The Brief

When the head of the nation’s largest publicly operated health plan worries about the looming federal cuts to Medicaid, it’s not just her job. It’s personal.

Martha Santana-Chin, the daughter of Mexican immigrants, grew up on Medi-Cal, California’s version of Medicaid, the government-run health care program for people with low incomes and disabilities. Today, she is CEO of L.A. Care, which runs by far the biggest Medi-Cal health plan with more than 2.2 million enrollees, exceeding the Medicaid and Children’s Health Insurance Program enrollments in 41 states.

“If it weren’t for safety nets like the Medi-Cal program, I think, many people would be stuck in poverty without an ability to get out,” she said. “For me personally, not having to worry about health care allowed me to really focus on what I needed to focus on, which was my education.”

As she begins her second year steering L.A. Care, Santana-Chin is grappling with federal and state spending cuts that complicate her task of providing health care to the poor and medically vulnerable enrollees in Medicaid. The insurer also provides Affordable Care Act marketplace plans through Covered California.

Santana-Chin warns that the GOP’s One Big Beautiful Bill Act, enacted last year and also known as HR 1, could result in 650,000 enrollees falling off L.A. Care’s Medi-Cal rolls by the end of 2028. This will strain the plan’s finances as revenues decline. The insurer had revenues of $11.7 billion in the last fiscal year.

HR 1 is expected to cut more than $900 billion from Medicaid over the next 10 years — including $30 billion or more in California, according to the Department of Health Care Services, which runs Medi-Cal.

Like other states facing big deficits, California has reduced its Medicaid spending through such steps as freezing new enrollments for immigrants without legal status and reintroducing an asset limit. And that’s before the state reckons with the spending cuts that likely will be required by the withdrawal of so many federal dollars under HR 1.

Santana-Chin oversaw Medi-Cal and Medicare operations for the for-profit insurer Health Net before taking the helm of L.A. Care in January 2025, nearly three years after state regulators fined L.A. Care $55 million over violations they said compromised the health and safety of its members. L.A. Care paid $27 million in penalties to the state and agreed to contribute $28 million to community health projects.

In a wide-ranging interview, Santana-Chin talked to KFF Health News senior correspondent Bernard J. Wolfson about the financial headwinds facing L.A. Care and why she believes health care shouldn’t be restricted based on a person’s immigration status. This interview has been edited for length and clarity.

Q: You grew up on Medicaid. How has that shaped your views now that you run one of the largest Medicaid plans in the country?

What really motivates me is knowing that many of the people that we’re serving are just like my family. They’ve struggled and have had to have their own children translate things that were very difficult to translate. I remember doing that for my own mother. You know, basic human dignity requires that you have access to health care.

Martha Santana - Chin, CEO of L.A. Care, is the daughter of Mexican immigrants and was a beneficiary of Medi - Cal throughout her childhood. Because of that experience, she says, the concerns of L.A. Care members resonate with her on a personal level.

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Bernard J. Wolfson

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KFF Health News

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Q: Has anything you’ve dealt with at Health Net or L.A. Care reminded you of your childhood experiences in Medi-Cal?

Back then they didn’t cover transportation, and we didn’t have a vehicle. Today, one of the issues we’ll hear from our members is the need to make sure we have trustworthy transportation that shows up on time, where the drivers treat them with respect. Had I had that, had my mother had that, life would have been much easier.

Q: What do you think the impact of HR 1 will be?

It’s going to devastate the delivery system. The state obviously isn’t going to be able to make up for the shortfalls in federal funding, and over the course of the next several years, funding is going to be less and less, and the people we cover are going to decrease significantly. We are expecting between now and the end of 2028 that we’re going to see 650,000 people drop off the rolls. That’s just L.A. Care.

Q: That’s over a quarter of your Medi-Cal enrollment.

Yes, it’s very, very significant. The reductions in payment and the rise in uncompensated care are really going to impact our delivery system. As the delivery system gets destabilized and hospitals and other health care providers are forced to close services or reduce the number of sites they have, it’s going to impact access. And it’s not only going to impact those that lose coverage.

Q: How will L.A. Care respond?

