Millions of Californians at risk of losing Medi-Cal coverage

Last week the Republican-led U.S. House of Representatives advanced a budget package gutting Medicaid spending by $700 billion in order to help offset the cost of extending President Donald Trump’s 2017 tax cuts that mostly benefit the wealthy.

In addition to California potentially losing as much as $20 billion a year and 217,000 jobs because of this, millions of low-income Californians on Medi-Cal — the state’s version of Medicaid — could lose coverage due to the bill’s proposed proof-of-work-hours requirement.

As CalMatters’ Ana B. Ibarra explains, about 15 million Californians are on Medi-Cal, and roughly 29% of Medi-Cal recipients can’t work because of caregiving responsibilities, school, a disability or other exemption. The bill would require certain adults to report work hours, which could lead to, by some estimates, between 1.2 million and 3.5 million Californians losing coverage.

In an interview with ABC’s Bakersfield affiliate, GOP Rep. David Valadao, who represents parts of San Joaquin Valley, said the average person “who is working really hard” thinks the work requirements are “the right thing to do.”

• Valadao: “For those who are able-bodied with no dependents and you choose not to try to make that effort to go get a job … yeah you’re probably going to be affected by this.”

But health policy researchers and advocates point to New Hampshire and Arkansas — two states that once imposed work requirements. Instead of increasing employment, the mandates left thousands of eligible people without health insurance within months. Both states have since eliminated the policies. 

• Katherine Hempstead, a senior policy officer at Robert Wood Johnson Foundation, a nonprofit health advocacy organization: “The program saves money through mistakes. And that’s not a good way to run social insurance or to run policy.”

All 43 California Democrats opposed the bill, while all nine GOP members — who represent a total of 2.5 million Medi-Cal enrollees — voted for it. The bill is now before the Senate and as currently drafted, work requirements would begin Dec. 31, 2026. 

Read more here.

From CalMatters economy reporter Levi Sumagaysay:

A federal trade court ruled the sweeping tariffs unlawful Wednesday, but that ruling was paused Thursday pending the U.S. Court of Appeals for the Federal Circuit’s consideration of the Trump administration’s appeal. A federal district court judge in Washington, D.C., also issued a similar ruling Thursday in a lawsuit brought by two small businesses.

• Kush Desai, White House spokesperson, in an email: “It is not for unelected judges to decide how to properly address a national emergency.” 

The administration has said trade deficits constitute an emergency and invoked the International Emergency Economic Powers Act to justify its tariffs.

The tariffs have had a big effect on California port activity, and remain in effect until the appeals court makes a decision on the lawsuit. Twelve states led by Oregon and five businesses brought on the lawsuit, which is similar to a separate lawsuit filed by California. It’s unclear how quickly the appeals court will act. 

• Brian Peck, international business law expert at the University of Southern California Gould School of Law: “I would hope (the appeals court is) not deaf, blind and dumb to what’s going on with businesses.”

Peck also suspects the case will end up at the U.S. Supreme Court.

For businesses, the legal wrangling means continued unpredictability, said Darlene Chiu-Bryant, executive director of GlobalSF, a San Francisco nonprofit that helps facilitate trade, especially with Asia.

On Tuesday Trump posted on social media that he would withhold “large scale” federal funding from California for allowing high school transgender athletes to participate in women’s sports. But that’s not the only federal action Trump is threatening against California LGBTQ+ students, writes CalMatters’ Adam Echelman.

To reduce federal spending, the president has proposed cutting more than $10 billion from the U.S. Department of Education, and threatened to pull funding from any school across the U.S. that promotes diversity, equity and inclusion efforts. 

Under this directive, Trump only called out one program by name: San Diego Community College District’s LGBTQ+ pride centers. In 2023 the district’s four community colleges received over $225,000 in federal grants to support spaces and programs for LGBTQ+ students. But the money supports “initiatives unrelated to students or institutional reforms,” according to Trump’s budget proposal.

To avoid possible clawbacks, the district’s chancellor said the centers are planning to spend down the federal money “as quickly as we can.” Meanwhile, Democratic Rep. Sara Jacobs, who represents parts of San Diego and requested the grants, said Trump is “attacking the ideals that higher education is founded on, like free speech.”

• Jacobs: “LGBTQ+ kids and especially trans kids are Republicans’ favorite scapegoat.”

Read more here.

A judge restricted Border Patrol from making warrantless arrests in a large part of California. CalMatters’ Sergio Olmos and video strategy director Robert Meeks have a video segment on the ruling, which follows a lawsuit over a controversial immigration sweep in Kern County, as part of our partnership with PBS SoCal. Watch it here.

SoCalMatters airs at 5:58 p.m. weekdays on PBS SoCal.