"This is a direct threat to patient care across California," said the chief of staff at the union sponsoring the ballot measure.

The labor union leading the fight for California's billionaire tax on Wednesday pointed to recent reporting about hospital layoffs to make the case for the ballot measure, which would impose a one-time 5% tax on state billionaires' wealth to fund healthcare.

The Orange County Register reported last week that "the more than 400 hospitals statewide have already laid off more than 3,400 healthcare workers as of mid-March, with as many as 1,600 coming from Santa Barbara to Orange County and the Inland Empire area, according to a tally of layoffs provided by the state's Employment Development Department and data collected by Paul Young, senior vice president of public policy and reimbursement with the California Hospital Association of Southern California."

As the newspaper detailed, hospital executives "are hinting of a second wave of layoffs," citing the One Big Beautiful Bill Act, or HR 1, that congressional Republicans passed and President Donald Trump signed last summer. The law will cut about $1 trillion from Medicaid over the next decade, which is expected to significantly impact the state's Medi-Cal program that covers more than 15 million lower-income residents.

The Center for Labor Research and Education at the University of California, Berkeley "estimates the Medi-Cal cuts could lead to a loss of 72,000 to 145,000 healthcare jobs throughout California, representing 3% to 5% of the state's 2.65 million healthcare positions," the Register noted. "These job losses include positions in hospitals, clinics, and home care."

The Service Employees International Union-United Healthcare Workers West, the lead sponsor of the ballot measure that Californians are set to vote on in November, highlighted the reporting in a Wednesday statement. SEIU-UHW chief of staff Suzanne Jimenez declared that "this is a direct threat to patient care across California."

"When hospitals lose funding, they lose staff," Jimenez said. "And when they lose staff, patients face longer wait times, fewer services, and reduced access to lifesaving care. Without urgent action, communities across California will lose access to the care they depend on."

In the union's statement, Mayra Castañeda shared concerns about losing her job as an ultrasound technologist at a hospital in Lynwood, California. She said: "Every day I come to work thinking about my patients, making sure they get the care they need, that they feel safe, that they're not alone. Now, I'm also thinking about whether I'll still have a job next month."

"We're already stretched thin, and the idea that more staff could be cut is terrifying," Castañeda continued. "It doesn't just impact us as staff. It impacts every patient who walks through our doors. You can't keep taking resources out of healthcare and expect people not to suffer."

Opinion: Unlike billionaires, we don’t need mansions or yachts. We're just asking for health care that our families can rely on.www.usatoday.com/story/opinio...
[image or embed]
— Billionaire Tax Now (@billionairetaxnow.bsky.social) April 1, 2026 at 3:40 PM

Experts estimate that, if passed, the billionaire tax ballot measure would raise about $100 billion from 2027-31 from California's 200 richest residents. Recent polling suggests the proposal is on its way to success.

It's drawn support from national progressive figures such as US Sen. Bernie Sanders (I-Vt.), who last month partnered with Rep. Ro Khanna (D-Calif.) to introduce the Make Billionaires Pay Their Fair Share Act. The bill would impose a 5% annual wealth tax and direct the revenue toward reversing GOP healthcare cuts from HR 1, expanding Medicare, building affordable houses, helping families pay for childcare, boosting teacher salaries, and sending direct payments to members of households making $150,000 or less.

Unlike the California ballot measure, that federal "tax the rich" bill and another introduced last month by Sen. Elizabeth Warren (D-Mass.) have no clear path to passage in the Republican-controlled Congress. However, hospital layoffs as a result of HR 1—which featured more tax giveaways for wealthy Americans—aren't limited to California.

According to a Public Citizen report released Tuesday, 446 hospitals across the United States could close or reduce services due to HR 1's cuts to Medicaid and the Children's Health Insurance Program. The publication notes that these "hospitals collectively have 68,986 beds and served approximately 6.6 million patients in 2024. They employ approximately 275,458 direct patient care workers (this does not include nonmedical workers, such as administrative staff)."

Public Citizen researcher and report author Eileen O'Grady stressed that "Trump's cuts to Medicaid will hurt millions of low-income and disabled Americans, and will deepen financial strains that are already plaguing rural and safety-net hospitals—compromising their ability to deliver care, potentially leading many to close."

"Congress should take urgent action to restore all Medicaid funding cuts enacted by Trump and Republicans in Congress," O'Grady argued, "and should extend the enhanced premium tax credits for coverage through the Affordable Care Act marketplaces."