Millions are at risk under federal health care cuts. California must step up

One in 10 Californians are at risk of losing their health insurance based on what Congress is up to in Washington, if Gov. Gavin Newsom's estimates are anywhere close to right.

This is the governor who once vowed to find the money to maintain tax rebates for electric vehicles if Donald Trump and his federal Republicans were to take them away, as if he can protect California from the shifting political winds back east.

Yet, now, Newsom and Sacramento Democrats aren't exactly racing to keep Californians insured.

Lawmakers all but ignored the health care implications to California of Donald Trump's so-called "Big, Beautiful Bill" as they passed a new state budget last week.

And who can blame them? The impacts of nearly 4 million Californians losing their health care coverage overnight are so massive, so expensive — and so downright cruel — all Newsom (or any of us) can really do right now is to quantify the inhumanity and hope that it doesn't actually happen.

"I never thought I'd see this in my lifetime," Newsom said the other day at a press briefing. "This is devastating." These impacted Californians don't fit into an established political identity that lawmakers can rally behind, such as the undocumented immigrants who will receive health care in next year's budget because they are an important constituent to Democrats (and as workers, important contributors to the economy).

Will anyone rise to be the champion of low-income Californians who don't work 20 hours a week and are at risk of losing their coverage? Or the family purchasing insurance through the state's Medi-Cal program that simply can't afford the higher premiums proposed in the federal legislation?

These are real people who don't fit tidily into a certain demographic. And they may be left on their own to deal with one personal crisis after another.

The legislation, in search of spending cuts that only partially pay for tax increases that go disproportionately to the wealthy, attacks health care in two ways. The biggest is Medicaid, the federal health care program for low-income Americans that is administered here as Medi-Cal.

In a complete reversal of the efficiency efforts previously championed by Elon Musk (who continues to hate this bill), Congress is proposing dozens of pages of new paperwork for many Medi-Cal recipients to maintain their coverage. Those between the ages of 19 and 64 would have to document 80 hours of monthly work, education or job training, to qualify.

Newsom's administration is estimating that 3 million Californians would no longer qualify for coverage and another 400,000 would outright lose it because they can't deal with or understand the new paperwork.

Meanwhile, Congress is also seeking to make life a lot more miserable for those getting subsidized insurance from the Obama-era Affordable Care Act, administered here as Covered California. Another 400,000 Californians could drop this coverage, by Newsom estimates, based on higher premiums proposed in the legislation.

The misery doesn't end there: An estimated 5.5 million Californians could be heading toward less-healthy diets, as Cal Fresh, a program that provides fresh produce to low-income residents, is on the congressional chopping block as well.

These cuts aren't about waste, fraud or abuse. This is a carefully crafted attack on some Americans who are among the most politically disenfranchised. These are people living on the edge who scramble to make end meets.

The solution isn't to go back into the state budget and strip it of health care coverage of undocumented Californians. This wouldn't come close to funding the care of those Californians who may be about to lose it. We should be heading toward a nation where everyone can see a doctor. Now we're racing precisely in the opposite direction.

Health care rarely rises as the top issue for voters.. If this legislation passes and does anything close to the damage that is envisioned, these victims will be left behind. Hopefully they will vote and send Washington a message that tax cuts for our most fortunate cannot be shouldered by our least fortunate. •

Tom Philp is a Pulitzer Prize-winning editorial writer and columnist for the Sacramento Bee.

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