Special Episode: CA vs. Donald Trump – Panel 1, Health Care

CAPITOL WEEKLY PODCAST: This Special Episode of the Capitol Weekly Podcast was recorded live at Capitol Weekly’s conference The Resistance: California vs. Donald Trump, which was held in Sacramento on Wednesday, February 26, 2025

 This is PANEL 1 – HEALTH CARE

Panelists: Beth Malinowksi, SEIU California; Devon Mathis, California Assembly (Ret.); Amanda McAllister-Wallner, Health Access California; Dr. Richard Pan, California Senate (Ret.)

Moderated by Samantha Young, KFF Health News

Please note: During this discussion, a speaker questions whether there may be a connection between Autism Spectrum Disorder and vaccines. Numerous studies over the past two decades have debunked a connection between autism and the measles, mumps and rubella (MMR) vaccine.

This transcript has been edited for clarity.

TIM FOSTER: So we’re going to go ahead and get started with our first panel of the day, on Health Care. Our moderator is Samantha Young, the California deputy editor for KFF Health News, where she oversees the coverage of health care, politics and policy in California. Samantha previously reported for The Associated Press, where she covered the California legislature and the Schwarzenegger administration.

By the way, we have full bios of all of today’s speakers and panelists posted in the event program, which you can find at the event page… And I’m going to go ahead and turn this over to Samantha. If you have any questions, please post them in the Q&A function and we’ll get to as many of them as we can at the end of the panel. Thanks again for coming.

Assemblymember Mathis is in the process of joining us, so we hope he’ll spring on in just a moment. Thanks again for coming.

Samantha, thank you again, and I’ll turn it over to you.

SAMANTHA YOUNG: Okay, great. Thank you. Fantastic. I’m excited to be here. Thank you very much. I’d like to do a quick introduction of our panelists. We have Dr. Richard Pan, former senator and assemblyman and the legislature expert, of course, on not just the medical practice side but the policy side of health care. We have Beth Malinowski with SEIU California. Thank you for joining us today. And we have the interim executive director of Health Access, Amanda McAllister-Wallner. And as Tim mentioned, we will be joined by former Assemblymember Devon Mathis.

So, I really just want to kick this off. We had some pretty big news last night. In Congress, the House passed the GOP budget proposal reconciliation package. It’s silent on Medicaid. But when you look at it, really many experts say that there is going to be big cuts to Medicaid to the tune of about $880 billion worth of cuts. And so I thought I would just ask Dr. Pan to kind of lay out for us here in California,  and much parts of the country, what Medicaid really is, because I think there’s some misconceptions out there. So, Dr. Pan, would you mind just giving us a quick overview?

RICHARD PAN: Sure. Thank you, Samantha, and it’s great to be here with everyone today. You know, the House did pass this package, and everyone’s looking at the Medicaid program. I think it’s important for people to understand what the Medicaid program is.

So a lot of people who actually know something about Medicaid go, “oh, it’s that program for the poor.” Lower income people. But I want to put some context to this. So first of all, when we’re talking about Medicaid, we are talking about, I’m a pediatrician, roughly half of all deliveries. So pregnant women delivering babies, that’s half. But the other part that I think people also need to recognize… and I’m a pediatrician, I take care of the young kids….

But for those of you who are in the sandwich generation like I am, and you have parents or grandparents that you’re concerned about that need long-term care, Medicaid is the major financer of long-term care. In fact, 37% of Medicaid dollars go to pay for long-term care.

And by the way, if you haven’t actually had to look this up, if you had to put your parent into a nursing home, it’s on average $10,000 per month, not per year, per month.

You can imagine most middle class families can’t afford that. So, your choices then become, if Medicaid is cut, is to basically say someone in the house is going to have to take care of that loved one in the home and probably not work. Right? So think about that hit, or, you know, so basically they’d have to be abandoned.

“Prior to the ACA expanding Medicaid California had a 17% uninsured rate. We’re now down to under 6%.” – Amanda McAllister-Wallner

Now, I will point out Medicaid does require to spend down. It’s not a perfect solution to the long-term care crisis, but it is something many middle-class families need to think about when they think about, “oh, they’re cutting Medicaid. What does that mean for my family?” And so people need to recognize that Medicaid covers people who are low income, but also it covers a lot of people who are basically middle class. And then, unfortunately, because of a financial crisis or tremendous health care needs, they need to then spend down their assets to be able to get those services.

SY: That’s great. Thank you, Dr. Pan, for that overview. You mentioned cuts and what that could mean for California. I was looking that up, and the California Budget and Policy Center had a pretty good estimate of what that could mean in California. It would be about $10 to $20 billion in Medicaid funding if the House GOP proposal were to pass or be reconciled with the Senate.

