The budget that legislators must adopt by June 15 will set California on one of two courses: protecting the health coverage that millions rely on, or allowing federal cuts to decimate Medi-Cal, the insurance program covering 15 million Californians. As budget decisions near, health care experts and community advocates have released guiding principles to shape the future of Medi-Cal and strengthen its role as a powerful equity lever. Courageous action now will ensure one in three Californians can continue seeing a doctor and get care before a crisis.
Last year, the federal government slashed $1 trillion from the nation’s health care safety net to boost corporate tax breaks and ramp up ICE enforcement in the bill known as H.R. 1. Gov. Gavin Newsom’s January proposed budget extended the harms instead of mitigating them. Without a strong response from lawmakers in the coming days, millions will be pushed out of coverage or lose critical health benefits, making California sicker and more unequal, deepening harm for low-income communities and communities of color who already face disparities in health outcomes. With 7 in 10 Californians worried about health care costs, protecting Medi-Cal now is vital to prevent overcrowded emergency rooms and higher costs for everyone.
Our organizations and our partners urge lawmakers to prioritize Californians with Medi-Cal in four crucial ways:
Fortify health guarantees. Medicaid — the federal program underpinning Medi-Cal — is an entitlement, which means the right to care with no waiting lists and no denial of covered services. For people with disabilities and elder Californians, these guarantees also include nursing homes and long-term care. Eroding these commitments through caps or cuts will force Californians with complex needs to skip medications, postpone treatment or take on crushing debt.
Before Medi-Cal expanded coverage, many people relied on a patchwork of county “indigent care” programs as last-resort care. Eroding Medi-Cal will mean forcing millions back into these threadbare safety nets which don’t guarantee comprehensive coverage and lack the funding to absorb millions of newly uninsured residents. The state must maintain commitments to keeping families covered, regardless of immigration status.
Reject new barriers to care. California has spent years reducing red tape so consumers can access care; now is not the time to reverse course. Work requirements and more frequent eligibility checks are premised on stereotypes and misinformation. About 82 percent of Medi-Cal recipients already come from working families. We must reject punitive work requirements that function primarily as coverage-termination machines.
Make every dollar deliver for consumers. While Medi-Cal already operates more efficiently and with less overhead than private insurance plans, federal threats mean we must redouble demands that public dollars prioritize patient care over profits for hospitals, health plans and other corporations. A recent state Legislative Analyst’s Office report points to rising costs Medi-Cal pays for care — not the number of people enrolled — as the primary factor behind the program’s growing budget.
End corporate welfare that forces workers onto public benefits. While corporations hoard billions in tax breaks, working and low-income families suffer, losing access to food and health benefits they need to survive. Many of the wealthiest companies pay poverty wages to workers, effectively pushing them into the Medi-Cal program. Senate Democrats have proposed a corporate “fair share contribution” to account for expenses the largest employers shift onto the state safety net. Gov. Newsom and Assemblymembers should likewise direct revenue to protect Californians covered by Medi-Cal and prevent even more widespread impacts from H.R. 1.
Many of us know the fear of crushing medical bills or the cost of being denied coverage. What we cannot afford is a crisis of millions of uninsured Californians. Lawmakers have a critical window of opportunity in the next 30 days to lessen H.R. 1’s impact on California and to show the country — and more importantly our families and neighbors — what it means to care about the health and dignity of our communities.
Kiran Savage-Sangwan is the executive director of the California Pan-Ethnic Health Network, a statewide multicultural health advocacy organization dedicated to closing racial and ethnic disparities.
Cori Racela is the executive director of Western Center on Law and Poverty, which advocates for economic and racial justice for Californians in the areas of housing, health and public benefits.
