A consequential step back in healthcare | Your Turn
Dr. Felix L. Nuñez
Your Turn
July 11, 2026, 7:00 a.m. PT
When H.R. 1, also known as the One Big Beautiful Bill Act, passed last year on the Fourth of July, we knew that helping people stay enrolled in the Medicaid program — known as Medi-Cal in California — would be a challenge unlike any other we had faced in the 15-year history of Gold Coast Health Plan, your local Medi-Cal plan for Ventura County. Aside from making it harder for people to stay enrolled by implementing more frequent re-enrollments and work requirements, we expected the federal government would be relentless in its effort to block states like California from providing coverage for our immigrant family, friends, and neighbors.
While we had hoped that our state elected officials would be able to fend off those targeted attacks, on June 29, Gov. Gavin Newsom signed a $351.7 billion budget that included transitioning about 2 million Medi-Cal members classified as having “Unsatisfactory Immigration Status” — those immigrants who are not otherwise eligible for the federal Medicaid program — from managed care plans to a fee-for-service program. While this is framed as an attempt to defend healthcare access for these residents, I believe this is a consequential step back — one that will negatively affect access to coordinated high-quality care and services for the most vulnerable people in our county.
On Jan. 1, 2027, more than 31,000 people in Ventura County — about 14% of our 223,000 current Medi-Cal members — will be losing access to the healthcare coverage that Gold Coast Health Plan now provides. It is unclear if we will be able to provide these community members with outreach to remind them to complete vital health screenings, facilitate transportation to their appointments, or connect them with interpreters who can relay important information from their doctor in their preferred language — all services that promote better health outcomes for the individual patients and community.
As a family doctor who has served uninsured and underserved people for the entirety of my 30-plus-year career, it is my sincere belief that this decision has the potential to negatively impact the disenfranchised members of our community who may now delay their care or seek services through hospital emergency departments in lieu of access to primary care. Emergency departments are not intended for managing chronic and preventive care for patients with conditions like diabetes, hypertension, kidney disease, or heart failure, or providing cancer care. But for thousands of our members, this will soon be their only option.
When emergency departments are in a perpetual state of overwhelm, our county health infrastructure, including Ventura County Health Care Agency clinics and hospitals — a critical safety net provider — will be seriously threatened under the strain. The impact of these changes will be a decrease in access for all of us who depend on these healthcare resources. Wait times at hospital emergency departments will increase. The burden of uncompensated care will lead to clinic and hospital instability. Our leaders will have to make difficult decisions about how limited funds are allocated to support critical infrastructure and support services.
Gold Coast Health Plan, in partnership with our sister health plans, our trade association, the Local Health Plans of California, and a coalition of provider groups and advocates, proposed an alternative solution that would have allowed our immigrant community members to remain connected with their care networks, with the state managing and paying for emergency, hospital, and pregnancy services. This proposal would have met federal mandates regarding state financing of care for immigrant populations and met the budget targets proposed by the governor. Ultimately, our lawmakers decided to move forward with the transition to fee-for-service.
Though we have strong reservations about the state’s decision, we remain committed to our mission and vision and to providing our members with the support and reork to strengthen our Ventura County healthcare infrastructure to weather this storm
For now, I am thinking about the members who finally had a dedicated doctor and care team to help them achieve better health and well-being. I am thinking about what it will mean for them when that is taken away. Their lives, as our own, have value, and we can do better by them. I hope we can all dedicate ourselves to a vision where high-quality healthcare access is not a commodity reserved for the privileged, but a right for all residents of our county and state
Dr. Felix L. Nuñez is a board-certified family physician and CEO of Gold Coast Health Plan, the local Medi-Cal managed care plan for Ventura County
