi-Cal, all programs “remain federally approved and operational.”\u003c/p>\n\u003cp>“We appreciate our Medi-Cal providers and community partners, and together we will push full steam ahead to transform our health system and improve health outcomes,” the department said.\u003c/p>\n\u003cp>Paul Shafer, co-director of the Boston University Medicaid Policy Lab, said decades of public health research show that people have worse health outcomes that require more expensive treatment when their social needs aren’t met.[aside postID=forum_2010101908967 hero='https://cdn.kqed.org/wp-content/uploads/sites/43/2025/02/iStock-1156622320-1-1020x574.jpg']“We’ve spent the last few decades in public health and health policy, arguing that so much of health and medical costs is driven by environmental factors — people’s living conditions, income, etc.” Shafer said.\u003c/p>\n\u003cp>But, Shafer said, programs like CalAIM are relatively recent and the research hasn’t had enough time to show whether paying for non-traditional services saves money.\u003c/p>\n\u003cp>For example, \u003ca href=\"https://calmatters.org/health/2022/12/homeless-health-care/\">California’s street medicine doctors\u003c/a> who take care of people who are homeless say that their patients often cycle in and out of the emergency room — the most expensive point of service in the health care system. They have no place to recover from medical procedures, no address to deliver medications, and the constant exposure to the elements takes years off of their lives, doctors say.\u003c/p>\n\u003cp>CalAIM gives them options to help their clients find housing.\u003c/p>\n\u003cp>The federal government’s decision not to fund programs like this in the future is a “step backward,” Shafer said.\u003c/p>\n\u003cp>“I think we can all read the tea leaves and say that that means they’re sort of unlikely to be renewed,” he said.\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>\u003cem>This article was \u003ca href=\"https://calmatters.org/health/2025/04/medicaid-waiver-calaim/\">originally published on CalMatters\u003c/a> and was republished under the \u003ca href=\"https://creativecommons.org/licenses/by-nc-nd/4.0/\">Creative Commons Attribution-NonCommercial-NoDerivatives\u003c/a> license.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>This story was originally published by \u003ca href=\"https://calmatters.org/\">CalMatters\u003c/a>. \u003ca href=\"https://calmatters.org/subscribe-to-calmatters/\">Sign up\u003c/a> for their newsletters.\u003c/em>\u003c/p>\n\u003cp>In 2022, California made sweeping changes to its \u003ca href=\"https://calmatters.org/tag/medi-cal/\">Medi-Cal\u003c/a> program that reimagined what health care could look like for some of the state’s poorest and sickest residents by covering services from housing to healthy food. But the future of that program, known as \u003ca href=\"https://calmatters.org/health/2022/02/california-medi-cal-reform/\">CalAIM\u003c/a>, could be at risk under the Trump administration.\u003c/p>\n\u003cp>In recent weeks, federal officials have signaled that support for creative uses of Medi-Cal funding is waning, particularly uses that California has invested in such as rent assistance and medically tailored meals. Medi-Cal is California’s name for Medicaid.\u003c/p>\n\u003cp>The moves align with a narrower vision of Medicaid espoused by newly confirmed \u003ca href=\"https://www.youtube.com/watch?v=66PQk_npFm0\">Centers for Medicare and Medicaid Services head Dr. Mehmet Oz\u003c/a>, who said during his swearing-in ceremony that Medicaid spending was crowding out spending on education and other services in states with the federal government “paying most of the bill.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“This one really bothers me. There are states who are using Medicaid — Medicaid dollars for people who are vulnerable — for services that are not medical,” Oz said.\u003c/p>\n\u003cp>It also fits with broader GOP calls to slim down the federal government. \u003ca href=\"https://calmatters.org/health/2025/03/medicaid-cuts-republican-districts/\">Medicaid is under scrutiny as part of a GOP-led budget process\u003c/a> in the House of Representatives that calls for $880 billion in cuts over 10 years to programs including Medicaid.\u003c/p>\n\u003cp>“The messaging that we want to go back to the basics of Medicaid puts all of these waiver programs in jeopardy,” said John Baackes, former chief executive of L.A. Care, the state’s largest Medi-Cal health insurer.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>CalAIM is authorized under a federal waiver that allows states to experiment with their Medicaid programs to try to save money and improve health outcomes. Under the waiver, California added extra benefits for high-cost users to help with food insecurity, \u003ca href=\"https://calmatters.org/housing/homelessness/2024/12/calaim-federal-waivers/\">housing instability\u003c/a>, \u003ca href=\"https://calmatters.org/health/mental-health/2025/04/medicaid-cuts-behavioral-health/\">substance use and behavioral health challenges\u003c/a>.