And so I’m curious what you all might think. How would California absorb that? What would the Medicaid program look like if California were asked to slash that much from their budget? Amanda, I was going to ask if you could start with you and then others if you could weigh in if there’s anything else to add.

AMANDA MCALLISTER-WALLNER: Yeah, of course. I want to talk for a minute about the vote last night. You know, as you mentioned, and as a number of our California members of Congress mentioned, there were no specific programs that were slated to be cut. There were no specifics in the budget proposal. But the vote last night really laid out a framework and set us on track for over $880 billion in cuts to the Medicaid program. That is what’s in the framework that was passed last night.

That would be an absolutely devastating cut and an absolutely devastating blow to the system that, as Dr. Pan described, really underpins so much of our health care system here in California. 15 million Californians are on Medicaid. Prior to the ACA expanding Medicaid California had a 17% uninsured rate. We’re now down to under 6%. And that’s thanks in large part to the gains under Medicaid, to the ways that the expansion allowed additional populations to be brought in and to additional work that California has done to improve and expand Medicaid to more populations. And to make sure that program is robust and that it offers health care that people actually can use and want to use, and covers the things that are important to Californians.

It’s not that long ago, when we were in the last recession, that we had to make significant cuts to Medicaid benefits. We cut things like dental services, like vision services from Medicaid, and really, it tore it down to just the bones of the program. When we know that, some of those “optional benefits” are incredibly important to people being able to access the care that they need to live full lives. And it’s especially devastating to people with disabilities and to families who rely on the program and who rely on those wraparound services that are provided by Medicaid as well.

We’ve also, here in California, used the Medicaid program to help bolster our efforts to end homelessness throughout the state. To tackle our mental health crisis. And all of those things are in jeopardy with these cuts that are on the line.

The ways that California has used Medicaid to make our state healthier and to invest in communities are on the line. Whether that might be changes to eligibility in Medicaid and in the Medi-Cal program, whether that might be changes to benefits and taking away some of those benefits that really make Medi-Cal the robust and vibrant program that it is in communities. Or whether that might mean that some of those hospitals and clinics, especially in rural areas that are really living on the edge right now, close down and aren’t able to make it without those investments from the Medicaid program that are so important to really underpinning the entire health system in California.

Millions of jobs, millions of people covered, and robust benefits. All of those things are on the line with these cuts that we’re talking about.

I think we really need to have all eyes on our California members to look at, “how are you going to back up what you said last night after the vote?” This isn’t about cutting Medicaid. Well, we know that it is.

“When I hear about cutting rural areas, when I hear about cutting disadvantaged communities, those are communities that I represented for 10 years that really need the help. When you talk about cutting dental and vision, that should never be on the table. When you talk about cutting people with disabilities that should not be on the table” – Devon Mathis

And we need to hold them accountable to making sure that they’re standing up for what California needs, which is that robust Medicaid program that is so important to so many people in our state. So, it will affect, like you mentioned, the California Budget and Policy Center report. That really goes into great detail as well about what other programs could be impacted, whether it’s public safety or education or these other programs that are important to the state. When our entire budget gets a $10 billion or more a year hole blown into it by this budget proposal. Every single program that we care about here in California suffers.

SY: Does anybody have anything else to add? And I’m curious, too. And thank you, Assemblyman Mathis. I see that you are raising your hand. So I’ll just go straight to you and welcome to the panel. I’d love to hear your perspective.

DEVON MATHIS: Samantha, thanks for having me on. What I’m not hearing is talk about cutting administrative costs. And too often, my tenure in the Assembly on the Budget subcommittee for Health and Human Services. You know, you always hear this number: about 80% of the costs in health care is administrative costs, and especially in rural and disadvantaged communities.

So instead of talking about cutting programs, I would hope California and those that are in office today would be looking at what are we doing administratively. I know this whole DOGE thing is getting everybody fired up, but they’re going through and weeding out, in some ways, unnecessary administrative positions. When you look at California, you look at the number of people that the state says are open for hire. But those jobs still sit empty. And it’s not just in the healthcare department, it’s across the board, whether it’s EDD, Caltrans, etc. we have these vacancies, these budgets that say we have hundreds of people that were going to work, but they’re not. And how many administrative staff do we really need, especially when we live in the day and age of technology and other things.

I remember a few years ago we were asking these questions in a joint budget hearing about how old are the computer systems in California. And some of the servers that we’re using were built in the ‘70s.

