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Bryce Montgomery

Healthcare in Crisis: 5 Takeaways from Santa Clara County Medicaid Townhall Series

On a hot, summer Thursday evening at Regional Medical Center’s cafeteria, over 100 community members jammed the room with one shared mission: to learn how HR 1, or the ‘Big, Beautiful  HORRIBLE Bill,’ will affect residents of Santa Clara County, especially those who rely on Medicaid to access healthcare?  County Leadership, County Executive James Williams and County Board Supervisor Betty Duong, made one thing evidently and abundantly clear — the passage of this federal budget has pushed our Public Healthcare system into crisis. 

We are all going to be affected no matter what. However, County leaders, and community based organizations, including Working Partnerships USA, are committed to strengthening our county health system and organizing to protect our healthcare from Billionaire tax breaks.

5 takeaways from the townhalls

  1. The reckless cuts to Medicaid/Medi-Cal endanger our County’s public healthcare system — but Santa Clara County is working hard to ensure everyone receives the care they need, and as citizens, we have a voice. 

Santa Clara County receives $3.7 billion in funding from the federal government, representing 30% of the County’s budget. With the passage of HR 1, the County is anticipating difficult conversations about how to mitigate this ginormous and unprecedented gap in funding. Medicaid, or known as Medi-Cal in California, is the largest source of federal revenue for Santa Clara County. As County Executive James Williams put it, “Medicaid is not a line item. It is a lifeline. It supports critical health care services that benefit everyone in our community.” 

1 in every 4 residents in Santa Clara County are Medi-Cal enrollees, meaning that 25% of Santa Clara County residents will lose healthcare insurance and will resort to only going to hospital emergency room visits rather than ongoing preventative care. The public healthcare system will continuously provide care to residents, but this care will be unpaid for – resulting in tremendous amounts of debt and funding gaps for the county and its residents. 

  1. Enroll in Medi-Cal before January 1, 2026 or enroll in the Primary Care Access Program (PCAP) 

HR 1 is also forcing state governments to foot more of the bill for healthcare. California is preparing for these cuts by freezing enrollment for Medi-Cal on January 1, 2026. Determine if you are eligible on Covered California’s website and learn how to apply on the CA’s Department of Healthcare Services’ website. However, California and other states that have expanded Medicaid to undocumented patients reported being forced to hand over patient information to the federal government and the Department of Homeland Security (AP News). Only enroll if you believe it is the best fit for you and your family. 

Santa Clara County also has the Primary Care Access Program (PCAP), a local low-cost healthcare insurance program for adults living in Santa Clara County. PCAP covers primary care, preventative care, pharmacy services, and some screening and diagnostic services. The program also covers emergency room visits at any of the County of Santa Clara hospitals including Regional Medical Center, Valley Medical Center, O’Connor Hospital, and St. Louise Regional Hospital. 

  1. Cuts will hit in 2026

Cuts to healthcare access with Medicaid and subsidized groceries from SNAP will be taking into effect in 2026 as reported by the The New York Times.

Cuts will occur by forcing patients to undergo laborious re-enrollments and qualifying with work requirements. Medicaid work requirements that are going to take into effect on December 31, 2026 for most states, mandating that adults with children 14 or older must obtain work in order to qualify for aid. These changes are expected to increase premium’s prices, reduce enrollment, and cause insurers to withdraw from the market, making healthcare access inaccessible for many residents. 

Additionally, Supplemental Nutrition Assistance Program (SNAP) or food stamp funding changes are also set to change starting in 2028. Similar to Medicaid’s work requirements, adults receiving SNAP benefits will also be required to work in exchange for assistance. These changes can create barriers to healthcare and food assistance, particularly for individuals with disabilities, insecure employment, and caregivers. 

  1. EVERYONE will feel cuts – even those not on Medicaid 

As the arduous paperwork for Medicaid benefits begin, the healthcare costs and ER ambulance wait times will go up. Residents will resort to only using the healthcare system when absolutely necessary, driving patients away from continuous ongoing care to one-time emergency room visits. Co-pays and hospital costs for everyone, even those with private healthcare insurance, will go up as companies and healthcare providers scramble to balance their budgets.

