ADVOCATES WARN PROPOSED MEDI-CAL CUTS COULD HARM RURAL MATERNITY CARE

Half of all births in rural California are covered by Medicaid; rural hospital closures would impact even moms with private insurance

By Suzanne Potter, California News Service

May 23, 2025 (Sacramento) -- The Republican-controlled House of Representatives is hashing out last-minute details of a huge funding bill which could come to a floor vote this week. Advocates warned proposed Medicaid cuts could force layoffs or closure of rural hospitals.

The Trump administration is looking for savings to fund his proposed tax cuts, which primarily benefit the wealthy.

Joan Alker, executive director of the Georgetown University Center for Children and Families, said rural hospitals are often the only maternity ward for hundreds of miles.

"It doesn't matter who their health insurer is. If they have private insurance, employer insurance, but there's no facility, then they can't safely give birth," Alker pointed out. "That's why these issues are so consequential."

In order to cut the cost of Medicaid, known as Medi-Cal in the Golden State, Republicans are considering drastic cuts to states such as California funding health care for low-income undocumented immigrants. They are also looking at decreasing access by adding work requirements and requiring states to verify eligibility more often.

Alexis Heaton, interim executive director of the nonprofit California Coverage and Health Initiatives, said by some estimates, up to 13 million Californians could lose coverage, a prospect worrying patients and providers who rallied last week in front of Dignity Health Mercy Hospital in Folsom.

"This hospital is potentially going to shut down and lay off, I think they said, up to 2,000 people," Heaton explained. "This is the number one facility that treats folks in El Dorado County that are seeking maternity care."

Eva Rivera, advocacy director of early childhood development at the Children's Partnership, said the cuts would be widely felt.

"In the rural areas of California, half of all births are being covered by Medicaid," Rivera reported. "In California, 27% of women, ages 19 to 44 years old, rely on Medicaid for health insurance. So a good portion of the population is depending on this care."

Rivera added primary care funded by Medi-Cal saves money in the long run because it treats conditions as they develop, which prevents expensive emergency care later on.