And it’s like, how come we don’t have an app for that? How come we’re not using AI for some of this? How come when it comes to health care and other services, our constituents, our people in California, 40 million people, can’t go onto an app, put in their information, have the riders for whoever needs it, and whatever department to see and cut a lot of these administrative jobs. And I’m sorry, it’s cutting jobs. Yeah, because the money doesn’t need to go to somebody to click through a program. The money needs to go to the people who are hurting the most that need it.

So when I hear about cutting rural areas, when I hear about cutting disadvantaged communities, those are communities that I represented for 10 years that really need the help. When you talk about cutting dental and vision, that should never be on the table. When you talk about cutting people with disabilities that should not be on the table, the first thing we need to do is take a scalpel to administrative costs.

SY: Dr. Pan, I’d love to hear you. Your response to that because you also were on the budget subcommittee.

RP: Yeah, I chaired the Budget Subcommittee on Health and Human Services. And actually, I share Assemblymember Mathis’s desire to cut administration and unnecessary bureaucracy. I appreciate he brought that up. Now, I do have to dispute that it’s 80% of the spend.

In fact, actually, public programs like Medicaid have lower administrative costs than comparable commercial. I said on the Office of Health Care Affordability, we’re looking at that. [Crosstalk] I raised this issue at the last board meeting. We should be looking at administrative overhead. So that’s very important. So certainly, that is something that we should always be looking at. And that’s what we did in my Budget subcommittee.

In fact, actually, one of the challenges when we talked about technology and old computer systems is oftentimes, we don’t invest in that.

And so when we look at how do we spend the money, we try to get the money to people’s services. And sometimes what gets short shrift is things like technology investments and so forth. In fact, when I was chair of the budget subcommittee, I actually, specifically invited because of our oversight over the Department of Health and Human Services. I specifically invited the Department of Technology to come, which isn’t part of our purview, to come and talk about what they can do to help us with those technology investments.

So, I do appreciate that Senator [Assemblymember] Mathis brought that up. And I think we’re probably going to touch on that a little later as well when we talk about work requirements.

But the other thing I also want to mention, I rattled off a few things about what Medicaid pays for long-term care. I appreciate Amanda bringing up mental health because Medicaid is the largest payer of mental health services as well in the country, including in the state of California. So when we have a massive cut to Medicaid for everyone who’s seeking mental health services, that’s going to have an impact.

“There is no easy way for us to absorb this level of cuts.” – Beth Malinowski

And the other thing I want people to keep in mind as someone who’s a health professional is that sometimes you’re like, “well, I’m not Medicaid. So it’s those people, right?” But the problem is the infrastructure to maintain, whether the emergency room so forth. If you have a bunch of people who don’t have health care coverage, so they basically go bankrupt, we send them a bill to go bankrupt. But they’re not able to pay their share or pay for the service they get. So they tend to delay, but they don’t pay. Then the rest of us actually have to subsidize.

When Arnold Schwarzenegger was governor of California and we’re looking at health reform. This is pre-ACA. They made note an analysis that every person back then who actually had commercial insurance, basically $1,000 per year of their premium, was needed to essentially support all the people who didn’t have insurance, because someone had to pay for it. You know, those expenses didn’t go away.

So, our Medicaid expansion helped actually decrease that type of so-called cross-subsidy and so forth. In order to be sure we had the hospitals, the clinics, the mental health professionals there to take care of you, who had commercial insurance. And I think it’s an important point to keep note when we’re talking about these massive cuts, potentially to a program like Medicaid that covers, by the way, a third of all Californians, I read off half of children, half pregnant women. That’s a third of Californians.

SY: Yeah. Oh, go ahead, Beth.

BETH MALINOWSKI: You know, I was just reflecting here on some of these initial remarks and just want to take it back to your question. Right. How can we absorb this? And I think one way I would summarize is that we can’t. Right?

There is no easy way for us to absorb this level of cuts. As Amanda laid out, and as others have agreed, what’s at stake here are making very hard choices regarding services, regarding individuals and who is covered. And I think the other layer here is that when we talk about these potential cuts to individuals who are receiving services, be the types of services they’re offering or who can be eligible, what we are also talking about is also slashing what has become one of the largest economic engines in our state.

So when we talk about the potential of cutting jobs to save revenue, really what’s at stake here is that we could actually be undermining the health care delivery system as a whole, and especially in our rural communities, where in many parts of them, rural hospitals or clinics are the largest economic engine for that community. Opening ourselves up to situations where we’re going to have closures, loss of jobs and with that undermining Main Street USA as we like to envision it.

SY: I’d like to ask Dr. Pan brought this up, and I know that several of you have talked about this, about one of the ways that has been suggested to help curtail some of the costs, some of the spend and Medicaid has been work requirements.