\u003c/p>\n\u003cp>Roughly \u003ca href=\"https://www.dhcs.ca.gov/CalAIM/Documents/CalAIM-ECM-a11y.pdf\">half of all Medi-Cal spending\u003c/a> can be attributed to 5% of high-cost users, according to state documents.\u003c/p>\n\u003cp>But in March, the federal government \u003ca href=\"https://www.medicaid.gov/federal-policy-guidance/downloads/cib03042025.pdf\">rescinded guidelines supporting Medi-Cal spending for social services\u003c/a>. It also sent states a letter in April indicating that the Centers for Medicare and Medicaid Services would no longer approve a \u003ca href=\"https://www.cms.gov/newsroom/press-releases/cms-refocuses-its-core-mission-and-preserving-state-federal-medicaid-partnership\">funding mechanism that helps support CalAIM\u003c/a>, although that money will continue until 2026.\u003c/p>\n\u003cp>Together, these moves should worry states that operate programs like CalAIM, said Kathy Hempstead, senior policy officer at the Robert Wood Johnson Foundation.\u003c/p>\n\u003cp>“Under the Biden administration states were encouraged to experiment with things like that: To prescribe people prescriptions to get healthy food, to refer people to community-based services,” Hempstead said. “This administration is not receptive at all to … that vision of the Medicaid program.”\u003c/p>\n\u003cp>In a press release, CMS said it is putting an end to spending that isn’t “directly tied to health care services.”\u003c/p>\n\u003cfigure>\u003cimg decoding=\"async\" src=\"https://calmatters.org/wp-content/uploads/2023/07/070523-Street-Medicine-Project-LV-CM_36-1024x682.jpg\" alt=\"Physician assistant Brett Feldman checks his patient, Carla Bolen’s, blood pressure while in her encampment at the Figueroa St. Viaduct above Highway 110 in Elysian Valley Park in Los Angeles on Nov. 18, 2022. Photo by Larry Valenzuela, CalMatters/CatchLight Local\">\u003cfigcaption>Physician assistant Brett Feldman checks his patient, Carla Bolen’s, blood pressure while in her encampment at the Figueroa St. Viaduct above Highway 110 in Elysian Valley Park in Los Angeles on Nov. 18, 2022. \u003cem>Larry Valenzuela/CalMatters/CatchLight Local\u003c/em>\u003c/figcaption>\u003c/figure>\n\u003cp>“Mounting expenditures, such as covering housekeeping for individuals who are not eligible for Medicaid or high-speed internet for rural healthcare providers, distracts from the core mission of Medicaid, and in some instances, serves as an overly-creative financing mechanism to skirt state budget responsibilities,” the press release states.\u003c/p>\n\u003cp>These signals from the federal government apply to future applications for Medicaid changes, and do not change California’s current programs or funding. The state’s CalAIM waiver expires at the end of 2026, and another similar waiver that supports \u003ca href=\"https://calmatters.org/health/mental-health/2023/02/medi-cal-mental-health/\">California’s efforts to improve behavioral health care\u003c/a> expires in 2029.\u003c/p>\n\u003cp>According to a statement from the Department of Health Care Services, the agency that oversees Medi-Cal, all programs “remain federally approved and operational.”\u003c/p>\n\u003cp>“We appreciate our Medi-Cal providers and community partners, and together we will push full steam ahead to transform our health system and improve health outcomes,” the department said.\u003c/p>\n\u003cp>Paul Shafer, co-director of the Boston University Medicaid Policy Lab, said decades of public health research show that people have worse health outcomes that require more expensive treatment when their social needs aren’t met.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“We’ve spent the last few decades in public health and health policy, arguing that so much of health and medical costs is driven by environmental factors — people’s living conditions, income, etc.” Shafer said.\u003c/p>\n\u003cp>But, Shafer said, programs like CalAIM are relatively recent and the research hasn’t had enough time to show whether paying for non-traditional services saves money.\u003c/p>\n\u003cp>For example, \u003ca href=\"https://calmatters.org/health/2022/12/homeless-health-care/\">California’s street medicine doctors\u003c/a> who take care of people who are homeless say that their patients often cycle in and out of the emergency room — the most expensive point of service in the health care system. They have no place to recover from medical procedures, no address to deliver medications, and the constant exposure to the elements takes years off of their lives, doctors say.\u003c/p>\n\u003cp>CalAIM gives them options to help their clients find housing.\u003c/p>\n\u003cp>The federal government’s decision not to fund programs like this in the future is a “step backward,” Shafer said.\u003c/p>\n\u003cp>“I think we can all read the tea leaves and say that that means they’re sort of unlikely to be renewed,” he said.\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>\u003cem>This article was \u003ca href=\"https://calmatters.org/health/2025/04/medicaid-waiver-calaim/\">originally published on CalMatters\u003c/a> and was republished under the \u003ca href=\"https://creativecommons.org/licenses/by-nc-nd/4.0/\">Creative Commons Attribution-NonCommercial-NoDerivatives\u003c/a> license.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"title": "New Social Security Rules Will Create Hurdles for Millions of Older Adults, Report Finds",
