We are navigating a time of major transition. Our systems have not yet adjusted to the new fiscal landscape — marked by the end of COVID-era funding, rising costs, and growing demand for essential services. On top of that, shifts in federal policy and unpredictable reimbursement structures are adding to the uncertainty. With roughly half of our County’s funding coming from state and federal sources, this volatility presents serious financial risks for the County.
At the federal level, I am very concerned about the deep cuts to Medicaid (called Medi-Cal in California) proposed by Congress and the changes to eligibility requirements that will cause significant coverage losses. Other critical programs that provide basic assistance and nutrition programs for individuals and families experiencing financial hardship, such as CalWORKS and CalFresh, are facing a similar fate. As discussed at the May 20 Board of Supervisor meeting, we are also seeing cuts to Medicaid at the state level. Governor Newsom's May Revise Budget proposes $5 billion in harmful cuts primarily to Medicaid, including freezing access to Medi-Cal for undocumented individuals.
These cuts are not just line items on a spread sheet. If implemented, these cuts will have a significant negative impact on the real lives of many people in our community. In Santa Cruz County, nearly 90,000 residents are on Medi-Cal. The County estimates at least a third of these individuals, many of whom are unhoused, could lose coverage. We could also see a 20% to 30% reduction in Medi-Cal patients in our clinics across the county.
In response to these threats, I will be doing all I can to protect and preserve essential services, especially for individuals from historically marginalized communities who are often disproportionally impacted. Behind every proposed service cut is a community that may feel the effects. We must approach this work with care, curiosity, and compassion.