Most people do not think about specialty care until they need it. Physical therapy, mental health services, speech and occupational therapy, specialist referrals for chronic conditions—this is the part of healthcare that keeps people out of emergency rooms. It is what turns a hospital stay into real recovery.
As a physical therapy assistant, I work at the intersection of acute care and long-term health. What I am seeing now, as federal cuts strip away Medi-Cal funding, is not just a budget problem, but a crisis. H.R. 1 represents the largest reduction to federal Medicaid funding in American history: nearly $1 trillion in cuts over ten years.
When people lose access to specialized care, the consequences do not always show up immediately. Someone who cannot complete a course of physical therapy after surgery may appear stable in the short term but is far more likely to fall, re-injure, or be readmitted within months. Before the health care cuts, a standard course of physical therapy might have covered twelve visits. Now we are seeing that coverage reduced to six.
Nearly half of the part-time staff at my company have been laid off due to Medi-Cal cuts. We lost physical therapists, occupational therapists, and speech therapists. When specialized positions disappear, they do not come back quickly, and the patients who depended on those services have nowhere else to turn.
Washington has cut $800 million from LA County’s Medi-Cal funding. Seven public health clinics have already closed. More than 200,000 Angelenos have lost coverage, equating to roughly 1,100 people each day. These patients don’t just disappear. They show up at the remaining facilities, where specialty services are already overwhelmed. Many cut short their stay in skilled nursing facilities rather than reach their optimal level of function. The conditions that go unmanaged today become the crises that flood emergency rooms tomorrow.
When the safety net weakens, all Angelenos feel it. People who have lost coverage or whose local clinic closed turn to emergency rooms, which drives up costs for everyone – including those with private insurance. Every lost Medi-Cal dollar translates to $1.85 in lost economic output, and across LA County, the cuts put 63,800 jobs and $9 billion a year at risk. At a time when Angelenos are dealing with a cost-of-living crisis, they shouldn’t also have to question whether they can still afford healthcare.
That’s why One LA has endorsed Measure ER. A temporary half-cent sales tax scheduled to end in 2031, this measure will stabilize the healthcare safety net over the next five years. Funding will support community clinics, county hospitals, and public health services, protecting access to medical, dental, behavioral health, and prescription care for uninsured and low-income residents. That includes the specialized services that are disappearing fastest. Keeping clinics open means keeping specialist programs funded, reducing the delays and gaps that turn manageable conditions into emergencies. While Measure ER is not a permanent fix, it will give us a necessary bridge to keep the system standing while we search for a sustainable solution.
When health conditions go unaddressed, it becomes harder and more expensive to treat them later. Measure ER will make sure the clinics, services, and specialists people need are still there for them. It means shorter wait times, fewer conditions left to worsen, and a system that will deliver on the care people were promised. From now until June 2nd, voters have a chance to save our faltering health care system. Vote yes on Measure ER to protect the specialized care Angelenos need, before the conditions we could have prevented become the crises we cannot.