Obviously, we’re going to see a significant drop in revenue. We’re very focused on making sure that we are operating as efficiently as we can operate. And we are looking at creative ways to use technology to empower our people to do higher-level work. Mostly supporting our call center agents with smarter technology that helps them answer questions and resolve problems more quickly. Some of it is automating processes on the claims payment side.

Q: What do you have to say to congressional Republicans who passed HR 1?

We are at a point of inflection in the health care delivery system. And we have to recognize that some of the components of HR 1 will have long-term unintended consequences — maybe they were intended; I’ve got to believe that some of these things are not. There’s probably a need to reconsider some of the things that were passed.

Q: Such as?

Work requirements are an example of something that many people did believe was the right thing to do to be good stewards of the health care dollar. It is very complex and is going to cause people to lose coverage that actually do qualify. It’s unfortunate, and that would be something that I would urge folks to reconsider.

Q: What impact do you expect from California’s decision to freeze Medi-Cal enrollment for immigrants without legal status?

It doesn’t matter what immigration status you are. If you are a human being and you need health care, you’re going to try to access health care wherever you can. That’s going to put a strain on the delivery system if you’re uninsured.

Q: What has L.A. Care done to address the state’s concerns in 2022 that it delayed authorizing care and addressing patient grievances?

There has been quite a bit of investment in the L.A. Care infrastructure over the last several years — our IT platforms, our data. There’s also quite a bit of investment in adding new capacity, adding bandwidth to many of the teams, more folks to help support the work.

Q: How have federal immigration raids in L.A. affected L.A. Care members and the broader community?

It absolutely has had a chilling effect. Families are afraid to come in. They’re not taking their children to get vaccinated. I’ve had numerous providers in emergency departments say that they have experienced a drop in the volume of individuals coming in. One of our case managers was really distraught because there was an individual that decided to forgo serious lifesaving treatment because of fear.

Some government funding streams for L.A. County’s public health system are drying up, and officials are turning to private philanthropy to fill the gap.

A new privately funded foundation launched Thursday to strengthen public health services after $50 million in federal, state and local funding cuts to the county’s Department of Public Health since early last year.

“It is really a hard day for our community when we have to ask for private donations to fund a public good, but unfortunately, we've lost too much money to not take this important step,” said Public Health Director Barbara Ferrer.

In February, the county’s Public Health Department closed seven clinics, with six remaining open. About half of the patients seen in those clinics are uninsured, according to county officials. The department also cut hundreds of staff positions.

Ferrer is on the board of the new foundation, The Fund for Advancing Public Health LA, which held its first meeting Thursday.

She said the fund will help the county maintain its basic public health infrastructure, including disease prevention, health promotion, environmental health, and emergency response efforts.

Other board members include several health insurance executives, as well as actors Sean Penn and Danny Trejo. Board member Saree Kayne of the R&S Kayne Foundation pledged $150,000 to the fund Thursday. Kayne said she hopes the donation encourages others to give.

The foundation aims to raise $2 million this year.

More cuts expected

L.A. County Supervisor Holly Mitchell said it’s crucial to have an alternative funding stream to protect services for the county's most vulnerable residents.

“We are saving public health,” Mitchell said. “This fund represents a new approach, one that brings together government philanthropy in the private sector to invest in community-based solutions, protect vulnerable populations, and strengthen our public health infrastructure.”

Officials say more public health cuts are coming, through the federal budget law known as the "Big Beautiful Bill," which slashes funding for Medi-Cal.

The county Department of Public Health anticipates losing up to $300 million in revenue over the next three years because of the federal budget bill and other potential funding freezes. Federal funding accounts for almost 50% of the public health budget, according to county officials.

Mitchell also led an effort to put a half-percent county sales tax increase to fund public health on the June ballot.

If approved by voters, that proposal, known as Measure ER, is expected to raise about $1 billion a year for county safety net health services, including about $100 million for the public health department.

