As Los Angeles recovers from devastating wildfires, another crisis looms—threats to Medicaid and the Affordable Care Act (ACA) from federal policy changes. In a recent Fierce Healthcare op-ed, Martha Santana-Chin, CEO of L.A. Care Health Plan, warns that proposed cuts and restrictions could unravel decades of healthcare progress, disproportionately affecting low-income Californians.
Santana-Chin, who grew up in an immigrant family dependent on safety-net programs, highlights how millions of working families rely on Medicaid and ACA subsidies to access essential healthcare. As the leader of the nation’s largest publicly operated health plan, serving 2.6 million low-income Angelenos, she expresses deep concern over policies that threaten California’s healthcare system, including:
• Eliminating ACA Subsidies – Proposals to shorten enrollment periods and remove funding for outreach efforts would leave millions without coverage, particularly in states that have not expanded Medicaid.
• Expanding Work Requirements – Despite evidence that most Medicaid recipients already work, new work requirements would create unnecessary barriers to care for the working poor.
• Switching to Medicaid Block Grants – Shifting Medicaid to block grants would transfer financial burdens to states, destabilizing a program that serves one in three Californians.
• Shifting Costs to California – Proposed federal cuts would force California to make up for lost Medicaid funding, undermining recent voter-supported initiatives like Proposition 35, which ensures sustainable Medi-Cal funding.
Santana-Chin warns that these so-called cost-saving measures will instead weaken the economy, disrupt care for vulnerable populations, and increase financial strain on hospitals and state budgets. She calls on policymakers to safeguard and expand the safety net, rather than dismantling it.
For Los Angeles physicians, these policy changes could have far-reaching consequences—jeopardizing patient access, reducing provider reimbursements, and worsening health disparities. Santana-Chin urges Congress and state leaders to reject shortsighted cuts and work toward lasting solutions that prioritize public health.
"Instead of dismantling the safety net, we should be building on it. This includes making ACA subsidies permanent, protecting eligibility for the expanded Medicaid population, and investing in preventive care to reduce long-term costs."
Read the full article in Fierce Healthcare: Op-Ed: Protecting Our Healthcare Safety Net from a Death by a Thousand Cuts.
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