Trump Throws the Grenade
California gets stuck choosing between classrooms and clinics.
THREE DOT DON
Monday, May 18, 2026
The County Gets the Bodies
Gavin Newsom’s final May Revision as governor overstates California’s fiscal well-being for FY 2027 and blithely minimizes the disastrous effects Trump’s Big Beautiful Budget Bill — aka H.R. 1 — will have on county services.
H.R. 1 squeezes reimbursements for public hospitals, outpatient care, mental health, public health, emergency medical services, and other county safety-net programs affecting millions. It increases uncompensated care and forces some public hospitals and counties to backfill lost federal dollars.
H.R. 1 intentionally punishes Medi-Cal enrollees by making coverage harder to keep, even when people remain eligible. Six-month renewals. Onerous work requirements. More paperwork. More deadlines. More chances for poor, sick, elderly, disabled, mentally ill, addicted, or simply overwhelmed people to lose coverage because proving eligibility becomes the punishment.
Specifically, H.R. 1 and Sacramento’s own immigrant-coverage retreat combine to push people out of comprehensive Medi-Cal coverage and back toward emergency rooms, county hospitals, public health clinics, mental health programs, and county systems already stretched thin by low provider rates, access gaps, and bureaucratic bottlenecks.
Trump and his complicit Republican Congress could have been less subtle by simply making poverty against the law.
The governor does have a “hole card.” Reinstating state worker furloughs or a Personal Leave Program could reduce state costs by cutting salary and benefit expenses. Painful? Yes. Politically radioactive? Of course. But budgets are choices, not press releases.
Or the Legislature could revisit Newsom’s billions in new school funding above the Proposition 98 minimum guarantee before telling counties to absorb a health-care stampede with couch change and sympathy. Ironically, that new education spending largely benefits families who may still lack childcare, stable health coverage, or access to county health systems that are about to get clobbered.
H.R. 1 is a master political stroke by Republicans who loathe public employee unions. It forces Sacramento into the ugliest Democratic family fight: schools versus the safety net, classrooms versus clinics, one public-sector union constituency staring across the table at another.
CTA and school employees on one side.
SEIU, county workers, nurses, and safety-net providers on the other.
Trump throws the grenade.
California argues over who has to hold it.