HR 1 exacerbates the already inequitable and health outcomes poor communities of color already face. Those most directly impacted by HR 1 the most are our low-income families. Mounting medical debt will drive patients into even deeper poverty and cuts to food assistance programs will lead to poorer health outcomes. Overall, this bill is exacerbating health inequity that already is pervasive in Santa Clara County and beyond. 

  1. The County committed to the Defend our Care’s Demands: 

The Defend our Care campaign asked the county at the end of their presentation to commit to five demands that will ensure transparency throughout the process of navigating these cuts. County leadership agreed to:

  1. Commit to Regular, Community-Based Public Forums on Healthcare Cuts and System Decisions
  2. Commit to Transparent Communication Through One County, One Future
  3. Partner with Community in State and Federal Advocacy
  4. Apply Equity Principles to Every Healthcare Budget Decision
  5. Commit to an Ongoing Partnership with Community in Reimagining Healthcare on the East Side

The fight for healthcare access is not over, we are compiling stories of patients who rely on Medi-Cal for their healthcare insurance. These stories will be used to continue to fight for healthcare access for everyone in California. Join our campaign to Defend our Care.

Additional Resources: 

Federal Funding and the County’s Budget | County of Santa Clara | County of Santa Clara (we are updating this page given the passage of H.R. 1 and the passage of the County’s budget)

A big win for fast food workers in Santa Clara County

 On April 8, thanks to the tireless efforts of fast food workers and the unwavering support of allies like you, the Santa Clara County Board of Supervisors took a critical step toward advancing Know Your Rights training for fast food workers in the county! This unanimous decision brings us closer to ensuring that every fast food cook and cashier knows their rights—from paid sick leave and family leave to protections against discrimination and wage theft. 

This victory didn’t happen by accident. It happened because workers refused to back down. From walkouts and strikes across the county to speaking out against unsafe conditions and injustice, fast food workers in Santa Clara County have shown incredible courage and persistence.

It happened because allies like you took action, from sending in letters of support to County leadership to giving public comment at the meeting.

Lastly, it happened thanks to the bold leadership of County Supervisors Betty Doung and Susan Ellenberg, who spearheaded the effort, despite pressure from industry lobbyists who wanted to keep workers in the dark about their rights. 

This isn’t just a win for workers’ rights—it’s a powerful step forward for immigrant rights and reproductive justice, at a time when these fundamental freedoms are under attack and far from guaranteed. Let’s keep the momentum going! 

HCA Healthcare Forced to Acknowledge Community Demands Ahead of Good Samaritan Hospital Expansion Permit

The creation of a Community Advocacy Committee and a payment of $3 million to City of San Jose is a first step towards community accountability

The Rescue Our Medical Care Coalition achieved a pivotal first step in holding HCA Healthcare accountable after the San Jose City Council approved the hospital’s rezoning request, contingent on a $3 million voluntary donation and the establishment of a Community Advisory Committee (CAC) – the first such committee for an HCA Healthcare facility in the region, signaling the beginning of a broader community engagement process.

While HCA was allowed to proceed with their rezoning, they were grilled on their decision to close mental health beds and shutter services across the county. The donation and Community Advisory Committee (CAC) are the direct result of months of persistent community organizing that began when HCA initially closed psychiatric beds at Good Samaritan Hospital in June 2023, and ramped up when HCA Healthcare downgraded  trauma, stroke, and heart attack services at Regional Medical Center in August of 2024.

The Community Advisory Committee (CAC), in particular, is a groundbreaking achievement for local healthcare accountability. HCA Healthcare is a multi-billion dollar corporation that has repeatedly demonstrated it’s more accountable to shareholders than to patients. This Community Advisory Council, the first such committee for an HCA Healthcare facility in the region, creates a mechanism for meaningful community engagement and ensures local voices will have a direct opportunity to influence decision-making.