I’m curious if one of you could lay that out for people. What would that look like? My understanding is that the overwhelming majority of people who are on Medicaid would be ineligible for work requirements and that it could actually cost states money. And so I’m curious how that would work here in California.

RP: Well, it’s actually, people have looked at work requirements for Medicaid and said, “well, what’s the impact of work requirements?” First of all, we need to recognize that many people who are on Medicaid actually do work, right? They work. The ones who aren’t working…. We have children. We have people with disabilities who actually are, unfortunately, because of their disability, unable to get jobs. So in fact, the vast majority of people either are… would probably be exempt because they are unable to work or actually are currently working who are on Medicaid.

So what you see when you put a work requirement in is not so much that you suddenly unload a bunch of people who are low income, who don’t want to work. What you see is actually increased bureaucracy, right? Because somebody has to enforce the work requirement. Right? And I love my state workers and so forth. But as I think Assemblyman Mathis said, “well, let’s cut the, let’s not increase the bureaucracy.”

So what that does is, of course, anytime you put a new another requirement. And I saw this as chair of the budget subcommittee, of course, there’s more positions to have to go to execute that. Somebody has to check those workers. All the paperwork you have to submit, whatever requirement or whatever documentation you have to provide to prove that you’re working. Somebody has to review that or to prove that you have that you’re unable to work. Hopefully, someone looks at a five year old, said, “I don’t need any additional documentation,” but that does take more.

“there’s a lesson to be learned in Florida when it came to human services. They require drug tests, and they actually spent more money doing drug testing than they did on the savings from catching people that were on drugs.” – Devon Mathis

So the thing is, is that what we’re trying to do is we’re going to have to spend a lot of money on overhead and administration to try to catch a very small number of people. Right? Now, the other impact it does have, of course, it’s another hoop that you have to go through, just like if you have to go get your driver’s license, right, they stand in line, etc.. And so, of course, that does decrease…. That’s where the savings come from. It’s not that these are people who are unqualified, just that sometimes people are just like, they’re busy. If you’re working, you’re busy, and then you didn’t get around on time to file your paperwork.

So as we’re approaching tax season, and remember paperwork. Finding your documents, etc., and then providing it to the government official literally to say, look, I still qualify. People do fall off because of that. And that’s where the savings come from. It’s not people. When people stated it’s not because you’re driving out, there’s large numbers of people who basically aren’t working and because they don’t want to work and they’re on Medicaid.

And so, frankly, my opinion to minimize overhead and try to be sure most of the money goes to the people who actually need the services. Work requirement, to me, goes in the wrong direction. It makes government less efficient. It increases bureaucracy for very little benefit other than trying to drive people who already qualify from getting a service that they should be able to get.

SY: I see a couple of hands up. Devon.

DM: So I would agree with Senator Pan on the workforce requirement being added bureaucracy. And again, I was the ranking member on the Assembly side of his Senate. You know, we Senate/Assembly, we both have the same committees looking at these things.

But there’s a lesson to be learned in Florida when it came to human services. They require drug tests, and they actually spent more money doing drug testing than they did on the savings from catching people that were on drugs. So it’s the same thing. You’re going to spend more money on bureaucracy trying to catch a very few people.

Now, does California have a really bad history? When we look at EDD in these other cases about systems being messed up. Yes, we do, but the overhead cost is just ridiculous. And this goes into the whole point of government efficiency. Are we cutting and trimming the fat and as Senator Pan and I agree on for the administrative costs? How much money are we spending in our bureaucracy on all of these things? How many overlapping things do we have? How many pairs of hands need to see the same documents? How many bosses do we need? We can train caseworkers who can work mobily out of their homes. A lot of them cut down costs there and run these programs and take care of people. It’s it’s not that hard.

But when we look at these costs and it was mentioned earlier too, with with the hospitals, there’s a law that was passed in the ‘80s that says anybody, regardless of insurance, gets treated at an emergency room. And this has crippled health care in California and in the US because the reimbursement rates are in some cases 60 cents on the dollar. I mean, who opens up a job plan? It’s like my business plan is only to get reimbursed 60% of my costs. And that’s health care in California, especially on these systems.

So what we did, and I was one of the few Republicans that agreed with this, is when we opened up for immigrant health care, I supported it. Because emergency room care costs 90% more money than primary care. It’s a fact. It’s an economical fact.

So when we look at these things and I think what happens too often in politics, especially DC politics, is we hear the red meat rhetoric of both sides. Both parties are guilty of this. When we talk about cuts, when we talk about how things are going to be done, we hear the red meat issues. And what really needs to happen on the policy side is to put the red meat aside and go, OK, what are we going to do that’s going to be fiscally the most economical thing to do, because there’s the popular things on both sides for both parties.