Board members

The Fund for Advancing Public Health LA announced its founding board of directors, which includes:

• Dr. Barbara Ferrer, LA County Department of Public Health director
• Debbie I. Chang, Blue Shield of California Foundation CEO
• Sean Penn, actor and co-founder of Community Organized Relief Effort (CORE)
• Martha Santana-Chin, LA Care Health Plan CEO
• Saree Kayne, R&S Kayne Foundation CEO
• Danny Trejo, actor and restaurateur
• Jarrett Barrios, an executive at the American Red Cross
• Dr. Deborah Prothrow-Stith, Charles R. Drew University College of Medicine Dean
• Kristin McCowan, an executive at the Los Angeles Dodgers

The Rose Bowl in Pasadena may be a centenarian, but it’s holding up pretty well as it continues to host events on its way to a starring role in the LA28 Olympics.

But before it can host the soccer final, it needs fixes, especially to the infrastructure serving the bathrooms and drinking fountains. Fears of a toilet backup while in the world’s spotlight led Rep. Laura Friedman to seek federal funds for upgrades. On Thursday she announced she secured just over $1 million.

“Two years from now, athletes around the world are going to compete for gold right where we are standing. This is not the time to find out whether or not these pipes are up to the task,” Friedman said.

The planned work, she added, will lead to improved water flow capacity and water drainage, eliminating the risk of backups and emergency maintenance.

The funds came from the House of Representatives Interior and Environment subcommittee. The fixes, an official said, will be completed by the LA28 Olympics.

The funds, however, are a drop in the bucket when it comes to what’s needed to make needed improvements to the Pasadena venue.

Officials, including (left to right) Rose Bowl Legacy Foundation President Dedan Brozino, Deputy Fire Chief of the City of Pasadena Tim Sell, Congresswoman Laura Friedman, and Rose Bowl Stadium CEO Jens Weiden announced infrastructure funding for the 103-year old Rose Bowl.

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“Over the  next 20 years there's about $200 million that we need to put in and that's everything from updating light fixtures to updating gas, water, wastewater lines, etc.,” said Dedan Brozino,  president of the Rose Bowl Legacy Foundation, the nonprofit that supports the Rose Bowl stadium's preservation and enhancement.

Getting venues ready will be expensive

The money is a much-needed win at a time when elected officials in city, county, state and federal offices have been struggling to find the funds to get L.A.-area venues ready for the global Olympic stage in two years.

The entrance to a men's bathroom at the Rose Bowl.

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A $360 million proposal to spruce up asphalt in parking lots around Exposition Park won’t be done in time for the Olympics, as originally planned. Meanwhile, just up the street, there’s concern that a $2.6 billion expansion of the L.A. Convention Center, which is hosting Olympic wrestling, fencing and judo in 2028 won’t be ready for the Olympics.

Additionally, to save money, LA28 organizers moved Olympic diving to the Rose Bowl complex last year because it has two Olympic-sized pools, while the Exposition Park complex doesn't and would need expensive upgrades.

Topline:

About the chick: The chick hatched March 14. The zoo opened its Cape vulture enclosure in February 2025 after years of planning to encourage the birds to roost and nest, welcoming a new breeding pair that year. When it grows to be an adult, it’ll have a wingspan of 8 1/2 feet.

About the enclosure: The L.A. Zoo said it spent years developing the vulture habitat, which was designed to mimic the vultures’ natural environment in South Africa and nearby countries. Dominick Dorsa II, the zoo’s director of animal care, said in a statement the successful hatching is “a testament to the design and construction” of the habitat.

How to see the chick: You can’t for the time being. Zoo officials are keeping it away from visitors until the chick matures, though you can still see adult Cape vultures at the zoo’s enclosure.

Though visitors will have to wait until the chick matures to see it in the enclosure, you can still take in the impressive eight and a half foot wingspan of the adult Cape vultures.

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Courtesy Jamie Pham/L.A. Zoo

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What zoo officials are saying: “Welcoming a Cape vulture chick is a thrilling moment for our team and a beacon of hope for African vultures,” the L.A. Zoo’s curator of birds Rose Legato said in a statement. “Vultures are one of nature's most misunderstood marvels, and I cannot wait for our guests to eventually watch this chick grow and learn just how vital they are to our ecosystems.”

