Contra Costa County patients could suffer if federal healthcare funding is cut

A previous version of this story incorrectly referred to LifeLong as a private facility. It is a 501 (c) 3 nonprofit.

Local officials who’ve been following the federal budget process say proposed cuts to programs such as Medicaid could threaten patient care and disrupt the west Contra Costa County healthcare ecosystem. 

“Health and social services are heavily reliant on federal funding,” said Contra Costa County Supervisor John Gioia, who represents Richmond. “Without it, the social safety net would fall apart. Those lives will be severely impacted.”

Earlier this month, the U.S. House of Representatives narrowly approved a budget plan that opponents say will significantly reduce Medicaid and other programs that pay for healthcare services.

The latest plan follows a budget resolution approved in February by House Republicans that called for $1.5 trillion in federal spending cuts over the next 10 years.

That House budget plan directed the Energy and Commerce Committee, which oversees Medicaid, Medicare and other health-related funding programs, to cut $880 billion over the next decade. 

The Congressional Budget Office reports that it will be difficult to reduce the budget that much without cuts to Medicare, Medicaid and/or the Children’s Health Insurance Program (CHIP), three programs that serve about 80 million people in the United States.

President Donald Trump has said he won’t cut Medicare, the program that provides health insurance for people 65 and older. However, Medicaid, which oversees many safety-net healthcare programs for lower-income households, could be up for cuts.

LifeLong Medical vows to advocate to protect patient services

Dozens of programs in Contra Costa County receive federal funding — from foster care to law enforcement to broadband infrastructure to transportation to agriculture.

Two-thirds of the Contra Costa Health Department’s nearly $3 billion annual budget is state-funded, with the federal government contributing about $223 million annually.

County health officials declined Richmondside’s requests to be interviewed for this story. However, others say they’re concerned about the impacts of these proposed budget cuts.

State Sen. Jesse Arreguin, whose district includes Richmond, estimates that a third of healthcare services in the state get funding from Medi-Cal, which administers California’s Medicaid program. To illustrate its impact: The program pays for the labor and delivery costs of half of the state’s annual births. Nationwide, about 5-in-8 people in nursing homes have their bills covered by Medicaid.

“A lot of people rely on Medi-Cal,” Arreguin said. “The cuts would have a terrible impact on healthcare and safety in our region. I’m very concerned.”

Among the providers that could be the most harshly impacted are Contra Costa County’s 11 public health clinics. The West County Health Center in San Pablo serves almost 32,000 people annually with a total of 115,000 patient visits, making it the second busiest county clinic behind the Pittsburg Health Center. 

Those clinics as well as facilities such as LifeLong Medical Care’s Richmond facilities and the RotaCare West Contra Costa clinic in San Pablo rely on reimbursements from Medicare and Medi-Cal so they can offer free or reduced-cost services.

LifeLong operates 20 health centers in six cities: Oakland, Berkeley, Richmond, San Pablo, Pinole and Rodeo.

In Richmond, LifeLong has the William Jenkins Health Center, the Williams Jenkins Immediate/Urgent Care Center and William Jenkins Dental Care. All are in the LifeLong medical complex at Harbour Way and Bissell Avenue in downtown Richmond.

LifeLong reports it served more than 55,000 patients in fiscal year 2024 at its 20 centers. About a third of those patients live in the Richmond area.

LifeLong officials say that about 65% of their patients were covered by Medi-Cal. In addition, they said 90% of patients had household incomes at or below the federal poverty level, which last year was $15,060 for individuals and $31,200 for a family of four.

Of LifeLong’s annual $132 million budget, about $85 million comes from patient services revenue, of which about $67 million is associated with Medicaid. Another $36 million is from grants and contributions, of which about $19 million is from federal sources.

LifeLong officials told Richmondside that they would continue to care for their patients no matter what happens politically.

“It is too soon to determine any potential impacts on funding. At this time, our focus remains firmly on delivering high-quality, comprehensive care to the more than 50,000 patients we serve each year across Contra Costa and Alameda counties,” Lifelong officials said in a statement. 

“No matter what lies ahead, our mission is unwavering. LifeLong will continue to provide care to all, regardless of ability to pay, and to advocate alongside our partners to protect access to the services our communities rely on,” they added.

Gioia and Arreguin both say the federal funding cuts will be felt at individual levels as well as at the clinical level.

They say healthcare providers will need to either reduce the number of patients they serve and/or reduce the services they provide.

“People will have to make decisions on when to go to see a doctor,” Arreguin said.

Cuts could have ripple effects at medical centers not reliant on federal dollars

Any reductions could also be felt at facilities that aren’t as reliant on federal money. That’s because people may skip preventive medical visits or routine check-ups, leading to worsening illnesses that force them to seek emergency care. And since Richmond’s only ER is a Kaiser facility, members of that healthcare provider could see longer wait times.

Kaiser officials declined a request to be interviewed, but others say the company will definitely feel the impact of federal healthcare budget cuts.

“Kaiser is not going to be able to handle this big influx of patients,” said Arreguin.

The RYSE Center in Richmond, which has a small free healthcare clinic for youths and young adults up to age 21, is in a similar position.

The nonprofit organization’s Health Justice Center receives only a small amount of state and federal funding, but RYSE officials say federal budget cuts could lead to an increased demand for their services.

“We do expect that if our partners across the health ecosystems have to reduce programs, we will see increases in both the number of people and the severity of crises they are navigating. And given that there are already extreme shortages (of care) for youth and young adults in areas like psychiatric care and housing, we are very concerned about what this will mean for families,” said Lana Tilley, RYSE development director.

In addition, Kaiser and other private medical providers also may not get reimbursed by Medi-Cal or Medicare for any services they step up to give. That could result in higher premiums or deductibles for members.

Gioia and Arreguin also point out that people who don’t get proper medical care also tend to spread illnesses throughout the community. They said that phenomenon was observed during the COVID pandemic.

“This affects the health and safety of everyone,” said Arreguin.

“When individuals get sick, the whole community gets sicker,” Gioia said.

One person who knows what it’s like to worry about healthcare is Marilyn Hertzberg, a retiree who has lived in Richmond for nearly 30 years.

Hertzberg initially pursued a career in the medical field but ended up owning a crafts business. For most of her working life, she didn’t have health insurance because she couldn’t afford it.

“I just prayed to God that nothing would happen,” she said. “I lived for years without insurance. It’s frightening. I was really lucky.”

Hertzberg is now covered by a Medicare Advantage plan, so she’s not worried about her health coverage being cut. However, she is concerned about people who don’t have sufficient insurance and can’t afford to pay for uncovered medical expenses.

She also says Richmond is becoming a “medical desert,” with residents having to travel farther away to receive specialized treatment.

“A lot of people are going to be in trouble,” Hertzberg said. “Healthcare should be a right, but that doesn’t mean it is a right.”