Federal and state Medi-Cal cuts are expected to put a strain on the county’s health care system.

With nearly 45 percent of Monterey County’s residents – just under 195,000 people – receiving Medi-Cal, California’s version of Medicaid, the impending cuts to the nation’s health safety net will impact not just those whose benefits are decreased or cut, but the entire community, according to local health officials. They predict increased health problems and lowered clinic and hospital revenues that could strain an already stressed health care system and decrease access for all residents.

President Donald Trump’s One Big Beautiful Bill passed in the Senate with a razor-thin margin of one vote on Tuesday, July 1, before heading back to the House of Representatives for a final vote, after the Weekly’s deadline. If passed, it could mean approximately 16 million people nationwide – 1.7 million in California – will lose access to Medicaid by 2034, according to analysis by the independent health policy organization KFF.

Monterey County officials are expecting between 17 to 25 percent of Medi-Cal recipients – approximately 33,000 to 45,000 people – will be impacted by cuts at the federal and state levels, says Prashant Shinde, the County of Monterey’s clinic services director.

It has Michael Schrader, CEO of the Central California Alliance for Health, the Medi-Cal provider for Monterey, Santa Cruz, San Benito and Merced counties, worried.

“Those folks who lose their coverage, who aren’t able to get coverage, they’re going to go to the emergency rooms,” the most expensive form of care, Schrader says.

Additional strain could be put on federally qualified health centers, he says, like the 12 County of Monterey clinics led by Shinde, which serve over 42,000 families a year, as well as the nonprofit Clinica de Salud based in Salinas. As FQHCs, they cannot deny service to anyone including those with no insurance coverage.

Less Medi-Cal patients also means less revenue for the clinics. Shinde says county officials are projecting a $5 million to $7 million decrease in revenue, “a significant chunk” of their $65 million annual budget.

The community at large could be impacted, as people forgo preventative care, including vaccines, cancer screenings, wellness exams and testing for sexually transmitted diseases.

On June 27, the California Legislature passed the 2025-2026 budget, which includes a freeze on new enrollment for undocumented residents beginning Jan. 1, 2026.

Full-scope dental benefits will end for undocumented adults beginning in July 2026. In July 2027 the state will impose a premium of $30 a month per household member for undocumented immigrants between the ages of 19 to 59.

Schrader calls the state cuts “bad,” but says “it will get worse,” with possible federal cuts, which would be rolled out over a four-year period beginning next year. They include a work requirement for individuals, as well as restrictions on state-levied taxes on hospitals, a decades-long program that translated into increased Medicaid reimbursements for the hospitals, a significant form of revenue, according to Schrader.

Rural hospitals such as Mee Memorial could be at risk of closing due to the cuts. A $25 billion fund to aid such hospitals was inserted into the federal bill to persuade senators who were on the fence.