The healthcare system in Los Angeles County, catering largely to the area’s low-income residents, is grappling with a financial crisis. This situation has come about due to cutbacks from the federal government and a Republican-led Congress, both looking to shrink government size significantly.
Recently, Trump’s “Big Beautiful Building” plan, approved earlier this month, is projected to take away around $750 million annually from the county’s health department, which manages several public hospitals and numerous clinics. An email circulated among staff on Friday described the bill as a “major devastating blow” to the system and announced an immediate hiring freeze.
The administration’s upcoming budget might also slash an additional $200 million from the county’s public health department, impacting vital services like disease outbreak monitoring, food safety testing, and substance use treatment.
“This isn’t sugar-coated,” Barbara Feller, the public health head, said in an interview. “We can’t keep going with these kinds of cuts.”
Christina Gary, who oversees Health Services, echoed the concerns, warning that the federal cutbacks could severely damage their agencies and the patients they help over the long term. Layoffs may be on the horizon.
Back in April, the White House canceled multi-billion dollar subsidies intended to help combat measles and avian flu; LA County was set to receive $45 million for this. California has joined other states in legal action against these cuts, and a preliminary injunction has temporarily halted the reductions.
This month alone, the county’s public health department lost an additional $16 million due to funding cuts related to Trump’s initiative for a program aimed at teaching food stamp recipients about healthy eating.
Sadly, there’s more ahead. Feller mentioned that the proposed budget for 2026 could harm her department even further, with a possible $200 million reduction, equating to a 12% cut.
“I’ve been here a long time,” she remarked. “I’ve never witnessed such chaotic shifts affecting public health.”
The looming cuts could jeopardize funding for the county’s bioterrorism watch program. There’s even the possibility of halting tests for saltwater pollutants. “It’s crucial to know if the beach you want to visit is safe, and these cuts are, well, counterproductive,” she said.
A layoff seems inevitable, according to Feller. The department currently relies on federal grants to support about 1,500 public health employees, and many of those funds are now under scrutiny. A detailed cost analysis is underway, as the department braces for a $280 million loss due to the new legislation.
“With these challenges, it’s hard to promise that layoffs can be avoided,” said Ghaly, presumably referring to the head of the health department.
Ghaly went on to explain that the bill has similarly reduced additional Medicaid funds, typically used to cover low-income patient care. Many might lose Medicaid eligibility under new requirements. Moreover, cuts in emergency service payments for undocumented residents are pushing the county to consider additional legislation.
No comments have been forthcoming from the White House.
Department officials predict that by 2028, losses could reach $750 million per year, pushing the fiscal deficit to a staggering $1.855 billion.
This past Tuesday, LA County supervisors voted to channel more funding into the system by potentially increasing a parcel tax first approved in 2002.
After a detailed discussion, supervisors Holly Mitchell and Lindsey Horvas directed $9 million from these taxes to the Martin Luther King Jr. Community Hospital, a crucial healthcare provider for South Los Angeles, which otherwise could face operating challenges due to the loss of emergency Medicaid patients.
“Without this funding, we risk closure,” said Elaine Batchler, CEO of Martin Luther King Hospital. “If we can’t get compensated for those patients, it’s a dire situation.”
Martin Luther King Hospital, known for replacing a previously closed facility that lost recognition due to severe malpractice claims, is already under significant strain. “I find it a crime that it had to close once,” said Mitchell, vowing to protect the integrity of their services.
Local healthcare providers have expressed concerns over changes at the state level, which have added further unpredictability. Starting in January, California’s Medicaid program will halt registrations for undocumented immigrants over 19 years old. Meanwhile, those aged 19-59 could face a new monthly premium beginning July 2027. “Most of our families make about $2,400 to $2,600 a month, so this is quite a burden,” noted Jim Manzia, who leads St. John’s Community Health.
St. John’s Clinic, serving over 120,000 mostly low-income patients annually, relies heavily on medical reimbursements. Without finding alternative revenue sources, Manzia warned they’d likely need to scale back services, possibly even closing centers. The clinic recently adapted by offering home-based care to immigrants who were skipping appointments out of fear of immigration enforcement.
At Venice Family Clinic, which provides services to around 45,000 annually, the scale of dependence on Medi-Cal is significant, with about 80% of patients using it. Dr. Mitesh Popat, a physician at the clinic, acknowledged that many eligible patients might slip through the cracks due to policy changes necessitating more documentation and new labor requirements.
“It’s just piling on additional hurdles for those already facing enough struggles,” Popat lamented. “They’re struggling to get by, trying to keep food on the table.”
