Budget cuts to Medi-Cal are threatening the fabric of Silicon Valley’s health care system — and immigrants are among the hardest hit populations.
Some immigrants have experienced delays in services, medication cuts, difficulties navigating the new health care landscape and uncertainties about available services. Others have dropped coverage completely for fear of having their information exposed to the federal government. They are increasingly relying on mobile clinics, nonprofits, county programs and alternative medicine to get by, according to sources familiar with the issue.
Samantha Rojas, lead patient organizer with nonprofit Latinas Contra Cancer, said county hospitals and clinics are at risk of closing, which would overwhelm emergency rooms, increase patient wait times and strain the entire medical system. This is the result of H.R. 1, federal legislation that cut funding to Medicaid, known in California as Medi-Cal.
“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 slashes funding for Medicaid by $1 trillion over the next decade, lowering reimbursement rates for providers and undercutting access to services for the region’s poorest. California expanded the state’s Medicaid program in 2024 to provide health care for all low-income residents, including undocumented people. However, it stopped accepting new undocumented enrollments at the beginning of the year. Other changes have begun to take effect, including limits on reimbursements for specific medications such as GLP-1 weight loss drugs.
In Santa Clara County, officials are looking at a $470 million deficit in the upcoming fiscal year due to federal budget cuts. Hospitals have experienced staffing shortages as dozens of nurses have been furloughed.
One immigrant, who asked not to be identified due to fears of immigration enforcement, said she needed a biopsy to check for bladder cancer. She was being seen by doctors at Valley Medical Center, but was transferred to O’Connor Hospital due to there being no availability, she told San José Spotlight in Spanish through a translator.
O’Connor canceled the procedure twice. She said doctors were worried about the biopsy given her epilepsy, and weren’t sure what Medi-Cal would cover if her seizures were triggered. She was transferred back to Valley Medical Center, where she underwent the biopsy and is awaiting results. Doctors told her if she is found to have cancer, Medi-Cal may not cover more extensive treatments or medications, she said.
The uncertainty of whether she would be able to receive the necessary medical procedures has caused her distress, she said.
“This has me feeling worried and frightened,” she said.
Her medications have also been impacted by the new law. She used to take three medications for epilepsy, but now only one is covered. Thankfully, that medication is keeping her seizures at bay, she said. Another change involved her migraine medication. Instead of a 30-day supply of pills, she is only covered for 20 per month. A 30-day supply would cost $725, a price she can’t afford.
Some immigrants have chosen to forgo health care altogether. They’ve taken to relying on alternative medicine, being more careful with their diets and turning to the internet for answers on how to handle medical situations. Some are even seeking medications and care in Mexico, Rojas said.
“They’re not taking care of themselves,” Rojas said. “It’s definitely heartbreaking to hear these stories.”
Immigrants are increasingly relying on nonprofits like Latinas Contra Cancer to find solutions for medical care. The organization has been receiving an influx of calls, and has a long waitlist of people seeking answers.
Health navigators such as Maria Zeledon help patients navigate insurance renewals and denials, fill out paperwork and sign up for insurance through the county if they no longer qualify for Medi-Cal or other marketplace insurance.
Zeledon said some immigrants were not receiving their paperwork to renew their Medi-Cal benefits through the mail. It’s unclear if it was due to families moving and not updating their addresses to protect themselves, or clerical errors.
Others are mindful of not taking on more work, which could bump them out of qualifying for Medi-Cal. It’s left them choosing between health care, paying rent or feeding their families. Those who suffer from chronic conditions don’t have the option of not having coverage, Zeledon said.
“This is the worst time,” Zeledon told San José Spotlight. “It’s very important (people) understand the importance of navigators. People need a lot of help. The services (are) essential to prevent people from being left completely stranded.”
Contact Joyce Chu at joyce@sanjosespotlight.com or @joyce_speaks on X.
]\This article was first published in San Jose Spotlight.