10.12.2026
Health coverage for the uninsured in Los Angeles hits a roadblock
Funding that Los Angeles County voters approved to provide healthcare for the uninsured, and to make up for federal cuts to County health programs, just hit a roadblock. At the same time, more of our patients are losing coverage, and a measure on the November ballot threatens the clinics that care for them.
Funding voters approved is on hold
In June, Los Angeles County voters approved Measure ER, a half-cent sales tax increase that will raise almost $1 billion a year. The money will cover uninsured patients at community health centers like APLA Health, especially undocumented Angelenos and other immigrants who can no longer enroll in Medi-Cal, California’s health insurance for people with low incomes.
Now the Libertarian Party of Los Angeles County has filed a lawsuit against the County. It argues that the tax increase is unconstitutional and also challenges the state law that allowed the County to raise its sales tax over the next five years.
The tax goes into effect this month. However, none of the money collected can be spent until the lawsuit is resolved, which could take years.
Our patients are losing coverage and access to specialists
Meanwhile, the number of people without insurance in Los Angeles County and at APLA Health is expected to grow sharply. Since January, California has stopped letting new adult immigrants without full legal status sign up for full Medi-Cal. And starting in 2027, H.R. 1, the Trump Administration’s 2025 budget law known as the “One Big Beautiful Bill,” will require many Medi-Cal members to renew twice a year and meet certain work requirements.
Both changes are designed to cut enrollment, saving the federal and state governments money but leaving many people without coverage. People with HIV are not automatically exempt from work requirements, and states that have added work requirements have seen enrollment drop.
The scale of these cuts is enormous. H.R. 1 will cut almost $1 trillion over the next 10 years from Medicaid. It is the largest cut to healthcare in U.S. history, and it shifts huge costs onto the states. California and its community health centers will be dealing with these cuts for years to come.
Medi-Cal, the largest state Medicaid program in the country, covers nearly 15 million Californians. In 2024, the state expanded full coverage to adults without full legal status, paid for with state funds only. The expansion cost far more than expected, closer to $10 billion, which is why the state froze new enrollment this January. New applicants in this group can now get only emergency coverage. The state also planned to end their dental benefits this past July, but pressure from advocates and the legislature delayed that cut until July 2027.
Immigrants who keep their Medi-Cal will face new barriers, too. Starting in January 2027, new federal rules will move about 2 million of them out of their health plans and into a version of Medi-Cal with no health plan organization to manage things and help them find doctors. They’ll keep their coverage, but on their own it will be much harder to see specialists, including hormone specialists for gender-affirming care, infectious disease specialists for HIV prevention and treatment, and heart doctors and other specialists for complex chronic conditions.
About 70% of APLA Health patients rely on Medi-Cal. We don’t yet know how many of our immigrant patients may lose coverage, but our enrollment staff and benefits counselors are working overtime to keep every patient covered.
Prop 44 is an attack on patients and clinics. Vote NO on November 3.
Community health centers face another threat in the November 3 election. Prop 44 could cut an estimated $1.7 billion from community health clinics like APLA Health in its first year alone. It would penalize clinics for spending on the staff and services patients need, such as human resources, IT, quality improvement, and transportation for patients, and send that money to the state instead of patient care. Hundreds of clinics could be forced to cut services or close, putting care at risk for the seven million patients who rely on clinics like ours each year.
Both the California Democratic Party and the California Republican Party oppose Prop 44, along with a broad coalition of patients, doctors, nurses, and community leaders.
Read our voter guide
This month we shared our APLA Health Voter Guide. It shares our positions on the statewide ballot measures with the greatest impact on healthcare access, LGBTQ+ rights, and HIV policy.
As supporters and friends of APLA Health, we hope you will help defeat Prop 44 and help us continue the care, treatment, and prevention we provide to all APLA Health patients and clients.
Thank you for supporting APLA Health and the communities we serve.