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"content": "\u003cp>Americans seeking retirement or survivor benefits from the \u003ca href=\"https://www.npr.org/2025/03/22/nx-s1-5320263/social-security-administration-changes-identity-office\">Social Security Administration\u003c/a> will no longer be able to apply over the phone, starting on Monday.\u003c/p>\n\u003cp>Instead, they will have to seek services online or travel in-person to a local Social Security field office, which a \u003ca href=\"https://www.cbpp.org/research/social-security/abruptly-eliminating-social-security-phone-services-threatens-access-to\">new analysis\u003c/a> from the left-leaning Center on Budget and Policy Priorities, or CBPP, found amounts to a “45-mile trip for some 6 million seniors.”\u003c/p>\n\u003cp>The group wrote this change “will close off an important mode of service for millions of people” who are eligible for services.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“More than 4 in 10 retirees apply for their Social Security benefits by phone, as do most spouses who are eligible for benefits,” researchers wrote. “So do the substantial majority of bereaved family members who are eligible for benefits following the death of a worker.”\u003c/p>\n\u003cp>This new policy, which also applies to anyone making changes to their direct deposit account, was first\u003ca href=\"https://www.ssa.gov/news/press/releases/2025/#2025-03-18\"> announced\u003c/a> last month — and then\u003ca href=\"https://www.npr.org/2025/03/22/nx-s1-5320263/social-security-administration-changes-identity-office\"> partially walked-back\u003c/a> a week later due to push back from disability groups and other stakeholders.\u003c/p>\n\u003cp>Agency officials have said these new measures “will further safeguard Social Security records and benefits against fraudulent activity” by creating “stronger identity verification procedures.”\u003c/p>\n\u003cp>In a statement to NPR, a spokesperson at the SSA said “telephone remains a viable option to the public” when these new policies go into effect. As of now, Medicare, disability, and supplemental income applications are exempted from the new changes.\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>“Beginning on April 14, Social Security will perform an anti-fraud check on all claims filed over the telephone and flag claims that have fraud risk indicators,” they wrote. “We will continue to conduct 100 percent ID proofing for all in-person claims. 4.5 million telephone claims a year and 70K may be flagged.”\u003c/p>\n\u003cp>Advocates for seniors and people with disabilities, however, have argued these changes amount to barriers to services for many of the people the agency is required to serve. This policy was also included in a legal challenge from disability rights groups against the agency that was\u003ca href=\"https://justiceinaging.org/wp-content/uploads/2025/04/AAPD-v.-SSA-Complaint.pdf\" target=\"_blank\" rel=\"noopener\"> filed last week (PDF)\u003c/a>.\u003c/p>\n\u003cp>The Social Security Administration runs a slew of programs for seniors and people with disabilities. Besides retirement services — which make up the largest share of services — the agency also runs programs that provide survivor benefits and disability benefits and supplemental income for the very poor. According to the latest monthly data, more than 50 million Americans \u003ca href=\"https://www.ssa.gov/policy/docs/quickfacts/stat_snapshot/#:~:text=Table%20of%20Contents,.%20.%20.%20=%20not%20applicable.\">received\u003c/a> retirement benefits from the SSA in February and \u003ca href=\"https://www.ssa.gov/policy/docs/chartbooks/fast_facts/2024/fast_facts24.html\">thousands\u003c/a> of Americans newly qualify for benefits every day.\u003c/p>\n\u003cp>Kathleen Romig, the CBPP’s director of Social Security and disability policy, told NPR these new in-person verification requirements will be “really burdensome” for the many Americans who qualify for these benefits, particularly those who live in more rural parts of the country.\u003c/p>\n\u003cp>For one, she said, it’s already “a lengthy process” to get an appointment for in-person services.\u003c/p>\n\u003cp>“There’s no way to schedule an appointment online,” Romig said. “So you have to call the agency’s 800 number. Right now, the wait for a call back from Social Security is two and a half hours. And that’s if you get through to an agent at all. Most people don’t.”\u003c/p>\n\u003cp>She also said once someone does get through and makes an appointment, they usually wait “more than 28 days for the next appointment” that’s available.