The Los Angeles County health system, which is responsible for caring for the area’s poorest people, is looking to cut back on the financial crisis as it cuts from the presidential administration and Republican-led Congress, which are trying to significantly reduce the size of its government.
Trump’s “Big Beautiful Building,” passed earlier this month, is expected to soon draw $750 million a year from the county health department, which oversees four public hospitals and about two dozen clinics. In an email from all staff on Friday, the agency called the bill a “major devastating blow to our health system” and said the employment freeze came into effect immediately.
And the Trump administration’s budget for the upcoming fiscal year could result in a $200 million cut to the county public health department, including monitoring disease outbreaks, food testing and providing substance use treatment.
“I’m not going to sugar coat it. We’re not going to survive this,” said Barbara Feller, head of public health, in an interview. “We can’t survive this big cut.”
Christina Gary, director of Health Services for both Feller and the Department of Health, warned that federal cuts will destroy their agencies and the patients they serve for years to come. There may be employee layoffs.
In April, the White House announced it would end billions of dollars worth of infectious disease grants, including the $45 million that LA County was supposed to use to combat spreading measles and avian flu. California joined other states in lawsuits fighting the cuts, and the court issued a preliminary injunction suspending the cuts.
Earlier this month, the protest in Anaheim, co-led by California nurse Assn, called on Senator Young Kim (R-Anaheim Hills) in voting against President Trump’s spending bill.
(Allen J. Scheven/Los Angeles Times)
This month, the county’s public health department lost another $16 million after cutting funds for Trump’s building for a program that educates food stamp recipients on how to buy healthy meals.
And there’s more to come. Feller warned that the Trump administration’s proposed budget for 2026 is still the biggest blow, subtracting $200 million from her division, a 12% cut.
“I’m old. I’ve been there for a long time,” Feller said. “I’ve never actually seen so many sloppy things to public health.”
Feller said the cut means there is not enough money for the county’s bioterrorism watch program. Soon, county officials said they might have to stop testing for year-round addiction saltwater.
“So, do you want to swim? You want to know that the place you swim is safe, but I’m against that kind of cut,” she said. “It affects everyone who goes to the beach.”
LA County Director of Public Health Barbara Feller said he is paying the budget with a $200 million cut.
(Al Seib/Los Angeles Times)
A layoff is likely, Feller said. Approximately 1,500 public health staff are supported through federal grants. More than half of the federal funds received by the department are attracting attention from outside organizations.
Similarly a rigorous cost analysis is underway in the county health department, with executives saying they expect to lose $280 million this fiscal year due to the bill.
“Due to the magnitude of the challenge, we cannot promise that we can avoid layoffs,” Ghaly says.
Ghaly said the bill significantly reduced the extra Medicaid money that the county could normally cover the care of low-income patients. They expect many patients may be kicked out of Medicaid due to new qualifications and job requirements. The federal government is pulling back payments for emergency services for undocumented people. That means the county has to step in more legislation.
The White House did not respond to requests for comment.
Officials with the Department of Health Services said they expect to lose $750 million a year by 2028. By then, the institution’s fiscal deficit is projected to have swelled to $1.855 billion.
LA County supervisors voted Tuesday to increase the parcel tax, which was first approved by voters in 2002, to put more cash into the system.
After Tuesday’s lengthy debate, supervisors Holly Mitchell and Lindsey Horvas worked to direct $9 million in parcel taxes to Martin Luther King Jr. Community Hospital, a private hospital that otherwise serves as a key safety net for South Los Angeles residents in the medical desert.
Without cash infusions from the county, Trump’s bill cuts would have been at risk of closing hospitals as the majority of emergency room patients are in Medicaid, said Elaine Batchler, chief executive of Martin Luther King.
“If they lose Medicaid compensation, we will not be paid for those patients,” she said.
Dr. Elaine Batchlor, chief executive of MLK Community Healthcare, said her hospital is financially hanging in the thread. Then there were more cuts.
(Francine Orr/Los Angeles Times)
Martin Luther King has landed the nickname “Killer King” replacing a county hospital that was closed after losing national recognition in 2005 due to serious medical malpractice.
“I think the fact that the hospital was closed in the first place is a crime. I’m going to do everything I can to protect the integrity of the service,” Mitchell said.
Local healthcare providers said changes at the state level have created additional uncertainty. The state budget for this fiscal year will freeze registrations in California’s Medicaid version of Medi-Cal for undocumented immigrants aged 19 and older starting January. Medi-Cal recipients aged 19-59 will be required to pay a monthly premium of $30 from July 1, 2027.
“Most families [we serve] I make about $2,400-2,600 a month. “We’re looking forward to seeing you in the future,” said Jim Manzia, head of St. John’s Community Health.
Having earned the majority of revenue from medical rebates, St. John’s Clinic serves more than 120,000 patients a year, most of which live under the federal poverty line.
If the clinic cannot find a way to replace lost revenue, Manja warned that it would need to reduce its services. The clinic recently began treating immigrant patients at home after realising they were skipping appointments because they were afraid of being arrested by federal immigration agents.
“So what we’re looking at is closing some health centres,” Manzia said. “We’re considering firing hundreds of staff.”
At Venice Family Clinic, a community health centre that serves nearly 45,000 patients a year, 80% of patients rely on MEDI-CAL. Approximately half of the clinic’s revenue comes from Medi-Cal refunds.
Dr Mitesh Popat, a family physician and head of the clinic, said changes to federal government policies, particularly the addition of more frequent documents and labor requirements, would likely push eligible patients out of Medi-Cal. He said clinics are looking for ways to expand patient support, navigate paperwork and maintain insurance.
“This places a lot of barriers that get in the way of people who already have enough challenges in their lives,” Popatt said. “They’re making it, trying to survive, and trying to put food on the table.”
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