Bakersfield Californian: Community Voices: Health care, not red tape: California elected officials must protect Medicaid

Published in the Bakersfield Californian
Op-Ed By Jim Mangia

May 17, 2025

Jim Mangia is the president and CEO of St. John’s Community Health in Los Angeles. 

Benina is a single mother of three, a cancer survivor, and once spent nine days in the hospital with severe COVID-19. Now 41, she’s been working since she was 16. She credits MediCal — California's Medicaid program — with keeping her family healthy and freeing up her income for essentials like housing and food.

Pablo is currently unemployed and searching for work. Medi-Cal enables him to afford the medication that keeps him alive. It also helps his family — his mother receives treatment for cirrhosis, and his brother accesses services for serious mental health needs.

Hector, legally blind due to a syndrome affecting his kidneys and vision, has had two kidney transplants by age 33. His autistic brother, who experiences seizures, needs round-the-clock care. Medi-Cal not only supports their health but eases the emotional and financial stress of their household.

Benina, Pablo and Hector are among the more than 40% of Californians who rely on Medi-Cal. They all work — or are trying to. And they all receive care at a community health center in Southern California. Yet if federal lawmakers succeed in imposing Medicaid work requirements or cutting the program, their lives could be upended.

In California’s 22nd district, 67% of residents depend on Medi-Cal. It allows people to care for their families, go to work or school, and stay active in their communities. That’s why a coalition of local health centers, doctors, and patients launched Medicaid Matters to Me — a campaign to protect health care access for millions.

Despite claims that work requirements would encourage employment, the reality is that most Medicaid recipients already work. According to recent data, 92% of Medicaid adults and 90% of Medi-Cal adults under 65 are employed, in school, or caring for others or living with disabilities that prevent full-time work.

So why push for work requirements? It’s not about jobs — it’s about cutting benefits. These policies rely on outdated, harmful stereotypes that wrongly portray Medicaid recipients as unwilling to work. In fact, Medicaid often enables people to stay employed by providing access to the healthcare they need.

If implemented, work requirements and similar restrictions could threaten coverage for 36 million people, including 8 million Californians. For many, Medicaid is what makes employment possible in the first place. Losing it would push more people out of the workforce, not bring them into it.

The problem isn’t that people don’t want to work — it’s the red tape. Many eligible individuals lose coverage due to administrative hurdles and paperwork errors. For those with serious health conditions, this bureaucratic maze can become a life-or-death issue.

Medicaid cuts would also devastate California’s health infrastructure. Nearly 200 federally qualified health centers and 2,500 delivery sites primarily serve Medi-Cal patients. Without adequate funding, many would be forced to close, causing layoffs for healthcare workers and leaving communities without essential services.

Low-wage workers and small-business employees would be hit especially hard. Thirty-six percent of California workers are low-wage earners, and many don’t have employer-sponsored insurance. Without Medi-Cal, small businesses would face the burden of covering insurance costs — or risk losing workers who rely on it.

Since 2014, the 40 states (plus Washington, D.C.) that expanded Medicaid have seen better health outcomes, more job growth and stronger economies. States that refused expansion continue to struggle with lower employment and income levels and worse health.

The evidence is clear: Medicaid supports work and economic stability. Lawmakers should eliminate red tape and expand access — not create barriers. Using people’s healthcare as a political bargaining chip only deepens financial and medical hardship.

If we want a stronger economy and healthier communities, the solution is simple: protect and expand access to healthcare for all.

Jim Mangia is the president and CEO of St. John’s Community Health in Los Angeles.