About the species: Cape vultures are listed as a vulnerable species due to human activities and encroachment. According to the L.A. Zoo, African vultures are more closely related to eagles and hawks than vultures native to the Americas, like the zoo's California condors that hatched last year.

This story first appeared on The LA Local.

What should have been a celebration for formerly incarcerated youth completing a reentry program at the Boyle Heights Arts Conservatory (BHAC) last week instead ended with seven students and two staff members detained by the Los Angeles Police Department, according to witnesses. 

Now, nearly a week later, BHAC staff and city officials are demanding answers from the LAPD, with some accusing officers of racial profiling. 

According to the LAPD, officers observed a large group gathered on the corner of Cesar E. Chavez Avenue and Mott Street around 4:16 p.m. on March 26. Authorities then requested backup for what they described as “a large group surrounding officers,” LAPD Public Information Officer Tony Im said. 

The group, classified by police as an “aggressive gang group,” consisted of seven 18-year-old students from the BHAC’s Bridge Academy Movement (BAM) program and two BHAC staff members.

The BAM program pays formerly incarcerated youth to complete 200-250 hours in media and visual arts training to prepare them for creative careers. That day, students were set to showcase their work at the BAM program graduation for families and community members. 

Rene Weber, a teaching artist at the BHAC, had been with the students setting up for the ceremony minutes before the incident occurred. 

According to Weber, the students had gone to coffee across the street at Milpa Kitchen as they often did, when staff were alerted that they were being detained. 

Weber said he arrived to find students and a staff member pressed against the wall in handcuffs. 

Video from the scene, taken by a staff member at the BHAC, shows multiple officers surrounding the group. At one point, an officer orders a person to “get on the wall” and displays a stun gun.  

“No, none of that, these are kids right here,” the staff member replies.

Another staff member, Teotl Veliz, recorded a large police response.  

“I counted 12 cop cars, that’s at least 25 cops, and they had a helicopter,” Veliz said. “It was just so comedic, tragically comedic, that it was on their graduation day too.”

Officers established a perimeter with yellow tape along the side of Ashley’s Beauty Salon as local business owners and witnesses gathered around the students. 

“I was just incredibly disappointed in LAPD… because it became so apparent to everybody, all at the same time, that it was racial profiling and nothing else,” Veliz said.

Weber said officers gave shifting explanations for the stop at the scene, including blocking the sidewalk and possible underage vaping. After Weber told the officers that all of the students were 18, they said they would investigate whether the group had any gang affiliation. 

Police have not responded to questions about what led officers to believe that the group was gang-affiliated. 

Weber recalled pleading with the officers to let the group go and explaining to them that they worked across the street. Community members and local business owners also stepped in to vouch for the students. 

“Our job is to help them gain a new perspective on life,” Weber said. “They’re coming out of juvenile detention and they’re turning their lives around. We can do our part in keeping them off the streets and keeping them doing better but what does it mean if they’re going to be profiled and treated exactly the same way?” 

In total, seven 18-year-old students and two staff members were detained. BHAC staff said one student and one staff member were taken to Hollenbeck Community Police Station and released less than two hours later after advocacy from community members and Councilmember Ysabel Jurado.

The incident ultimately resulted in an infraction for smoking a cannabis e-vape on a public sidewalk, according to a photo of the infraction shared with the Beat. LAPD did not provide details about the people taken to Hollenbeck Station or the infraction. 

The graduation ceremony was cancelled that night and is expected to be rescheduled in April. 

“Graduation should be a moment of pride and possibility — not fear,” Jurado said in a statement. “I’m seeking answers about what occurred, and this underscores the need for stronger relationships between law enforcement and community organizations so moments like these are protected, not disrupted.”

Carmelita Ramirez‑Sanchez, the conservatory’s executive director, said she was grateful to the community and Jurado for advocating for the students’ release. Jurado met her at Hollenbeck Station within 20 minutes of being alerted to the incident, she said. 

“They had store owners, señoras, barbers, that ran out and were trying to explain to the police who our kids were,” Ramirez‑Sanchez said. 

Still, she said the incident tarnished what should have been a joyous celebration.

“I imagine that what this does is derail this entire idea that you can be an active participant in your own restorative growth,” she said.