How we made a documentary on California’s Medi-Cal cuts

By Kristen Hwang, CalMatters

This story was originally published by CalMatters. Sign up for their newsletters.

Reporting on healthcare last year felt like tumbling through a hurricane. The changes were immediate and relentless.

On the first day of his second term President Donald Trump issued an executive order canceling billions of dollars in public funding — hitting clinics and medical centers, Black maternal health programs, HIV prevention plans, and vaccine clinics for low-income kids. 

In California, Republican lawmakers had argued for years that the state had overextended its budget by expanding Medicaid — Medi-Cal in California. A reckoning was coming due, they said. 

Then came the fight in Congress over funding Trump’s first term tax credits. As Mark Peterson, senior fellow at UCLA’s Center for Health Policy Research put it: “As the old adage goes, why do you rob banks? That’s where the money is. Why do you go after healthcare? That’s where the money is.”

As a health reporter, here’s what I was hungry to know: What choices would providers have to make when the money ran out? What would patients who rely on Medi-Cal do if they lost coverage?

Few storytelling forms can capture emotion and action like film, as I’ve experienced documenting how climate change upends the lives of nomadic bee keepers and how California’s promise to help inmates reenter their communities fell short.

My colleagues had started working on short video, partnering with Evident Media and Bellingcat to investigate mass deportation raids in Kern County, and I was eager to collaborate on a healthcare film. 

Stepping inside some of California’s hardest hit clinics

I turned to Jim Mangia, president and CEO of St. John’s Community Health, a system of clinics in South Los Angeles providing free or reduced-cost care. Mangia and St. John’s had taken an early and public stand against the cuts, publishing grant termination letters from the Trump administration and vowing to defend transgender patients, hate-crime victims and other marginalized groups whose care was being defunded. St. John’s also helped California Attorney General Rob Bonta recover money the Trump administration wanted to cut. 

Mangia opened St. John’s doors, giving me and CalMatters the time and space to earn the trust of patients and providers. Working with Kevin Clancy from Evident, I spent months interviewing patients about what Medi-Cal means for them. We traveled to MacArthur Park with St. John’s street medicine team, where months earlier federal immigration agents had ordered them at gunpoint to stop providing care. At one point while filming, thieves smashed our car window; they took some of our gear but not our memory cards.

As we planned our film, Congress passed and Trump signed the One Big Beautiful Bill Act, the largest cuts to Medicaid in history — eliminating nearly $1 trillion in healthcare spending over the next decade mostly through new work requirements experts say will remove people who still qualify. California officials estimate the state could lose $30 billion — about 15% of current spending — annually for Medi-Cal.

“To take care of someone and then strip that away is more damaging than to have never had the help in the first place,” said Jesse Hoagland, a physician assistant we interviewed. 

Healthcare helped Maria Gomez off the streets and into housing. She has chronic seizures and difficulty walking, and her case manager said without coverage Gomez would end up homeless again.

We also filmed St. John’s leadership grappling with loss of tens of millions from federal and state budget cuts, and appealing to representatives in Sacramento and Washington, D.C. for help. As filming went on, St. John’s and other L.A. County health groups developed a plan to soften the blow: a new sales tax on the June ballot to raise money for health programs.

The measure appeared headed for defeat on election night but narrowly passed, carried by the county’s poorest neighborhoods over the objections of wealthy areas like Beverly Hills. The measure will raise $1 billion for healthcare annually.

That is where our documentary ends, but we’re continuing. 

What’s next and how you can help

Experts say insurance cuts will lead to service cuts, longer wait times, and higher prices for everyone.

The Los Angeles health groups have pointed out that budgeted need remains hundreds of millions of dollars greater than the likely revenue the tax will generate each year. And during the same election, voters in Contra Costa County defeated a similar tax for healthcare. Contra Costa and the state’s 56 other counties have few options to make up for the cuts, and difficult choices lay ahead. 

We’re not done. If Medi-Cal has helped you or someone you know, or if you’re worried about losing it, tell us your story. It may be part of what comes next.

This article was originally published on CalMatters and was republished under the Creative Commons Attribution-NonCommercial-NoDerivatives license.