Imagine a San Diego where a mother can’t get prenatal care, a diabetic skips vital checkups, a farm worker goes without treatment for tuberculosis, and a child misses vaccinations because the only clinic they can afford has cut services or closed its doors. That is not a hypothetical; it is exactly what is going to happen because Congress passed H.R. 1, President Trump’s “Big Beautiful Bill,” and slashed Medicaid funding for Federally Qualified Health Centers such as Vista Community Clinic.
Community clinics are lifelines. At Vista Community Clinic, we serve tens of thousands of patients each year, many of whom rely on Medicaid for the care that keeps them healthy, working, and living with dignity. More than half of our patients depend on that coverage. Without it, the reality is stark: fewer providers, longer waits, reduced access to specialty services, and, in some cases, closed clinic doors.
What’s at stake
These cuts are not just numbers in a budget. They mean the construction worker who relies on us for chronic injury care has nowhere to turn. The young mother loses her prenatal visits. The child misses essential vaccines. And when patients lose care, the impact ripples outward. Children miss school, adults miss work, and families face crushing medical debt.
Economic sense — and moral obligation
Medicaid funding for community clinics is not just a health care expense; it is an investment in community well-being. Every dollar spent on primary care through a clinic saves the system many times over in avoided emergency room visits and preventable hospitalizations.
Cutting Medicaid may seem like a budget fix in Washington, but here in North County San Diego, it will raise costs over time. Hospitals will absorb more uninsured patients, local governments will see increased demand for social services, and employers will lose workers to untreated illness.
Beyond economics, there is a moral imperative. Health care should not be a privilege for those who can afford it. It is a basic human need. For decades, community clinics have been the backbone of that promise, delivering high-quality, culturally competent care regardless of ability to pay. The Big Beautiful Bill threatens to break that promise.
A Call to Action
At Vista Community Clinic, I have seen the power of accessible care. I have seen patients walk in with nowhere else to turn — and leave with hope, healing, and a plan for a healthier future. That is what is at risk now that Congress is moving forward with these cuts.
I urge our federal representatives, and everyone who values strong, healthy communities, to reconsider the already approved Medicaid reductions in H.R. 1. Protecting funding for community clinics is not partisan politics; it is common sense. It ensures that no matter who you are, where you live, or what your income is, you can get the care you need.
Now that H.R. 1 has passed in its current form, the impact will be measured in disrupted lives, untreated illnesses, and lost opportunities. The stakes are too high, and the consequences too real to remain silent. We must continue to speak up — for our patients, our communities, and the future of health care in America.
For the first time since our founding in 1972, Vista Community Clinic may be forced to seek support from private donors in order to continue providing a full range of essential health services, including adult medicine, pediatrics, women’s health, behavioral health, chiropractic care, acupuncture, diabetes management, communicable disease prevention and treatment, optometry, dental care, senior services, and transportation for patients in need.
For background, here is a summary of how the Big Beautiful Bill will affect Vista Community Clinic:
Patients served by annually: Approximately 70,000 Percent on Medicaid: Over 65% Locations: 14 clinics in North County San Diego and Orange County Medicaid-dependent services at risk: Prenatal care, diabetes management, behavioral health, preventive screenings, vaccinations Projected impact of H.R. 1: Will result in service reductions affecting tens of thousands of local residentsFernando Sañudo is CEO of Vista Community Clinic.
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