Opinion: Trickle-Down Pain: Federal Funding Cuts Hit Home

Last July 4, President Trump signed the “One Big Beautiful Bill” (H.R. 1) into law. This bill creates a difficult new environment for California’s working families, hospitals and health systems, and state and local governments.

More than one-third of Californians (and 44% of Humboldt residents) rely on Medi-Cal for essential health care: in May 2025, 58,783 Humboldters — including 17,441 children (0-18) and 5,732 seniors (65 and older) — received Medi-Cal benefits. H.R. 1 changes eligibility requirements for critical MediCal reimbursements that sustain community- based services, which will lead to weakened provider capacity and more reductions in care.

A recent UC Berkeley Labor Center study estimates that changes in Medi-Cal eligibility will impact 10,000 Humboldt residents by 2028. Statewide, the study says, some 3.4 million low-income Californians may lose coverage and roughly 15 million Californians will see Medi-Cal health service reductions, longer wait times and more crowded emergency rooms. Those whose Medi-Cal eligibility is affected — including those 10,000 Humboldters — will continue to become ill and will be forced into ERs for care; many will need hospital stays. These costs will be uncompensated, a potentially huge liability for our financially stressed hospitals and clinics.

Under the BBB, the state could lose $9.5 billion in federal Medicaid (Medi-Cal) funding annually. The bill will add $5 trillion to the federal debt and provide massive tax breaks to large corporations and the wealthiest Americans. This bill marks the largest downscaling of health-and-human-services funding in U.S. history — $1 trillion in reductions over the next decade.

Reductions in eligibility will leave counties to manage the consequences as more residents are moved off Medi-Cal and into indigent programs at a time when counties are not prepared to absorb these costs or handle complicated eligibility requirements.

Meanwhile, Affordable Care Act (ACA) subsidies expired in December; moderate-income families who purchase coverage through the health insurance marketplace may be forced to drop coverage because of increased costs.

The Kaiser Family Foundation (KFF) found that 9% of ACA enrollees dropped health insurance coverage at the end of 2025 and another 17% are at risk of doing so because they cannot afford the new monthly premiums, which nearly doubled from $399 to $731/person. About 22 million people received ACA subsidies in 2025, with enrollment expected to fall to 12.5 million by 2028, said the Congressional Budget Office.

Also under H.R. I, a 2025 Urban Institute study estimates that some 3.1 million California families may lose Supplemental Nutrition Assistance Program (SNAP) benefits and “widen the persistent gap between benefits and food costs.” This is a profound disinvestment in families and communities overall. Between 2014-2024, every age group in Humboldt County showed increased CalFresh (California’s SNAP) enrollment, especially in the 18-59 age group.

One-quarter of Humboldt children and one-sixth of seniors rely on CalFresh benefits. In January, 28,608 Humboldt residents received CalFresh benefits, including 6,957 children under 18, up sharply from a decade ago. Wages here remain low. Median household incomes fell farther behind statewide averages from 2014-2024, with the number of full-time workers living in poverty nearly doubling, according to a UC Davis report.

Last year, Californians worried more about medical bills than any other expense, according to a study by the California Health Care Foundation; 67% said medical expenses were their top concern, compared to 48% worrying most about paying rent or mortgage and 47% worried about affording food. A recent United Way study concluded that over 3.8 million California families (35%) do not earn enough to meet basic needs; households with children are twice as likely as households without children to be unable to make ends meet.

These are real people, real families, real children — our friends and neighbors — who are being harmed by federal policy with seemingly little concern for the societal consequences. Safety net programs don’t just help families survive; they prevent homelessness, hunger and health emergencies. They give neighbors a chance to bridge the gap between modest wages and California’s high cost of living. We can and must do better if we are to create a community that cares for all.

Dr. Jack Irvine and Dr. Bruce Kessler are retired longtime Humboldt County physicians.