Budget cuts to Medi-Cal are significantly impacting Silicon Valley’s health care system, with immigrants facing the most severe challenges in accessing necessary medical services.
Recent budget cuts to Medi-Cal are threatening the stability of Silicon Valley’s health care system, disproportionately affecting immigrant populations. Many immigrants are experiencing delays in services, reductions in medication access, and difficulties navigating the evolving health care landscape.
Some individuals have opted to drop their coverage entirely due to fears of having their personal information exposed to federal authorities. As a result, they are increasingly relying on mobile clinics, nonprofit organizations, county programs, and alternative medicine to meet their health care needs, according to sources familiar with the situation.
Samantha Rojas, lead patient organizer with the nonprofit Latinas Contra Cancer, expressed concerns that county hospitals and clinics are at risk of closure, which could overwhelm emergency rooms, increase patient wait times, and strain the entire medical system. This crisis stems from H.R. 1, a federal legislative measure that has cut funding to Medicaid, known as Medi-Cal in California.
“Our immigrant population are the ones who are suffering the most,” Rojas told San José Spotlight. “But it doesn’t just hurt this population; it hurts all of us.”
H.R. 1 has slashed Medicaid funding by $1 trillion over the next decade, leading to lower reimbursement rates for providers and reduced access to services for the region’s most vulnerable residents. In 2024, California expanded its Medicaid program to provide health care for all low-income residents, including undocumented individuals. However, the program ceased accepting new undocumented enrollments at the beginning of the year, and other changes have begun to take effect, including limits on reimbursements for specific medications like GLP-1 weight loss drugs.
In Santa Clara County, officials are grappling with a projected $470 million deficit for the upcoming fiscal year due to these federal budget cuts. Hospitals are facing staffing shortages, with dozens of nurses having been furloughed.
One immigrant, who requested anonymity due to fears of immigration enforcement, shared her experience of needing a biopsy to check for bladder cancer. Initially seen at Valley Medical Center, she was transferred to O’Connor Hospital due to a lack of availability. Unfortunately, O’Connor canceled her procedure twice. The doctors expressed concerns about the biopsy in light of her epilepsy, unsure of what Medi-Cal would cover if her seizures were triggered. Eventually, she was transferred back to Valley Medical Center, where she underwent the biopsy and is now awaiting results. She reported that if cancer is detected, Medi-Cal may not cover more extensive treatments or medications.
The uncertainty surrounding her ability to receive necessary medical procedures has caused her significant distress. “This has me feeling worried and frightened,” she said.
Her medication regimen has also been affected by the new law. Previously, she took three medications for epilepsy, but now only one is covered. Fortunately, that medication is effectively managing her seizures. Additionally, her migraine medication supply has been reduced from a 30-day supply to only 20 pills per month, with a full supply costing $725—a price she cannot afford.
As a result of these challenges, some immigrants have chosen to forgo health care altogether. They are increasingly relying on alternative medicine, being more cautious with their diets, and seeking medical advice online. Some are even traveling to Mexico for medications and care, according to Rojas.
“They’re not taking care of themselves,” Rojas lamented. “It’s definitely heartbreaking to hear these stories.”
Many immigrants are turning to nonprofits like Latinas Contra Cancer for assistance in navigating the complex health care landscape. The organization has seen a surge in calls and now maintains a lengthy waitlist of individuals seeking help.
Health navigators, such as Maria Zeledon, are working to assist patients with insurance renewals, denials, and paperwork, as well as helping them sign up for county insurance if they no longer qualify for Medi-Cal or other marketplace options.
Zeledon noted that some immigrants have not received their paperwork for renewing Medi-Cal benefits, leaving them in limbo. It remains unclear whether this is due to families moving without updating their addresses for safety reasons or if it is a result of clerical errors.
Others are hesitant to take on additional work, fearing it may disqualify them from Medi-Cal. This has forced many to choose between health care, paying rent, or feeding their families. Those with chronic conditions face an especially dire situation, as they cannot afford to be without coverage.
“This is the worst time,” Zeledon told San José Spotlight. “It’s very important for people to understand the role of navigators. They need a lot of help. These services are essential to prevent people from being left completely stranded.”
For more information, contact Joyce Chu at joyce@sanjosespotlight.com or follow her on X at @joyce_speaks.
This article was first published in San José Spotlight.