{"id":18,"date":"2026-05-22T17:21:16","date_gmt":"2026-05-22T17:21:16","guid":{"rendered":"https:\/\/frontierhousingreport.com\/?p=18"},"modified":"2026-05-22T17:21:16","modified_gmt":"2026-05-22T17:21:16","slug":"the-real-stakes-behind-californias-billionaire-tax-fight-health-care-access","status":"publish","type":"post","link":"https:\/\/frontierhousingreport.com\/?p=18","title":{"rendered":"The Real Stakes Behind California\u2019s Billionaire Tax Fight: Health Care Access"},"content":{"rendered":"
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This article was produced by Capital & Main, an award-winning publication that reports from California on economic, political, and social issues. It is co-published here with permission.<\/em><\/p>\n

Read more How Israel Got This Way<\/a><\/p>\n

Just as California\u2019s billionaires would prefer, the public conversation around a proposed one-time tax on a fraction of their immense wealth has become centered on a single threat: They\u2019ll leave and take their money with them if the tax passes.<\/p>\n

It\u2019s a wild notion unsupported by history, but you can expect to hear more about it all the way to the Nov. 3 general election. That is partly because the billionaires themselves are spending huge in an effort to defeat the measure\u2014with some of the largest contributions coming from those, like Google co-founder Sergey Brin, who claim they\u2019ve already fled the state.<\/p>\n

More from Capital & Main<\/em><\/strong><\/p>\n

But there is another piece of the conversation that consistently isn\u2019t getting enough attention here. It is the question of what California\u2019s health care landscape will look like in the face of the Trump administration\u2019s wholesale attack on Medicaid and the deep funding cuts that follow\u2014reductions that revenues from the are meant to partly offset.<\/p>\n

Increasingly, that landscape appears treacherous. And as recent comments from the CEO of one of Southern California\u2019s most prominent nonprofit health systems make clear, the fallout will hit the state\u2019s most vulnerable residents the hardest.<\/p>\n

\u201cThe house of cards didn\u2019t just weaken,\u201d Chris Van Gorder, president and CEO of San Diego-based nonprofit Scripps Health, said in an essay posted to the health care industry site Becker\u2019s Hospital Review. \u201cIt collapsed.\u201d<\/p>\n

FOR YEARS, RURAL HOSPITALS<\/strong> and community clinics have walked a tightrope financially. These operations form the core of California\u2019s safety net health care system (more than residents rely on Medi-Cal, the state\u2019s version of Medicaid, for their coverage), but reimbursement rates from both Medicaid and Medicare have for years run below the actual costs of providing care.<\/p>\n

The projected cuts from H.R. 1, which will slice as much as $30 billion a year from California\u2019s Medi-Cal funding, turn that problem into an existential crisis. Already, Los Angeles County has closed seven clinics. Planned Parenthood also shuttered at least five clinics in the state, and a recent report by the consumer rights group Public Citizen concluded that federal cuts put 83 California hospitals at risk of either closing, reducing services or laying off staff.<\/p>\n

Scripps Health, a $5 billion integrated health system that serves between 600,000 and 700,000 patients a year, will survive, but that doesn\u2019t mean its services won\u2019t have to be reduced or modified. That\u2019s nothing compared with what faces smaller clinics and health groups, many of which have already eliminated some services and implemented severe austerity measures.<\/p>\n

\u201cOver the past decade, health systems have streamlined operations, reduced administrative overhead and implemented technology to improve care delivery,\u201d Van Gorder said. \u201cThere is no excess left to trim without affecting patient care.\u201d<\/p>\n

His words echo almost precisely those of scores of health care executives, politicians, doctors and nurses with whom I\u2019ve spoken over the past several years. Their message has been plain: Extreme financial hardships mean their systems and clinics won\u2019t be able to deliver the care they should to the lower-income workers and families who depend on them.<\/p>\n

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\u201cWe don\u2019t have services to cut,\u201d Rena Salamacha, CEO of the Mee Memorial Healthcare System in King City, California, told me last year. The system, in southern Monterey County, serves a community of largely immigrant agriculture workers, and it leans heavily on Medi-Cal reimbursements to keep the doors open. But between Gov. Gavin Newsom walking back coverage for undocumented workers and the funding issues that H.R. 1 will exacerbate, the system is in for more rough times.<\/p>\n

Under heavy financial pressure, Mee Memorial Hospital closed its labor and delivery services seven years ago. It\u2019s the only health facility for 50 miles in any direction.<\/p>\n

IT IS SITUATIONS LIKE THIS<\/strong> that the Billionaire Tax Act is meant to address. It would raise an estimated $100 billion over five years, with most of the revenue being used to offset as much as possible the Trump-led, GOP-approved Medicaid cuts contained in the so-called One Big Beautiful Bill Act.<\/p>\n

Proponents of the California plan submitted nearly 1.6 million voter signatures to the state, more than twice the amount required to place it on the November ballot. The measure is being led by the Service Employees International Union-United Healthcare Workers West, which represents many of the workers whose jobs could be threatened by systems either closing or reducing services.<\/p>\n

When people can\u2019t see a doctor because they either lack coverage or can\u2019t afford it, it kicks into motion a chain of events that impoverishes the entire state, health experts said. Those patients remain sick, often going to work or school that way; they endure medical conditions that only worsen over time; and, lacking any other option, they ultimately wait until their situation is so dire that they head straight for the emergency room\u2014the one place they know they can\u2019t be turned away.<\/p>\n

Providing that emergency care without reimbursement, the hospital itself begins to suffer financially. But the hospital doesn\u2019t serve only low-income patients.<\/p>\n

\u201cWe all use one door for the emergency room,\u201d Jarrod McNaughton, CEO of the Inland Empire Health Plan in San Bernardino and Riverside counties, told me. \u201cIf that door is no longer there, it doesn\u2019t just impact Medi-Cal patients\u2014it impacts the entire community that that hospital or provider serves.\u201d<\/p>\n

Taxing the ultra-wealthy, even in technology-rich California, won\u2019t fully make up for the federal funding cuts. But to the millions who are at risk of losing their coverage, the plan represents a lifeline.<\/p>\n

And this is where the conversation should land, not on the vague and intentionally scary notion that some ultra-wealthy residents will bolt because of a one-time, 5% tax on their wealth\u2014which they would be given five years to pay.<\/p>\n

It\u2019s probably easier to talk about the prospect of rich people fleeing the state than it is to help voters see the long-term consequences of hollowing out California\u2019s safety-net health system. But that doesn\u2019t change the reality: Clinics and hospitals are under siege. The state\u2019s collective health depends upon finding solutions.<\/p>\n

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