如果国会削减医疗补助计划，加州可能会失去多达217000个工作岗位

UC Berkeley Center for Labor Research and EducationApril 2025 California Could Lose Up to 217,000Jobs if Congress Cuts Medicaid By Laurel Lucia Republicans are considering major cuts to Medicaid to offset tax cuts. Houseand Senate Republicans have passed abudget resolutionas an initial step inthis process, with the House budget instructions including $880 billion in cutsover a 10-year periodto be focusedon Medicaid. Depending on the specific mechanisms and timing for cutting Medicaid, whichare yet to be proposed, California could expect to see between $10 billionand $20 billion fewer federal dollars per year coming to Medi-Cal, the state’sMedicaid program. This would be a reduction of between 8.5% and 16.9% inthe$118 billionin federal Medi-Cal spending projected for 2025-26. Thesefederal cuts not only threaten health care access for many of thenearly 15million–or one out of three–Californians currently enrolled, they would also leadto significant job loss in health care and other sectors. Health care is a major segment of California’s economy, and Medi-Cal is akeypillarof California’s health care system. Medi-Cal is critical to hospitals, clinics,nursing homes, and other health care providers; their suppliers; and to localbusinesses where health care workers spend their income. Compared to ascenario in which current federal Medicaid funding levels are maintained, theloss of $10 billion to $20 billion in federal Medi-Cal funding in 2026 wouldresult in: •Between 109,000 and 217,000 lost jobs,•$18.5 billion to $37.0 billion in reduced economic output, and•$860 million to $1.7 billion in reduced state and local tax revenue. These estimates, based on analysis using IMPLAN input-output economic modeling software,incorporate the direct effects of Medicaid cuts on health care jobs, the indirect effects on jobsat health care suppliers, and the ripple effects (or “induced effects”) of reduced consumerspending by affected workers. This analysis accounts for the fact that federal Medi-Cal dollarscirculate through the California economy multiple times until the dollars eventually leave thestate when consumers purchase goods or services that are produced elsewhere. The continuedcirculation of dollars through the economy is often referred to as the “economic multipliereffect.” With this analysis we find that every lost federal Medi-Cal dollar means $1.85 in losteconomic output in the state. See the methods section for a table breaking down the lost jobs,economic output, and state and local tax revenue by direct, indirect, and induced effects. We assume in our analysis that California maintains its current level of state Medi-Cal spending,but, due to the size of the Republicans’ proposed Medicaid cuts, would be unable to backfillthe lost federal funds. As context for the significance of a $10-20 billion federal cut, the stateis projected to spend $13.6 billion on Corrections and Rehabilitation and $23.3 billion onHigher Education (University of California, California State University, and Community Colleges)according to theGovernor’s January proposalfor budget year 2025-26. Approximately two-thirds (67%) of the lost jobs—72,000 to 145,000—would be in health caresectors, including jobs at hospitals, clinics and doctors’ offices, nursing homes, other healthcare settings, insurance companies, and in home care. This would be between 3% and 5% ofthe approximately 2.65 million health care jobs in the state, based on analysis using IMPLANand including a broad range of health care sectors. The projected loss in jobs reflects theelimination of some jobs that exist today, as well as the creation of fewer new jobs due to slow-er-than-expected job growth. The loss of health care jobs would primarily be due to the directeffects of the Medicaid cuts, but also includes some jobs that would be lost due to indirecteffects at suppliers and induced effects related to reduced consumer spending. Health care comprises a large share of California employment, accounting for approximatelyone in seven jobs, based on analysis of 2023 data from theQuarterly Census of Employmentand Wages. A number of health care occupations offerwagesand benefits that supportmiddle-class families. Hundreds of thousands of hospital, clinic, nursing home, and home careworkers in the state are represented by unions. At the same time, Medi-Cal not only fundsmuch of the care provided by health care workers, but it is also a source of health coverage forhealth care workers with low income, who would be doubly threatened by federal Medi-Calcuts. For example, approximatelyhalfof California home care workers have public coverage. The remaining one-third of jobs—36,000 to 72,000—lost due to federal cuts to Medi-Cal wouldbe in sectors other than health care. Job loss would be most likely to occur at businesses thatsupply the health care industry, such as food, laundry, and building services, medical supplycompanies, employment agencies, and accounting firms, and at lo