And it’s really great to say, “oh, we’re going to cut this and we’re going to slash this funding and we’re going to do this.” I got sick of it in my 10 years and I stood up against it. Because if for the Republicans, I challenge all of you, if you’re going to call yourself a fiscal conservative, you need to look at the economics. What is going to make the most economical sense?

For my Democrat side, really? How much administrative cost do we need? How big does the bureaucracy need to be? Because we all know, and this is something that I’ve heard my entire life. You know, you always hear this saying, “government should run like a business.” And I completely disagree with that, because a business is supposed to make more money and get bigger.

Well, when government makes more money and gets bigger, the taxpayers have less money, and we have higher administrative costs. So we need to think more fiscally. We need to trim the fat. We need to look at what programs work. When we talk about cutting programs, we really need to prioritize. What do we actually need to do for basic human health, dental, vision, primary care, and then build out from there?

SY: Thank you. I really appreciate that. We have spent quite a bit of time on Medicaid because it is such a big program here in California, but I would like to kind of move on to a few other topic areas, which also we were talking with Doctor Pan at the very beginning before we came on to the rest of you that we have just had our first case in Texas of where a child died of measles, an unvaccinated child. And Dr. Pan, as many of you all are aware, was a champion of some key legislation for vaccinations, and you have tangled with our new HHS secretary, Robert Kennedy Jr. And I would love to hear your thoughts, Dr. Pan, on his views on vaccines. And what your concerns are not just for the country, but really for California as well. For Californians to have someone …that is going to affect state policy at all?

RP: But you know most of public health policy and powers are located in the states. But the federal government plays a very large role in funding, and also things like approval of medications like vaccinations. So Robert F Kennedy has a long history of opposing vaccines, but also basically pushing conspiracy theories about them. He came to California, to Sacramento when I did my bill in 2015 and called vaccination the Holocaust. And although he technically apologized for that, he has repeated that claim many times since then, even fairly recently. So clearly he is opposed to vaccines. I had an opportunity to meet with him on two different occasions when he came to lobby against my bills. And frankly, was not able to share any information about vaccinations that was accurate or compelling to question them.

“So certainly, RFK, if he wanted to, could make life very difficult here in California. He can’t change our laws but could make vaccines much less available.” – Dr. Richard Pan

I think, as we see what’s happening in Texas right now… actually, that outbreak in Texas is larger than the one we had in California in 2015. It’s already had more cases in the space of fewer months, and it’s still ongoing. So, there’s, of course, the human cost of the infectious disease. 18 were hospitalized. Now we have a child who died of the disease. For people who have measles, the long-term effects of measles is immunosuppression for several years. So you get more likely to be vulnerable to other infections and so forth.

“We have a propensity to have a cycle of neglect, panic, repeat, in public health funding” – Beth Malinowski

But there’s also a financial cost since we’re talking about expenses too. It costs money to try to contain these outbreaks. It costs money to take care of people who got sick. In order to prevent the spread, we often have to close schools and businesses and other things as well. So it’s a cost to taxpayers. It’s a cost to businesses. It’s a cost to kids’ education to try to stop these outbreaks. And it’s preventable. And that’s the thing it is preventable. We know what to do. The science is very clear.

So it is unfortunate that this is happening. Hopefully, now, I know Robert Kennedy was around Samoa when many children died and didn’t seem to change his mind. But hopefully, our members of Congress, both… from both parties as well as the administration, will realize with this outbreak happening at the very beginning of the Trump administration that, I think, tampering with vaccines and vaccine policy and the CDC and FDA is going to be very dangerous for our country. And that, frankly when voters see the impact of the spread of these diseases, I know we just came out of Covid, but that the voters will push back against any effort by Robert Kennedy or any of the other appointees to try to undo current vaccination policy.

So certainly, RFK, if he wanted to, could make life very difficult here in California. He can’t change our laws but could make vaccines much less available. He could actually try to change the vaccine recommendations in a way that would, again, mean less federal funding for vaccines and actually access and supply to vaccines as well. But hopefully, that is something that they will choose not to do, especially in light of this outbreak.

SY:  Governor Newsom and Democratic leaders have come together to have this, Trump resistance, if you will, in the legislature and build a defense. And I would love to hear from you guys about what you think really should be the top priority when it comes to health care that the legislature should be focusing on or that the governor should be focusing on. Is there anything that just comes to the top of mind when you think of something that California can respond to?

BM: Samantha, if I may, I’ll start by answering the question, by offering maybe a reflection on Dr. Pan’s words around public health. One, I want to just second and agree with all of Dr. Pan’s points there. When we think about public health, yes, it’s important to be talking about vaccinations. It’s also important to be talking about our public health infrastructure and public health workforce.

