As Congress advances budget reconciliation legislation, the California Medical Association (CMA) is urging California’s congressional delegation to reject the devastating Medicaid cuts that will undermine the health and economic stability of California communities, and harm access to care for generations to come.

In a June 23 letter sent to all California Members of Congress, CMA President Shannon Udovic-Constant, M.D., warned that the proposals in HR 1 and the Senate Finance Committee’s companion legislation would cause catastrophic coverage losses for millions of residents.

“As physicians, we are sounding the alarm: Californians will die if this bill is enacted,” Dr. Udovic-Constant wrote.

These bills reverse decades of progress we have made in California to cover the uninsured and improve and expand access to care. An unprecedented 16 million Americans, and 2-3 million Californians, are projected to lose their health care coverage under these proposals. The Senate plan increases the Medicaid cuts by nearly $200 billion over the House cuts – reaching more than $900 billion in overall Medicaid cuts

Among the key concerns highlighted in CMA’s letter:

• Massive Medicaid Cuts: The Senate bill proposes nearly $1 trillion in Medicaid cuts, including slashing provider taxes and state-directed payments that fund California’s Medi-Cal program. CMA warns these provisions would force closures of hospitals, clinics and physician practices across the state.
• Loss of Coverage for Millions: The Congressional Budget Office estimates that 16 million Americans—including up to 3 million Californians—could lose coverage under the proposed changes to Medicaid and the Affordable Care Act.
• Threats to Rural Health Care: Rural hospitals and providers, already struggling with staff shortages and financial strain, would be hardest hit. The University of California estimates that more than 200,000 California health care jobs could be lost.
• Elimination of Medicaid Expansion: The proposed bills would effectively end Medicaid expansion in 41 states, including California, stripping coverage from low-income working adults and increasing disparities in health outcomes.
• Burdensome Work Requirements: CMA strongly opposes administrative red tape that would kick millions of eligible Medicaid recipients off coverage due to punitive work verification rules.
• Cuts to ACA Subsidies: Without action from Congress, ACA premium tax credits are set to expire, threatening affordability for more than 660,000 Californians enrolled through Covered California.
• Student Loan Program Rollbacks: The proposed cap on federal student loans and elimination of Public Service Loan Forgiveness (PSLF) eligibility during medical residency would worsen physician shortages, especially in underserved areas.
• Failure to Address Medicare Payment: CMA called on Congress to reverse the 2.8% Medicare physician payment cut and provide inflationary updates to ensure seniors retain access to care.

CMA urges lawmakers to reject these proposals and work collaboratively on health care reforms that preserve access, equity, and sustainability.

“Californians are proud to have one of the lowest uninsured rates in our history and in the nation,” the letter concludes. “The physicians of California urge you to protect these important advances by rejecting the draconian Medicaid cuts and the student loan cutbacks, extending the ACA premium tax credits, and addressing the failure to improve Medicare physician payment.”

Read the letter here.