\u003c/p>\n\u003cp>And for many seniors and disabled Americans, Romig said, an in-person appointment is not physically doable.\u003c/p>\n\u003cp>“Not everyone drives, particularly seniors or people with disabilities,” she said. “And not everyone is able to leave the house. Think about people who are homebound or hospitalized. So, this is incredibly burdensome for the older and disabled people that the SSA serves.”\u003c/p>\n\u003cp>Romig said this new policy disproportionately affects every bereaved person who is applying for a Social Security survivor’s benefit, because they don’t have the option of applying online.\u003c/p>\n\u003cp>“That is Social Security’s version of life insurance, that a widow or widower or surviving child of a worker who has died,” she said. “Those are the monthly benefits that Social Security calls survivor’s insurance. So, all of those people need to go in person to apply for benefits because there is no online option for that.”\u003c/p>\n\u003cp>And even when beneficiaries are able to apply online, there are still hurdles, the CBPP report found.\u003c/p>\n\u003cp>“Many seniors and people with disabilities lack internet service, computers or smartphones, or the technological savvy to navigate a multi-step, multi-factor online verification process,” researchers wrote. “Even as SSA is encouraging people to do business online, the Department of Government Efficiency (DOGE) is making changes to online identity authentication that are triggering system outages and access problems.”\u003c/p>\n\u003cp>Romig said ongoing \u003ca href=\"https://www.npr.org/2025/02/28/nx-s1-5296986/trump-worker-cuts-social-security-administration\">staff cuts\u003c/a> at the agency also make it likely that wait times for in-person services will continue to grow.\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Americans seeking retirement or survivor benefits from the \u003ca href=\"https://www.npr.org/2025/03/22/nx-s1-5320263/social-security-administration-changes-identity-office\">Social Security Administration\u003c/a> will no longer be able to apply over the phone, starting on Monday.\u003c/p>\n\u003cp>Instead, they will have to seek services online or travel in-person to a local Social Security field office, which a \u003ca href=\"https://www.cbpp.org/research/social-security/abruptly-eliminating-social-security-phone-services-threatens-access-to\">new analysis\u003c/a> from the left-leaning Center on Budget and Policy Priorities, or CBPP, found amounts to a “45-mile trip for some 6 million seniors.”\u003c/p>\n\u003cp>The group wrote this change “will close off an important mode of service for millions of people” who are eligible for services.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“More than 4 in 10 retirees apply for their Social Security benefits by phone, as do most spouses who are eligible for benefits,” researchers wrote. “So do the substantial majority of bereaved family members who are eligible for benefits following the death of a worker.”\u003c/p>\n\u003cp>This new policy, which also applies to anyone making changes to their direct deposit account, was first\u003ca href=\"https://www.ssa.gov/news/press/releases/2025/#2025-03-18\"> announced\u003c/a> last month — and then\u003ca href=\"https://www.npr.org/2025/03/22/nx-s1-5320263/social-security-administration-changes-identity-office\"> partially walked-back\u003c/a> a week later due to push back from disability groups and other stakeholders.\u003c/p>\n\u003cp>Agency officials have said these new measures “will further safeguard Social Security records and benefits against fraudulent activity” by creating “stronger identity verification procedures.”\u003c/p>\n\u003cp>In a statement to NPR, a spokesperson at the SSA said “telephone remains a viable option to the public” when these new policies go into effect. As of now, Medicare, disability, and supplemental income applications are exempted from the new changes.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“Beginning on April 14, Social Security will perform an anti-fraud check on all claims filed over the telephone and flag claims that have fraud risk indicators,” they wrote. “We will continue to conduct 100 percent ID proofing for all in-person claims. 4.5 million telephone claims a year and 70K may be flagged.”\u003c/p>\n\u003cp>Advocates for seniors and people with disabilities, however, have argued these changes amount to barriers to services for many of the people the agency is required to serve. This policy was also included in a legal challenge from disability rights groups against the agency that was\u003ca href=\"https://justiceinaging.org/wp-content/uploads/2025/04/AAPD-v.-SSA-Complaint.pdf\" target=\"_blank\" rel=\"noopener\"> filed last week (PDF)\u003c/a>.\u003c/p>\n\u003cp>The Social Security Administration runs a slew of programs for seniors and people with disabilities. Besides retirement services — which make up the largest share of services — the agency also runs programs that provide survivor benefits and disability benefits and supplemental income for the very poor. According to the latest monthly data, more than 50 million Americans \u003ca href=\"https://www.ssa.gov/policy/docs/quickfacts/stat_snapshot/#:~:text=Table%20of%20Contents,.