A colleague of mine often says that in public health, we have a propensity to have a cycle of neglect, panic, repeat, in public health funding. And California, coming out of the pandemic, under this administration, under this legislature, took the leadership to begin to think differently about how we fund public health infrastructure and workforce through our future of public health funding investments.

And so, I’ll just say, as relates to public health, specifically, one thing this Legislature and governor can be doing is to continue that line of funding to make sure we have dedicated state funding for public health infrastructure and workforce. More broadly, Samantha, we will just say, just to answer your question, that I think it’s really important that right now, our legislature, working with our AG’s office and the other elements of our administration, are thinking about all the different ways we can stabilize our overall health care delivery system in this time of uncertainty. So continuing the work we’re doing, putting pressure on our congressional colleagues to make sure they’re doing right by California too.

AMW: You know, I think that the challenges ahead of us are tremendous. I think we are we are at the lowest uninsured rate that we’ve ever been. We’re making progress on health care costs through the work that Dr. Pan mentioned at the Office of Health Care Affordability. We have the most affordable health care in Covered California that we’ve ever had, thanks to investments from the Inflation Reduction Act, and the enhanced premium subsidies, and the work that California has done to invest in reducing out-of-pocket costs. And we have a more equitable health care system than we’ve had in the past. And, all of that is on the line right now.

The potential $880 billion in cuts – or more – that are on the table threaten to really to undermine those gains that we’ve made. There’s a lot of work for California to do to protect our investments and to protect the progress that we’ve made in covering more people and in making our health care system stronger and our population healthier. And we also know that some of these attacks are politically motivated as well. The president has… and others have made it really clear that because of California’s policies of having inclusive health care for transgender Californians, for making our community safer and healthier for our immigrant communities that California is being politically targeted as well for some of these attacks.

And again, that work and that partnership between the governor, the AG and the legislature will be really important to make sure that we continue to defend our California values. That we continue to make these investments to make our communities healthier and stronger. And that we don’t fall backwards, that we don’t… not only have people falling out of coverage, losing coverage because they can’t afford it, or because we’re cutting eligibility or, you know, the work requirement policies create so many administrative burdens that folks who should be eligible are dropping out of coverage.

All of those things are very real possibilities. If we aren’t steadfast in defending our health care system right now and defending against these attacks and these potential cuts. And so I think really there’s important defensive work to do. And ways that California can keep moving the ball forward and make our health care system work better for folks is by helping to make it more affordable by investing in affordability assistance by tackling high costs of health care at the Office of Health Care Affordability, by improving provider directories so that people can actually find a provider when they need it. By making sure that charity care is available. All of these things that California is doing, we need to continue moving that ball forward while… and not take our eye off of that while at the same time being very aware that many of our California values are under attack right now.

SY: Who wants to jump in next?

RP: I think Senator [Assemblymember] Mathis was first up.

DM: Thank you. You know, I, I find it interesting when we talk about California values because California has the most progressive edict in the country. When we look at things… I’m a parent. I’m also a veteran. Coming out of the Assembly, I got my the “Do you want to keep your coverage that you had in the Assembly?” $3,500 a month is what the bill was. So I’m back on my VA health care, which is a whole other thing. And now I get to I got a screening question talking about vaccines.

Let’s go back to that for a moment. I was.. I did two tours in Iraq, and I have to get a environmental screening. And in that question, the whole packet of questionnaires, there’s a list of questions asking specifically what vaccines I have and what birth defects my children have. Linking literally linking vaccines to birth defects in the VA health care questionnaire. And I have two children with autism and one with spina bifida. And there’s a question specifically about vaccines in children with spina bifida.

So I think it’s important for a scientific discussion to raise the questions, to look into those things. I know it’s not popular, but the fact that Doctor Fauci got pardoned. Why? What’s hiding behind all of that? Not to be conspiracy theory and put a tin foil hat on. But why answer that to the American people? Answer that to all of the veterans who are being asked, my brothers and sisters in arms, what vaccines the military gave us and if our kids have birth defects.

AMW: I really I really don’t think we should be giving airtime to further conspiracy theories.

DM: Those are facts, Amanda. That’s great. So let’s go to California values. I have children that are in high school that require permission slips to go on field trips but do not require a permission slip for a sex change or an abortion at 12 years old. So my 16-year-old has to get a permission slip, but my 12-year-old daughter or my 13-year-old son can go do other things without any parental consent, without parents even knowing. That’s the California values that are being discussed.

