Nationwide, President Donald Trump’s recently passed “One Big Beautiful Bill” means trillions of dollars in tax cuts and the clawing back of funding for Medicaid and food support programs for lower-income people. In parts of the East Bay, the cuts could mean an increase in uncompensated care and millions of dollars reduced annually to at least one county’s health system.
The Contra Costa County system, which includes Contra Costa Health and the Contra Costa Regional Medical Center, will see annual cuts of between $121 million and $129 million, according to U.S. Rep. Mark DeSaulnier, D-Walnut Creek, who represents parts of the county.
DeSaulnier’s district is the fifth-wealthiest in the country, but more than 131,000 of those residents still rely on Medicaid, known as Medi-Cal in the state, DeSaulnier said during a July 10 virtual town hall on Trump’s cuts.
Almost 18,000 households in the district also rely on food stamps, known as the Supplemental Nutrition Assistance Program (SNAP).
“(Food stamps) are a benefit to all of us, particularly young people,” said DeSaulnier. “When they get the nutrition they need, their cognitive development, as we all know science tells us, improves. And we all benefit from that.”
Cuts to Medicaid alone total almost $1 trillion for the country over the next 10 years. Nearly $200 billion will also be cut from SNAP in that same time.
DeSaulnier said that while the county is still evaluating the complete impact of the cuts, it could result in hospitals and clinics being closed.
Rural hospitals in Northern California face impacts
In a June letter, leading Democrat and Republican congressmembers warned that the cuts would put 338 rural hospitals at risk of closure or unable to provide services. One of those is in the North Bay — Adventist Health St. Helena in Napa County.
The cuts were approved alongside a $75 billion increase in funding for U.S. Immigration and Customs Enforcement, around $45 billion of which is for immigration detention centers and the other almost $30 billion for personnel and other operational costs.
“There is reason to believe that with an increased budget, California will see more targeting from the administration,” a presentation by DeSaulnier said.
ICE raids in the Bay Area have sparked protests across the region, with some resulting in temporary closures of the immigration courthouses in Concord and San Francisco.
“We’ve got to win elections. We’ve got to win the midterms and hopefully Republicans who believe in oversight will stop being afraid to provide oversight. All of this money that is going to ICE and border security is an open check to this administration.” Rep. Mark DeSaulnier
DeSaulnier said it is imperative to ensure congressional oversight of immigration efforts and funding because what’s happening is “not American democracy.”
“We’ve got to win elections. We’ve got to win the midterms and hopefully Republicans who believe in oversight will stop being afraid to provide oversight,” DeSaulnier said in response to a constituent’s question. “All of this money that is going to ICE and border security is an open check to this administration.”
DeSaulnier said he believes that part of the strategy around implementing the cuts is to make people think the cuts have little effect because they will be going into place over the next several years instead of right away.
“There won’t be any changes, as much as you imagine, because it’ll be 2026 when they take effect and 2028,” he told the audience.