The $3 million contribution, split between interim and permanent housing, represents a modest acknowledgment of the systemic harm HCA Healthcare has inflicted on the regional healthcare infrastructure through its pattern of service reduction.  As Council Member Peter Ortiz explained ahead of the vote, HCA has created a two-tiered healthcare system in San Jose. The very services now being praised as life-saving were systematically eliminated from the East Side’s Regional Medical Center. The maternity ward, STEMI center, and other critical services have been stripped away over the past four years.

HCA also continues to challenge the county, currently suing Santa Clara County for $130 million in public subsidy reimbursements. As coalition member Darcie Green, these $130 million could have funded mental health services at Good Samaritan Hospital for the next decade – services HCA unilaterally cut.

While this represents a step forward, the Rescue Our Medical Care Coalition is more resolute than ever. This is not the end of our fight — we will continue to shine a light on HCA’s practices, demand accountability, and work tirelessly to ensure that healthcare in Santa Clara County serves the community first, not corporate bottom lines.

HCA Healthcare Pushes for Good Samaritan Expansion While Gutting Mental Health Services in a Crisis

Representatives from the Rescue Our Medical Care Coalition, joined by District 9 Council Member Pam Foley, met today with Good Samaritan Hospital’s CEO to address concerns over HCA Healthcare’s proposed facility expansion amid ongoing service reductions across San José. The Coalition presented clear demands to hospital leadership, focusing on two critical priorities: the restoration of acute psychiatric beds and the establishment of a patient protection fund to safeguard healthcare access for all San José residents. 

HCA Healthcare made no commitments to restore mental health services or invest in a patient protection or community benefits package.  “It’s evident that HCA’s actions will worsen the city’s mental health crisis. The real question is, will the City Council let that happen?” said Darcie Green who attended the meeting with other coalition partners.  “San Jose and Mayor Matt Mahan will never be able to end encampments without offering these critical services, and it’s up to the City Council to step in and stop this.”

Good Samaritan Hospital, owned by HCA Healthcare, has faced mounting criticism for decisions that have reduced critical mental healthcare access in the County, which is currently experiencing a mental health and substance abuse crisis. The meeting follows the San José Planning Commission’s recent 7-1 vote recommending the rejection of HCA Healthcare’s land use plans, highlighting the urgent need for binding commitments to protect community healthcare services. The meeting’s timing is particularly crucial, coming just days before the San José City Council is set to vote on HCA Healthcare’s expansion plans on November 19, 2024.

The Planning Commission’s strong stance, combined with the upcoming City Council vote, has created heightened pressure for HCA to address community concerns about mental health service restoration and healthcare accessibility.  

Before the meeting, patients, mental health advocates, and community members from the Rescue Our Medical Care Coalition rallied in front of San José City Hall. The Coalition supports critical upgrades that would keep staff and patients safe without disrupting services. However, HCA is delaying these improvements by avoiding accountability and pushing forward with a plan that disrupts healthcare access for San José residents and undermines the city’s General Plan. Despite being behind schedule, HCA is prioritizing a $1.2 billion expansion of Good Samaritan Hospital while abandoning critical mental health services that once served thousands of local residents.

“Let’s set the record straight: It’s not this Coalition or community advocates slowing down the process for Good Samaritan’s zoning. The real delay comes from Good Samaritan’s own incompetence and refusal to engage in this process in good faith. That is why we are here today—to demand a Patient Protection Fund and the restoration of mental health services at Good Samaritan Hospital,” said João Paolo, Organizing Director of Working Partnerships USA.

“HCA Healthcare, the parent company of Good Samaritan, has consistently put our community’s care in jeopardy, cutting essential services at the expense of the entire community. The City Planning Commission made it clear when they rejected HCA’s proposal…Now, the City Council has the opportunity to ensure that HCA finally does right by our communities and starts to rebuild the trust they once had,” said Council Member Peter Ortiz who urged his fellow council members to defer consideration of this project.

“HCA Healthcare removed a large number of beds from availability when we were already facing a shortage. I’m asking the San Jose City Council not to hand HCA an open check to keep bleeding our services and stripping off the profit. The issue isn’t with Good Samaritan Hospital expanding; it’s that they’ve upset the balance and aren’t giving back to the community they serve,” said Karen Deloumi, Board Member, NAMI (National Alliance for Mental Illness).