“There have been laws that have been passed by Congress and signed by presidents. And just because this president doesn’t like them doesn’t mean they’re still not law.” – Dr. Richard Pan

So any parents out there listening really think about that when we want to talk about fiscal and where money goes. Why is California?.. Why are families paying for prisoners to get sex changes? There’s a program, [Crosstalk] and I know that’s not popular for California, but that’s a reality for parents. Parental rights have been completely eroded in the state of California, and in some cases, there are examples that can be pointed out always of where there were bad parents.

But the fact that 12-year-olds can do things without parental consent, but our 16 and 17 year olds still need permission slips for field trips. It’s quite appealing that those are the California values that are being discussed, and I know that’s not popular for this panel, but it’s a reality for many Californians.

SY: Well, if we could get back to the topic, I would really. Dr. Pan, I saw you had your hand up. Did you want to weigh in?

RP: So a few things. First of all, I want to thank Senator [Assemblymember] Mathis for your service to our country as a veteran and also appreciate your support of coverage for undocumented immigrants under Medi-Cal system. I agree with you that we need to look at the impacts and the facts about what is most beneficial, and not only for the person, but also for the taxpayers in the state of California.

I will say that, first of all, to go back to your original question about the resistance. One of the things that I think the state of California needs to do, and I know the Attorney General is going to be speaking, is actually we need to follow the rule of law, right?

There have been laws that have been passed by Congress and signed by presidents. And just because this president doesn’t like them doesn’t mean they’re still not law. And that also applies to California, as that also applies to federal laws that affect people in California. So what’s been going on now is basically… some significant issues in terms of are we are we following the laws of this country?  And so, of course, our chief law enforcement officer should be at the forefront as we’re seeing changes in people at the DOJ and resignations to be sure that the rule of law is actually enforced here in the state of California.

And of course, for Californians ensured that the state of law is, at least in this country, applies to people here in the state of California. We may disagree with some of those laws, and that’s why we should go through the democratic process. We have a constitution, to change those if that’s the case. But we should be enforcing the rule of law. So, that’s sort of the first step in terms of resistance.

I think it’s also important that we educate people… we talked about here and appreciate the session about how proposals that are to change the laws, to change the federal budget and so forth will impact the people of California. And we have Congress members of both parties who represent California in the House of Representatives. So it’s important that the people of California understand that those decisions that they’re making will impact their constituents and the people of California as well. That’s going to be extremely important.

The other thing I want to touch on, I heard the term “parental rights.” I’m a pediatrician, I’m a physician. I think that it’s very important for the doctor-patient relationship that government not interfere. We don’t have government walking into the exam rooms saying, “no, no, no, you can’t talk about reproductive rights. No, no, no, we can’t talk about gender identity.”

We can’t talk about these topics because from outside, parents have made decisions about what they think is in the best interest of their child in conjunction with their physician. And we should allow the physicians to be able to provide the care that their children need. That’s, to me, is what parental rights is about. Parents making decisions with their health professionals, their physicians, and then being able to get that care for their children.

That is not happening in too many places in this country. And of course, that only applies to children. I’m a pediatrician, but unfortunately for many women and other people in this country where, basically government is trying to step into the exam room and trying to restrict the ability of people to get the health care they need. And we have to fight to protect that. That people, that Americans, including Californians, should be able to get the health care that they choose for themselves and they choose for their children. So, with that, I think I can keep going on, but I’ll stop there.

SY: I would like to kind of ask a question. We’ve touched on it a little bit, but about how does California, how do the elected officials, how do Californians as a whole protect the health benefits that already exist? We’ve talked a lot about scenarios about what could be cut, what might have to be done. But for those Californians who want to keep what advances that have already been made here in California, what can be done to offset anything that might come down from Washington?

BM: Samantha, may I start by saying, yesterday’s vote, while deeply troubling, is not the end of the effort. So yesterday set in motion activities are going to be happening now through House committee processes, while those committees have to come out with bills that will then get voted on. And so I just want us to be talking about what everyday Californians can be doing right now to express how much the Medicaid or Medi-Cal in California means to them, and really sharing their voices and their experiences because this fight is not over.

“The programs that we’ve been talking about, Covered California and Medi-Cal, are only stronger than they were eight years ago, and more people are benefiting than ever. More people are invested in this program than ever.” – Amanda McAllister-Wallner

And so, if I may, I do think it’s important that our audience is hearing that today that that last night’s vote does not end the activity. It does not end the conversation. But what it does do is sends a really strong signal to everyday Californians regardless of where you live, regardless of where you work in California, that now is the time for you to be sharing your story with everyone you can. Your city council member, your mayor, your Congress member. It’s important that they are hearing how these changes will impact you and how much you rely on Medi-Cal as you know it today. Maybe it is for that pediatrician’s visit. Maybe it is for that chronic condition. Maybe it’s to help treat that autism.