%20.%20.%20=%20not%20applicable.\">received\u003c/a> retirement benefits from the SSA in February and \u003ca href=\"https://www.ssa.gov/policy/docs/chartbooks/fast_facts/2024/fast_facts24.html\">thousands\u003c/a> of Americans newly qualify for benefits every day.\u003c/p>\n\u003cp>Kathleen Romig, the CBPP’s director of Social Security and disability policy, told NPR these new in-person verification requirements will be “really burdensome” for the many Americans who qualify for these benefits, particularly those who live in more rural parts of the country.\u003c/p>\n\u003cp>For one, she said, it’s already “a lengthy process” to get an appointment for in-person services.\u003c/p>\n\u003cp>“There’s no way to schedule an appointment online,” Romig said. “So you have to call the agency’s 800 number. Right now, the wait for a call back from Social Security is two and a half hours. And that’s if you get through to an agent at all. Most people don’t.”\u003c/p>\n\u003cp>She also said once someone does get through and makes an appointment, they usually wait “more than 28 days for the next appointment” that’s available.\u003c/p>\n\u003cp>And for many seniors and disabled Americans, Romig said, an in-person appointment is not physically doable.\u003c/p>\n\u003cp>“Not everyone drives, particularly seniors or people with disabilities,” she said. “And not everyone is able to leave the house. Think about people who are homebound or hospitalized. So, this is incredibly burdensome for the older and disabled people that the SSA serves.”\u003c/p>\n\u003cp>Romig said this new policy disproportionately affects every bereaved person who is applying for a Social Security survivor’s benefit, because they don’t have the option of applying online.\u003c/p>\n\u003cp>“That is Social Security’s version of life insurance, that a widow or widower or surviving child of a worker who has died,” she said. “Those are the monthly benefits that Social Security calls survivor’s insurance. So, all of those people need to go in person to apply for benefits because there is no online option for that.”\u003c/p>\n\u003cp>And even when beneficiaries are able to apply online, there are still hurdles, the CBPP report found.\u003c/p>\n\u003cp>“Many seniors and people with disabilities lack internet service, computers or smartphones, or the technological savvy to navigate a multi-step, multi-factor online verification process,” researchers wrote. “Even as SSA is encouraging people to do business online, the Department of Government Efficiency (DOGE) is making changes to online identity authentication that are triggering system outages and access problems.”\u003c/p>\n\u003cp>Romig said ongoing \u003ca href=\"https://www.npr.org/2025/02/28/nx-s1-5296986/trump-worker-cuts-social-security-administration\">staff cuts\u003c/a> at the agency also make it likely that wait times for in-person services will continue to grow.\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"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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"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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"headTitle": "California Faces $17 Billion Economic Hit, 140,000 Job Losses Under GOP Budget Cuts | KQED",
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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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"title": "California Faces $17 Billion Economic Hit, 140,000 Job Losses Under GOP Budget Cuts | KQED",
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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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"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": "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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"mindshift": {
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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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"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.",
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"possible": {
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"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.",
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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.",
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"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-World-Podcast-Tile-360x360-1.jpg",
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},
"radiolab": {
"id": "radiolab",
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"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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},
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