“Every time HCA shutters essential services, it’s the local government and the community that step in to pick up the pieces and save lives—at the expense of taxpayers. That’s why we need a Patient Protection Fund controlled by the community, to ensure HCA is held accountable and to safeguard against future harm,” said Darcie Green, Executive Director of Latinas Contra Cancer.

Santa Clara County to reclaim Regional Medical Center: But there is still work to be done

Today, our community has achieved a monumental victory. The decision by Santa Clara County to take over Regional Medical Center and keep its doors open is a step in the right direction to reclaim healthcare, not just for the Eastside — but for every resident across Santa Clara County.

This is what happens when our local government truly listens to its people and prioritizes care, inclusion, and the well-being of all.

The decision to acquire RMC and restore the trauma center, stroke services and the maternity ward that was shuttered in 2020 delivers a blow to private corporations that have hijacked our health systems across the country for their own profits —  especially targeting communities of color and working-class neighborhoods like ours.  But today, we’ve shown them that we are not to be underestimated. When we come together, we can protect our lives, our health, and our future. 

But there is still work to be done — we need to keep organizing to ensure that the Board of Supervisors and HCA Healthcare reach an agreement swiftly, and in alignment with what patients, doctors and medical workers need.

Maria Noel of Fernandez, Executive Director of Working Partnerships said, “We are grateful to the County for stepping up when others failed to and our work is not done until HCA works with the County, alongside the community and labor partners to restore services and rebuild community trust on the Eastside.”

“I am proud to live in a community where we stand united for health justice and equity, fighting for everyone’s right to a healthy future. Thanks to our County’s bold leadership, we are reclaiming our healthcare and safeguarding our community. But our work is not over. HCA caused harm and we must continue to hold HCA accountable for the damage they’ve caused and demand for repair and a significant commitment to justice and equity for the residents of East San Jose,” says Darcie Green, Executive Director of Latinas Contra Cancer. 

Victory: California Supreme Court Strikes Down “Taxpayer Deception Act” Initiative

Court decision safeguards crucial funding and upholds voter power against corporate influence

This morning, the California Supreme Court issued a unanimous decision ruling the “Taxpayer Protection and Government Accountability Act” initiative cannot be included on the November 2024 ballot.  

Working Partnerships USA Executive Director, Maria Noel Fernandez, emphasizes, “In striking down the unconstitutional Taxpayer Deception Act, the California Supreme Court has boldly confronted corporate influence and defended our communities. This victory not only preserves billions in critical funding for schools, reproductive healthcare, and paid family leave but also underscores the power of voters in our state. We know that the same corporate interests aligned on this measure are also moving to roll back other wins — including life-changing criminal justice reform and critical environmental and health regulations. We stand alongside our diverse local coalition of elected representatives, community and labor leaders, workers and residents of Santa Clara County, as well as our legislative champions and regional partners, ready to protect our progress and defend against any future assaults on our safety and well-being, and democratic principles.”

The court’s decision was based on recognizing that the “Taxpayer Protection and Government Accountability Act” initiative posed a serious threat to our community’s ability to fund essential services without unnecessary hurdles. By requiring voter approval for tax increases already approved by elected officials, this measure would have tied the hands of local leaders in responding to our community’s needs promptly. The court rightly saw this as a major overhaul (a revision) of our state’s governance structure rather than a simple tweak (an amendment). They emphasized the importance of following the strict procedures outlined in Article XVIII of the California Constitution for making such profound changes. This ensures that any proposals with significant implications for governance undergo thorough scrutiny and respect the democratic processes designed to protect the interests of all Californians.

This is a huge victory against a handful of big real estate developers and corporations who want to illegally change our Constitution and shift taxes to working people so they can continue to profit and enrich themselves. We’re grateful for our fierce coalition of community and labor leaders, local city and county representatives and residents who have been advocating against this deceptive and unconstitutional measure alongside us.