Federal cuts leave Los Angeles County health system in crisis

The Los Angeles County Health System, which is responsible for care for the poorest in the region, cares about a financial crisis due to cuts from a presidential administration and the Congress led by the Republicans who seek to considerably reduce the size of the government.

President Trump’s “Big Beautiful Bill”, which was adopted earlier this month, is expected to scratch $ 750 million a year from the county health services department, which oversees four public hospitals and about two dozen clinics. On Friday, in an email of everything, the agency called the bill “big devastating blow for our health system” and declared that a job freeze had entered into force, immediately.

And the Trump administration’s budget for the next fiscal year will likely lead to a reduction of $ 200 million in the County Public Health Department, the responsibilities of which include monitoring of disease epidemics, food inspection and the supply of treatment for substance consumption.

“I’m not going to do sugar. I will not say that we survive this, “said Barbara Ferrer, head of the Department of Public Health, in an interview. “We cannot survive this big cut.”

Ferrer and Health of Health Services Christina Ghaly warned that the federal cuts would devastate their agencies – and the patients they serve – for the years to come. Employee dismissals are likely.

In April, the White House announced that it put an end to subsidies with infectious diseases worth billions of dollars, of which $ 45 million This County of Los Angeles was supposed to use to combat the spread of measles and bird flu. California has joined other states in a trial to fight against the cuts, and the court issued a preliminary injunction suspended the cuts.

A demonstration earlier this month in Anaheim, co-directed by the California Nurses Assn., Called representative Young Kim (R-Alaheim Hills) to vote against the President Trump expenditure bill.

(Allen J. Schaben / Los Angeles Times)

This month, the County Public Health Department lost an additional $ 16 million after Trump’s bill reduced the financing of a program educating food coupons on how to buy healthy meals.

And there is more to come. The budget proposed by the Trump administration for 2026 will be the biggest blow to date, warned Ferrer, by firing $ 200 million in its department – a decrease of 12%.

“I’m old. I have been there for a long time, ”said Ferrer, whose public health work dates back to the Reagan administration. “I have never seen so much disdain for public health.”

Ferrer said that the cuts mean that it no longer has enough money for the Bioterorisms surveillance program of the county, which monitors epidemics that could report a biological attack. Soon, she said, county officials may have to stop testing the ocean water for toxins all year round, spending only half of the year.

“Like, you want to swim? You want to know that the water is sure where you swim, then you opt for this kind of cuts,” she said. “This affects everyone who goes to the beach.”

The director of public health of the County, Barbara Ferrer, said that she was preparing for $ 200 million in her budget.

(Al Seib / Los Angeles Times)

The layoffs are likely, said Ferrer. About 1,500 public health staff are supported through federal subsidies. More than half of the federal money that the ministry receives is channeled towards external organizations, which should probably make cuts to stay afloat.

An equally dark cost analysis is underway in the Department of County Health Services, where managers said they expected to lose $ 280 million this exercise due to the bill.

“I cannot make the promise that we will be able to avoid layoffs due to the extent of the challenges,” said Ghaly.

Ghaly said that the bill had reduced additional medication money that the county generally has to cover care for low -income patients. They expect many patients to be launched by Medicaid due to new eligibility and work requirements. The federal government withdraws payments for emergency services for undocumented persons, which means that the county will have to pay more invoice.

The White House did not respond to a request for comments.

Officials from the Ministry of Health have said they expected losing $ 750 million a year by 2028. At the time, the agency’s budget deficit should have increased $ 1.85 billion.

In an attempt to pump more money into the system, the County Supervisors of the County voted on Tuesday to increase a parcel tax approved for the first time by the voters in 2002, which is expected to raise an additional $ 87 million for the County Trauma Care Network.

After a long debate on Tuesday, the supervisors Holly Mitchell and Lindsey Horvath worked to lead $ 9 million dollars of the Martin Luther King Jr. Community Hospital, a private hospital which serves as a critical safety net for the residents of South Angeles who otherwise find themselves in a medical desert.

Without this county cash infusion, the cuts In Trump’s bill would have put the hospital at risk of closing because the majority of patients in his emergency room are on Medicaid, said Elaine Batchlor, managing director of Martin Luther King.

“If they have lost their Medicaid coverage, we will simply not be paid for these patients,” she said.

Dre Elaine Batchlor, general manager of MLK Community Healthcare, said her hospital was suspended financially by a thread. Then came more cuts.

(Francine Orr / Los Angeles Times)

Martin Luther King replaced a county hospital that closed after losing national accreditation in 2005 due to a serious medical fault, landing the nickname “Killer King. “”

“The fact that this hospital has closed in the first place, I think, is criminal, and I intend to do everything I can to protect the integrity of services,” said Mitchell, whose district includes the hospital and which has pushed a reduction in money from the increase in plot.

Local health providers said that state changes have created additional uncertainty. The state budget for this exercise exercises registrations in Medi-Cal, California, the version of Medicaid, for undocumented immigrants aged 19 and over from January. The beneficiaries of Medi-Cal aged 19 to 59 will have to pay a monthly bonus of $ 30 from July 1, 2027.

“Most families [we serve] earn about $ 2,400 at $ 2,600 per month. They will have to choose between paying for their medi -calm costs for a family of four – it’s $ 120 per month – or paying rent or paying for food, “said Jim Mangia, St. John’s community health, who said the cuts would disrupt care for tens of thousands of low -income residents.

The St. John’s clinic, which derives most of its reimbursements from Medi-Cal, serves more than 120,000 patients per year, most of whom live below the federal poverty line.

If the clinic does not find a way to replace lost income, warned Mangia, the services will have to be reduced. The clinic recently began to treat immigrant patients at home after realizing that they had jumped out because they feared being arrested by federal immigration agents.

“Then what we look at is to close several health centers,” said Mangia. “We plan to dismiss hundreds of staff members.”

In Venice Family Clinic, a community health center which serves nearly 45,000 patients per year, 80% of patients count on Medi-Cal. About half of the clinic revenues come from reimbursements from Medi-Cal.

Dr. Mitesh Popat, family doctor and chief of the clinic, said that changes in federal policy – in particular more frequent documents and additional work requirements – will probably postpone eligible patients from Medi -Cal. He said the clinic explores the means to extend support to patients to navigate the documents and maintain their coverage.

“It puts a bunch of barriers about the way of people who already have enough challenges in life,” said Popat. “They try to do it, trying to survive, trying to put food on the table.”