So these are the things that I think is most important right now that our listeners are really focusing in on, is that we can still change the course and direction in DC, but that will take everyone. Certainly, we did see the Republican delegation of California yesterday kind of fall in line behind party leadership. But coming out of that, you did see some distinct messages from them on social media, which indicated, I thought, at least some openness that some had understanding and appreciating what was truly at risk here.

And so I just want to offer that for folks today that it’s not just about what folks that are in positions of power like our state elected can be doing right now, but it’s also about everyday Californians.

AMW: To build off of that, Health Access and SEIU California, along with CPEHN and a number of other partners, have a campaign called Fight for Our Health, which is focused on what Californians can do to engage in this fight. How they can share their stories, you know, connecting people with hundreds and thousands of grassroots activists across the state who are speaking out against these potential cuts to Medicaid, who are reaching out to their members of Congress who are writing into newspapers, who are planning events, who are collecting postcards and making their voices heard.

We, you know, were able to prevent the repeal of the Affordable Care Act during the first Trump administration. And now the programs that we’ve been talking about, Covered California and Medi-Cal, are only stronger than they were eight years ago, and more people are benefiting than ever. More people are invested in this program than ever. These programs are more popular than ever, and our members of Congress know that. And they need to know that we’re paying attention, that their constituents are paying attention, that they did not send them to Washington to cut their health care in order to give tax cuts to billionaires. You know, they sent them there to represent their communities and to do what’s in the best interest of them and their families.

“Polling shows that over 60% of Republican voters actually don’t want to see bad things happening to Medicaid. So, this is a bipartisan issue.” – Dr. Richard Pan

And for folks who are looking for ways to plug in. FightOurHealth.org. You can you can find events in your area. You can find opportunities to join with other folks who are pushing back against the attempts. And like Beth said, there’s we’re still at the beginning of this fight. There is plenty of fight left in us. There’s plenty left to do, and plenty of opportunities still to get involved and to prevent some of the catastrophic cuts to benefits to our communities’ health care systems that we talked about.

RP: Yeah. I just want to weigh in. First of all, I totally agree with the previous two speakers. This is an across-the-board effort. It’s not just your state officials. I just mentioned that way back when, when I was a resident, actually, in Massachusetts, before I came to California. You know, Newt Gingrich and the Contract with America, for those of people who still remember those days, came in, and they wanted to block grant the Medicaid program in the country. So think about how many decades ago and it looked like it was going to happen.

But when people spoke up and talked about what Medicaid did, how the fact that if you block granted it, it could not respond to economic downturns because the block granting fixes the amount of money, right? It took away the entitlement. People pushed back. And now how, many decades later, even though it keeps coming up, it still has not happened.

So, this is just the very beginning of the conversation. I appreciate that there’s bipartisan concern about what this means. And I point out that polling shows that over 60% of Republican voters actually don’t want to see bad things happening to Medicaid. So, this is a bipartisan issue. And in terms of support. And so I think it’s important that all of us convey what Medicaid really means to us and our families and hopefully, this panel as well, sort of explained for people who may feel like that, oh, Medicaid doesn’t have much to do with me and my family how it might touch you and your family as well.

And, of course, you said there’s a third of all Californians, half of all children, and all pregnant deliveries are through Medicaid. So that means your pediatric care, your OB care… If Medicaid goes away, even if you’re not, Medicaid will impact your care because that whole infrastructure there is part of that. That’s the top funder of mental health and top funder of long-term care. It’s the major funder.

So when that if that gets goes away or gets cut significantly, that impacts the availability of all those services. Because imagine you’re a business and you lost half of it. Even the other half who still want your business get impacted if you lose half your business. So that’s the kind of thing that Californians and the American people need to think of.

So there’s both mobilizing California and do you have family in other states and so forth? You should talk to them about it. Because this is a federal issue. You know, it’s going to be decided by Congress to represent the whole country. So this is a conversation that needs to be had. And I think what Californians can do is they can share, hey, when you have a state that wants to make it work, what we can actually achieve.

Because I think we have a lot of positive things here in California when it comes to Medicaid or Medi-Cal. We have problems, but we have a lot of positive things that we’ve been able to achieve, and that’s the possibility. That’s an example of the possibility that other states could also achieve as well if, but only if Congress doesn’t actually slash away. I mean, this is not a minor. Even though it’s not specific, the amount of money they’re talking about certainly have profound impacts on people’s access to health care.

SY: Thank you all very much. We have to wrap up. We are out of time. And I just want to thank you all for spending this time with us and talking us through everything that’s going on. I really appreciate it all, and we hope this has been helpful to our viewers.

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