The newly signed "Big Beautiful Bill" is expected to cut billions of dollars in funding in California for Medi-Cal and CalFresh each year, according to state estimates. More than a million San Diego County residents currently rely on these programs for health care and food assistance.
Changes to MediCal, known outside the state as Medicaid, include more frequent eligibility checks and new work requirements that could push 3.4 million Californians off health coverage, according to state estimates.
“I'm very worried about the effects of this bill on child health. We know Medicaid cuts are going to be huge,” said Dr. Marsha Spitzer, a San Diego pediatrician and past president of the American Academy of Pediatrics Chapter 3..
Spitzer said that reduced access to Medi-Cal will make it harder for children to receive essential health care services.
“We know children are going to have a harder time getting into clinic to be seen for medical care, for urgent care, emergency care, dental care.”
CalFresh, California’s version of the Supplemental Nutrition Assistance Program (SNAP), supports more than 128,000 children in San Diego. The program faces a 30% cut and could force the state to reduce benefits or cover new costs.
Spitzer said hunger can have long-term effects beyond nutrition, especially for children.
“The most obvious. They may not grow as well. They may be shorter, they may be malnourished, they may get sick more often,” Spitzer said. “But I think one of the things we don't think about, too, is what that does to their emotional, developmental and mental health.”
If children lose access to vaccines, she worries about a resurgence of preventable diseases.
“I'm afraid that we're going to go back to a time where we do have to think more about measles, diphtheria, tetanus, whooping cough, hopefully not anything like polio.”
The San Diego County Board of Supervisors has ordered county staff to assess the expected impact of the law in the county by July 22 and to prepare a strategy for responding to the funding cuts by the end of September.
“We're going to have to take some pretty aggressive measures to protect San Diegans from the cuts that are coming,” said Supervisor Tara Lawson-Remer.
Spitzer said part of her job now is helping families understand what these changes mean.
“If they unfortunately lose Medicaid, that pediatricians are still going to see them,” she said.
She said they won’t turn families away.
