Los Angeles County’s well being system, which is liable for the care of the area’s poorest, is careening towards a monetary disaster due to cuts from a presidential administration and Republican-led Congress seeking to drastically slash the dimensions of presidency.
President Trump’s “Massive Lovely Invoice,” which handed earlier this month, is anticipated to quickly claw $750 million per yr from the county Division of Well being Providers, which oversees 4 public hospitals and roughly two dozen clinics. In an all-staff e mail Friday, the company known as the invoice a “large, devastating blow to our well being system” and mentioned a hiring freeze had gone into impact, instantly.
And the Trump administration’s funds for the following fiscal yr will probably end in a $200-million minimize to the county Division of Public Well being, whose duties embrace monitoring illness outbreaks, inspecting meals and offering substance use remedy.
“I’m not going to sugarcoat it. I’m not going to say we survive this,” mentioned Barbara Ferrer, head of the general public well being division, in an interview. “We are able to’t survive this large a minimize.”
Each Ferrer and Division of Well being Providers head Christina Ghaly warned that the federal cuts will devastate their businesses — and the sufferers they serve — for years to return. Worker layoffs are probably.
In April, the White Home introduced it was ending infectious illness grants value billions of {dollars}, together with $45 million that L.A. County was supposed to make use of to fight the unfold of measles and fowl flu. California has joined different states in a lawsuit preventing the cuts, and the court docket has issued a preliminary injunction suspending the cuts.
A protest earlier this month in Anaheim, co-led by the California Nurses Assn., known as on Rep. Younger Kim (R-Anaheim Hills) to vote in opposition to President Trump’s spending invoice.
(Allen J. Schaben/Los Angeles Occasions)
This month, the county public well being division misplaced one other $16 million after Trump’s invoice minimize funding for a program educating meals stamp recipients about easy methods to purchase wholesome meals.
And there’s extra to return. The Trump administration’s proposed funds for 2026 would be the largest blow but, Ferrer warned, yanking $200 million from her division — a 12% minimize.
“I’m outdated. I’ve been round for a very long time,” mentioned Ferrer, whose work in public well being dates again to the Reagan administration. “I’ve by no means really seen this a lot disdain for public well being.”
Ferrer mentioned the cuts imply she now not has sufficient cash for the county’s bioterrorism watch program, which displays for outbreaks which may sign a organic assault. Quickly, she mentioned, county officers might need to cease testing ocean water for toxins yr spherical, slicing again to simply half the yr.
“Like, you wish to swim? You wish to know that the water is secure the place you swim, then oppose these sorts of cuts,” she mentioned. “That impacts everyone who goes to the seashore.”
L.A. County Public Well being Director Barbara Ferrer mentioned she is bracing for $200 million in cuts to her funds.
(Al Seib/Los Angeles Occasions)
Layoffs are probably, mentioned Ferrer. About 1,500 public well being staffers are supported via federal grants. Greater than half the federal cash the division receives is funneled to outdoors organizations, which might probably have to make cuts to remain afloat.
A equally grim price evaluation is underway on the county Division of Well being Providers, the place executives mentioned they count on to lose $280 million this fiscal yr due to the invoice.
“I can’t make a promise that we will keep away from layoffs due to the magnitude of the challenges,” mentioned Ghaly.
Ghaly mentioned the invoice slashed the additional Medicaid cash the county usually will get to cowl look after low-income sufferers. They count on many sufferers is perhaps kicked off Medicaid due to new eligibility and work necessities. The federal authorities is pulling again on funds for emergency companies for undocumented individuals, that means the county must foot extra of the invoice.
The White Home didn’t reply to a request for remark.
Division of Well being Providers officers mentioned they count on to lose $750 million per yr by 2028. By then, the company’s funds deficit is projected to have ballooned to $1.85 billion.
In an try and pump extra cash into the system, L.A. County supervisors voted on Tuesday to improve a parcel tax first accepted by voters in 2002, which is anticipated to boost a further $87 million for the county’s trauma care community.
After an extended debate Tuesday, Supervisors Holly Mitchell and Lindsey Horvath labored to direct $9 million of the parcel tax cash to Martin Luther King Jr. Neighborhood Hospital, a non-public hospital that serves as a crucial security web for South Los Angeles residents who would in any other case discover themselves in a medical desert.
With out that money infusion from the county, the cuts in Trump’s invoice would have put the hospital liable to closing, because the majority of sufferers in its emergency room are on Medicaid, mentioned Elaine Batchlor, Martin Luther King’s chief government officer.
“In the event that they’ve misplaced their Medicaid protection, we merely gained’t receives a commission for these sufferers,” she mentioned.
Dr. Elaine Batchlor, chief government of MLK Neighborhood Healthcare, mentioned her hospital was hanging by a thread financially. Then got here extra cuts.
(Francine Orr/Los Angeles Occasions)
Martin Luther King changed a county hospital that closed after shedding nationwide accreditation in 2005 due to critical medical malpractice, touchdown it the nickname “Killer King.”
“The truth that that hospital closed within the first place I feel is legal, and I intend to do all I can to guard the integrity of the companies,” mentioned Mitchell, whose district contains the hospital and who pushed for it to get a minimize of cash from the parcel tax improve.
Native well being suppliers mentioned that modifications on the state stage have created extra uncertainty. The state funds for this fiscal yr freezes enrollment in Medi-Cal, California’s model of Medicaid, for undocumented immigrants ages 19 and older beginning in January. Medi-Cal recipients ages 19 to 59 must pay a $30 month-to-month premium starting July 1, 2027.
“Most households [we serve] are making about $2,400 to $2,600 a month. They’re going to have to decide on between paying their Medi-Cal charges for a household of 4 — that’s $120 a month — or paying hire or paying for meals,” mentioned Jim Mangia, head of St. John’s Neighborhood Well being, who mentioned the cuts will disrupt look after tens of 1000’s of low-income residents.
The St. John’s clinic, which will get most of its income from Medi-Cal reimbursements, serves greater than 120,000 sufferers a yr, most of whom reside beneath the federal poverty line.
If the clinic doesn’t discover a approach to exchange the misplaced income, Mangia warned, companies must be decreased. The clinic not too long ago began treating immigrant sufferers of their houses after realizing that they had been skipping appointments as a result of they feared being arrested by federal immigration brokers.
“Then what we’re taking a look at is closing a number of well being facilities,” mentioned Mangia. “We’re taking a look at shedding a whole lot of employees.”
At Venice Household Clinic, a group well being middle that serves almost 45,000 sufferers yearly, 80% of sufferers depend on Medi-Cal. Roughly half the clinic’s income comes from Medi-Cal reimbursements.
Dr. Mitesh Popat, a household doctor and head of the clinic, mentioned that federal coverage modifications — particularly extra frequent paperwork and added work necessities — will probably push eligible sufferers off of Medi-Cal. He mentioned the clinic is exploring methods to broaden assist for sufferers to navigate the paperwork and hold their protection.
“This places a bunch of boundaries in the best way of people that have already got sufficient challenges in life,” Popat mentioned. “They’re attempting to make it, attempting to outlive, attempting to place meals on the desk.”
