By Larry Buhl
Originally published in Los Angeles Public Press
The federal budget reconciliation bill passed by Republicans in Congress and signed into law by President Trump on July 4 will put the food safety net at risk, harming the health of Los Angeles residents and threatening to damage the local economy, experts say.
The law’s impacts are likely to be dramatic. It cuts federal funding to the national food stamp program, known as Supplemental Nutrition Assistance Program (SNAP), or CalFresh in California, by 30% nationally, which could cause food insecurity for some of the 5.38 million Californians who use it.
Reductions in nutrition assistance, experts say, will make people sicker, especially those with chronic illnesses. Not only will previously qualifying people in LA see their CalFresh benefits curtailed, but people with chronic conditions with complex healthcare needs who receive education and resources through CalFresh Healthy Living are likely to see those benefits cut entirely. CalFresh Healthy Living (known as SNAP-Ed at the national level) provides free nutrition education and physical activity promotion to those eligible for or receiving CalFresh (SNAP) benefits, with the aim of helping them make healthier food and lifestyle choices within a limited budget.
Becky Schlikerman Sernik, a spokesperson for the Los Angeles County Department of Public Health, said in an email to LA Public Press that the cuts risk reversing years of progress on diet-related chronic disease in a county where food insecurity is already widespread. “Once the program is cut, there is no viable, large-scale plan to ensure the continued delivery of free nutrition education to low-income Angelenos,” she said.
The federal spending bill also eliminates 12% of federal funding for Medicaid (known as Medi-Cal in California) over a 10-year period, according to a recent analysis by independent health policy research firm KFF. The cuts are likely to create a perfect storm of more sickness and fewer people insured, with downstream effects on the hospital system.
Losing medically-tailored meals could create fiscal and health care storm
According to the county health department , cuts to Medi-Cal, which covers 2.2 million LA County residents, could take effect late next year. CalFresh benefits, used by more than 1 million households, would see cuts starting in 2028. CalFresh Healthy Living, however, would be completely defunded this year.
“[CalFresh Healthy Living is] one of the most effective and affordable investments we can make in public health and healthcare,” Sernik said.
The proposed cuts would eliminate free nutrition education and healthy food initiatives in schools, clinics, food pantries and other community settings, according to the county health department. In 2024, CalFresh Healthy Living reached 174,380 people with education materials and distributed 1.68 million pounds of produce countywide.
“CalFresh Healthy Living programs play a key role in preventing diet-related chronic diseases such as obesity, diabetes and heart disease, especially among communities of color and lower-income families,” Sernik said. “Cuts would undermine upstream prevention, leading to higher healthcare costs and worse outcomes in Los Angeles County’s already overburdened public health system.”
Nutrition expert Lindsey Haynes-Maslow, an associate professor at the University of North Carolina, said studies show that medically-tailored meals help reduce hospitalizations and could save more than $13 billion in U.S. healthcare costs. When nutrition support and insurance are cut simultaneously, more people end up in emergency rooms, she said.
She added that people delay seeking health care when budgets get tight, which means they’re likely to end up in the ER with serious conditions. “You’ve got cascading impacts of being food insecure and not being able to manage your chronic conditions,” Haynes-Maslow said. She pointed to research showing that people whose funds run short toward the end of the month tend to cut back on food, which is especially dangerous for diabetics who “might start cutting medications in half” or end up needing emergency care like “a foot amputation.”
Catherine Macpherson, senior vice president and chief nutrition officer at Mom’s Meals, a company that provides medically tailored meals to Medi-Cal patients, agreed. She said the loss of medically tailored meal benefits for people with chronic conditions would “lead to worsening health, hospital readmissions and increased ER use.”
She cited a pilot study involving Mom’s Meals and Inland Empire Health Plan that tracked 93 heart failure patients who received medically tailored meals and nutrition education. Even a year after the program ended, participants had 42% fewer hospitalizations and 21% lower care costs.
Organizations partnering with the county health department in the CalFresh Healthy Living program are already anticipating the worst. Jennifer Grissom, executive director of Food Access Los Angeles, expects that 1.5 million people in LA County will lose SNAP benefits, whether medically tailored meals or not. However, federal data shows about 1.5 million county residents currently receive SNAP benefits, according to the Federal Reserve Economic Data. Based on the governor’s projection that 14% of California’s CalFresh recipients are at risk, an LA Public Press analysis suggests approximately 210,000 LA County residents could lose benefits.
“We will see a sharp incline in diet-related illnesses and greater disparities in overall community wellness. We work to reduce the barriers to fresh, nutritious food in historically underserved neighborhoods. While we remain committed to our mission, I’m concerned that without continued support for supplemental benefits, we won’t be able to sustain truly equitable local food systems.”
Venice Family Clinic, which educated nearly 5,000 residents on healthy cooking and distributed nearly 1 million pounds of healthy, free food throughout LA last year, said it expects its ability to feed and educate its clients to be severely curtailed.
“These are the people that are usually being referred because their health is so poor and they need additional help from our health education team,” said Dalila Lopez, the clinic’s director of health education.” Lopez said the clinic is actively looking for other ways to fund its food distribution and education programs in the wake of SNAP (CalFresh) cuts.
There’s also ample evidence that access to basic nutrition, whether medically-tailored or not, pays dividends in the form of lower healthcare costs for individuals and families.
A 2022 study by the Center on Budget and Policy Priorities found that food-insecure households spend 45% more on medical care annually than food-secure families — $6,100 versus $4,200.
The study also found that children in SNAP families are more likely to get regular checkups, helping catch health problems early. Adults in the program spend about $1,400 less per year on medical costs than similar low-income people not receiving benefits, with even bigger savings for those with chronic conditions like heart disease.
Medi-Cal cuts would hurt hospitals, economy, study shows
Nearly one-third of LA residents rely on Medi-Cal, and while it’s not yet clear how the benefits will be cut, a new study by the LA-based nonprofit research group Economic Roundtable concluded that a 12% loss of federal funding for the program would “diminish the health of Medicaid patients, compromise public health and undercut the financial stability of hospitals and clinics.”
The Medi-Cal cuts, whether from direct reduction in benefits or from greater hurdles to get coverage, will have a ripple effect on the general economy, said Daniel Flaming, the report’s author.
Flaming said about half of Medicaid money flows to suppliers — from medical equipment to legal services. Healthcare providers including hospitals, nursing homes, pharmacies and clinics create economic ripple effects through their supply chains.
“For every Medicaid dollar spent ultimately you get $2.20 worth of economic impact out of it,” he said. “And if you cut back on those expenditures, you get the same shrinkage.”
Flaming said these changes will affect everyone, not just people on Medi-Cal. He said he expects a “burden shift” onto people who can pay, to cover the expenses of people who can’t.
“If hospitals continue to treat people who no longer have insurance coverage, then the patients with insurance coverage or who pay from their own pockets will be charged more. And there will also be a reduction in services for poorer folks.”