This story was first published california healthline.
Six years after he took office vowing to become California’s “.medical governor” Democrat Gavin Newsom will create rules to make health care more accessible and affordable for all Californians, while cutting hundreds of safety net services for the state’s neediest residents. It has allocated billions of dollars in public funds.
More than 1 million Californians living in the United States without authorization are now eligible for Medi-Cal, the state’s version of Medicaid, making California one of the first states to do so. Cover low income people Regardless of residence status. The state is experimenting with Medicaid money to pay for social services such as housing and food assistance, especially for people living on the streets and people with chronic illnesses. And the state is forcing the medical industry to: Control rising costs While being dignified new rules We work with doctors, hospitals, and insurance companies to provide better, more accessible care.
But Newsom has so far failed to fully realize his most sweeping health policy. And many changes are still not visible to the public. Medical expenses continue. risehomeless It’s getting worseand many Californians still struggle to access basic health care.
Now, as Donald Trump returns to the White House, some of Newsom’s signature health initiatives that could shape his profile on the national stage are at risk. National health policy experts say California stands to lose billions in health funding if the Trump administration changes its Medicaid system. as a republican showed Very likely. Such a move could force states to make significant cuts to benefits and eligibility.
And despite funding being provided to allow immigrants without legal status to register for free health services. almost completely Using state funds to make California a political target.
UCLA medical expert Mark Peterson said, referring to the “Make America Great Again” movement, “This is a Republican MAGA that says we’re taking taxes from good Americans and providing health care to immigrants.” It is the fuel that fuels these claims.”
Newsom declined an interview with KFF Health News. In a statement, he acknowledged that much of his work is a work in progress. But even as the governor tries to work with Trump, he has vowed to protect health care policy during his final two years in office.
“We are approaching the next administration with open hands, not closed fists,” Newsom said. “Ensuring that all Californians have access to quality, affordable health care is a top priority of my administration.”
Mark Ghaley, who served as Secretary of Health and Human Services under Newsom, said changing the way health care is paid for and delivered can be difficult. “It wasn’t perfect,” Gurley said. “Implementation is always a pain in a state with 40 million people.”
Speaking ahead of President Trump’s inauguration on January 20, Newsom said: Proposed allocation of $25 million Challenge President Trump on reproductive health care, disaster relief, and other services. His request is pending in the Democratic-controlled state Legislature.
Key initiatives shaping Newsom’s medical legacy include:
medicaid
The possibility of federal cuts looms large in America’s most populous state. How California spends $261 billion Nearly $116 billion flows from the federal government to health and social services each year. Most of that goes to Medicaid. 1 in 3 Californians. Republican leaders in Washington have proposed the following ideas: patella medicaidbenefits may be reduced or enrollment may decline.
Additionally, California is expanding Medi-Cal to the following areas: 1.5 million Immigrants without legal status are expected to cost the state about $6.4 billion in the fiscal year that ends June 30. Newsom indicated in early December that the state would continue to fund expanded health care for immigrants in the next budget year. refused to say Whether he will maintain his coverage in the future.
Advocacy groups stand ready to defend these benefits if President Trump targets California on this issue. “We continue to protect access to health care and we don’t want to go backwards,” said California Health Access Interim Executive Director Amanda McAllister Wallner.
generic drugs
Due to the high cost of prescription drugs, Newsom in 2022 plowed 100 million dollars It was incorporated into his plan to produce generic insulin for California. Launch state manufacturing plant Manufactures various generic drugs. Three years later, California has done neither. But Newsom did announce the contract In April, the state made bulk purchases of the opioid recovery drug naloxone available to schools, clinics and other institutions. discount.
“It’s certainly disappointing that there hasn’t been more progress,” said the paper’s author, former state Sen. Richard Pan. Unique generic drug law.
