This story aired in the June 12, 2025 episode of Crosscurrents.
By now, many of us have heard about the “One Big Beautiful Bill Act.” It narrowly passed the vote in Congress about three weeks ago, and now, it’s going to the Senate where they’ll vote on it before July 4. It says in the title it’s big — there’s so much in it, some representatives said they didn’t even realize everything they were voting on. And one of the issues that seems to be most controversial among republicans is how it would affect Americans’ access to Medicaid.
A report from the Congressional Budget Office estimates over 10 million Americans would lose federally subsidized coverage within the next decade.
It can be hard to fully understand what all the changes will mean in a real way. In our neighborhoods, for our families. KALW works with student journalists who look at these issues with fresh eyes, and new questions. One of them, Autumn Alvarez, was working on a reporting assignment about healthcare and she realized that her family had a personal connection to it.
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Story Transcript:
REPORTER: The debate over federal budget cuts in Washington D.C. feels a million miles away from me. But, it actually might have an impact on a place that’s close to home. That place is Alviso. It’s just north of San Jose. It’s where my Dad’s from.
JUAN ALVAREZ: My name is Juan Manuel Alvarez. I’m 62-years-old. I grew up in Alviso, California.
REPORTER: He remembers getting check-ups at a community health clinic in the 70s. He says before that there was limited access.
JUAN ALVAREZ: I can say the people were happy, you know, there was something being built in town because there was no supermarket ... To have a family health center there, I think it was probably good for the community.
REPORTER: Back then, the clinic was known as the Family Health Foundation of Alviso. It was started by people in the community with support from Stanford and the Federal government .
The clinic was created to serve Mexican farm workers and low-income families. It’s still there and now it's headquarters for Gardner Health Services. Gardner serves more than 40,000 patients in 11 clinics every year in San Mateo and Santa Clara Counties.
RAFAEL VAQUERANO: For the most part you’re looking at underrepresented communities. Not just Latinos — majority are Latinos. Our second largest population is the Vietnamese population.
REPORTER: Gardner’s CEO Rafael Vaquerano says because a lot of their patients haven’t had regular access to healthcare, they tend to see people who have been struggling with health issues for a long time. And almost all of those patients use Medicaid to pay for their care. In California we call it Medi-Cal.
Now, these community health clinics are facing a lot of uncertainty as Republicans and Democrats battle over priorities within budgets and bills.
ABC10 REPORT, Feb. 26, 2025: Now healthcare spending, particularly spending for Medicaid, could be on the chopping block as lawmakers look to cut $800 billion over the decade…
REPORTER: I was only 13 when California passed a Medicaid expansion — it allowed more people to get coverage — pretty much anyone who makes under $30,000 a year. That was in 2014 and it was part of the Affordable Care Act. Now, Vaquerano is worried that expansion might get cut.
RAFAEL VAQUERANO: If they remove the Medicaid expansion, I know a third of my patients are going to lose coverage.
REPORTER: And for the people who are at risk, it makes for hard choices.
RAFAEL VAQUERANO: If I have to pay out of pocket, especially on the low income side of the patient population, I would rather choose food, gas, and rent or my car, than go get my health checked out. But with the expansion, we've seen a lot of improvements over the past year and people's health outcomes.
REPORTER: Any cuts to government subsidized healthcare could impact people’s options for being seen and clinics ability to see them and have their costs covered.
RAFAEL VAQUERANO: With Medi-Cal, you can kind of go wherever you want. So you would not be turned away. So now, if you lose that coverage, you're going to be limited to where you're able to seek care, right?
REPORTER: Talking to Vaquerano, I start to get a better sense of how the conversations that officials have in capitol buildings shape the fate of my community.
CBS 8 San Diego Mar. 13, 2025: State lawmakers received notice that California will require a 3.4 billion dollar loan to cover expenses for Medi-Cal which more than 15 million Californians are enrolled in.
RAFAEL VAQUERANO: So a lot of my work is talking to senators, Congress, Assembly Members, Boards, Supervisors, that's a lot of my work.
REPORTER: The decisions these politicians make affect people we know, and that’s no exception for Vaquerano.
RAFAEL VAQUERANO: So my parents are from El Salvador … my father was undocumented, my mom was here on Visa … So for me, you know, seeing the health inequities and healthcare for the Latinos being seen differently and saying they're not enough. You know, so my job here is really to advocate for those voices that we can't always be, can't always be heard and or seen.
I still have some family members out there that are undocumented, right? They may not be my patients, it still hits home. Because at the end of the day, “What am I doing to make their lives better?” is my goal.”
REPORTER: And, as for my dad, like most people, he hasn’t totally wrapped his head around what his options will be when he retires.
JUAN ALVAREZ: I think when I get that age, or before I get that age, I'm going to have to look into what I can apply for … I have to find out, “What would it cover for me? And also for my wife, you know?”
REPORTER: That's in two years and with so much changing so quickly, it's hard to know where we'll be at that point.
Autumn was a student in the Mosaic Spring Journalism Internship. It was made possible by the Santa Clara County Office of Education and the Silicon Valley Community Foundation.
Sarah Lai Stirland was the audio editor and teacher for the Mosaic Spring Journalism Internship. Truc Nguyen engineered this story. Shereen Adel supervised and Ben Trefny is the executive director. Mosaic Executive Director Sharon Noguchi supervised the project and directed the print portion.