Regarding generic insulin, Newsom said, “While we acknowledge that insulin is taking longer to get to market than we would have liked, we are committed to providing 30% insulin to everyone who needs it as quickly as possible.” “We remain committed to delivering insulin at an affordable price.”
abortion
The Governor was instrumental in making the 2022 campaign a success. Enshrining access to abortion In the state constitution. he signed laws that ensured abortion and miscarriage not criminalized and allow out-of-state doctor Performing abortions in California. built a stockpile of abortion pill When mifepristone faced a national ban. and set aside $20 million to help Californians People who cannot afford to access abortion care.
Mr. Newsom has also made reproductive rights a central idea of his political agenda. funded advertising And he has traveled the country attacking Trump and other Republicans in red states who have rolled back access to abortion.
After Trump won the election, Newsom called a special session of Congress to prepare for a potential legal battle with the federal government. He told KFF Health News that the state is preparing “in every way possible to uphold the rights guaranteed by the California Constitution and ensure bodily autonomy for all people in our state.” spoke.
Rising medical costs
In 2022, Newsom Medical Expenses Affordability Bureau Set limits on health care spending and impose penalties on industry payers and health care providers that fail to meet targets. By 2029, California plans to limit annual price hikes for health insurance companies, doctors and hospitals to 3%.
President Trump has expressed concern about the steadily rising cost of health care nationwide and the quality of care Americans are receiving, but his ideas are focused on deregulation and deregulation. Replacement for the Affordable Care Actexperts say it can be costly health insurance for millions of people and increase patient medical spending. California could lose federal aid that has helped it in the past. offset insurance premiums In most cases, approximately 1.8 million People who purchase health insurance from California’s ACA marketplace, Covered California, will increase out-of-pocket costs for patients.
The state can use funds collected from own health insurance fines For the uninsured, Newsom adopted Obamacare’s individual mandate after Congress repealed it in 2017. The revenue of these states is $298 million this fiscal yearaccording to the state Department of Treasury. This represents a portion of the federal health insurance subsidies that California receives–approximately $1.7 billion annually.
health and homelessness
Under Newsom, California spent an unprecedented amount of public money He has made progress in tackling homelessness, but the crisis has worsened under his watch.
From 2019, when Newsom took office, to 2023, the number of homeless people jumped 20%. Over 181,000Despite spending more than $20 billion to take people off the streets, including converting hotels and motels into hotels. homeless housing. He also pumped about $12 billion into CalAIM. experimental efforts to Infusing Medi-Cal with social servicesincluding rental and eviction assistance.
a state audit Last year, it was discovered that the state was not doing a good job of tracking the effectiveness of taxpayer money. CalAIM is not serving as many Californians as expected, and patients face difficulty accessing treatment new benefits From your health insurance company.
“The crisis of homelessness on our streets is unacceptable,” Newsom acknowledged. “But we are starting to see progress.”
Experts expect the Trump administration to reverse liberal policies that have allowed Medicaid funds to be used for medical experiments through waivers. encouraged by the Biden administration. Notably, Trump attacked Newsom for his handling of the homelessness crisis and vowed to respond more forcefully. move people off the street. California’s CalAIM exemption ends at the end of 2026.
For example, instead of expanding housing assistance and food assistance, states cut off CalAIM benefits; more restrictive Medicaid.
Mental health and substance use
Newsom launched the most extensive overhaul of California’s behavioral health system in decades, directing billions of dollars in state funding to a new network of treatment facilities and prevention programs.
His two most controversial signature efforts were; Suggestion 1 and care coatfunnels funding to treatment and housing for Californians with behavioral health conditions, especially at-risk and homeless people. And CARE courts allow judges to compel treatment for people suffering from debilitating mental illness or drug use.
Both are stalled by funding issues, implementation is dependent on counties, and both could take years to see significant results. While Newsom aims to expand community-based treatment, Trump has promised a return to institutions, calling for moving homeless people and people with severe behavioral health conditions into “facilities.” suggested.Cheap land on vast land”
Newsom said he hopes his “innovative” approach will transform behavioral health care “with a focus on people with the most serious illnesses and substance use disorders.”
KFF Health News is a national newsroom that produces in-depth journalism on health issues and is one of KFF’s core operating programs and an independent source of health policy research, polling, and journalism.
