From Struggle To Service: Why The Big Beautiful Bill Threatens California’s Future

By Dr. Dawnté Early and Rep. Ami Bera, M.D. | Special To The OBSERVER

OPINION – We come to this issue from different paths — one as a community advocate and CEO, the other as a policymaking physician — but we share a common purpose: ensuring every California family has what they need to live with dignity and stability.

We also are living proof of what happens when government invests in people.

Becoming a mom at 19 while still in school wasn’t the path I imagined — but that unexpected turn became the foundation of my journey. It wasn’t easy. There were moments when I didn’t know how I’d cover rent, pay for diapers or get to class with gas in the tank. But I wasn’t alone. CalFresh meant my son never went to bed hungry. Medi-Cal covered his well-baby visits and vaccinations, so I didn’t have to choose between his health and my education. Tax credits gave me the breathing room to keep going.

These weren’t handouts — they were a bridge that carried me toward a degree, a career and a purpose rooted in service. Today, I lead one of the very organizations that helped me all those years ago. And I carry that story into every decision I make — because I know what it looks like when the safety net works.

As the son of immigrants, I know what it means to work hard and still lie awake at night wondering if it will be enough. My path to becoming a physician wasn’t paved with privilege — it was made possible by hard work, federally funded student loans, scholarships and a community that believed in giving the next generation a fair shot. That’s the American Dream in action. But today, only 36% of Americans believe they’re on track to achieve the American Dream. It’s not because people are working less — it’s because the system isn’t working for them. But I’m proof of what’s possible when those systems are strong.

That’s why we’re deeply concerned about a proposal moving through Congress known as the “Big Beautiful Bill.” Behind the name lies a dangerous reality: This legislation would gut essential programs like Medi-Cal and CalFresh and sharply limit access to the Child and Earned Income Tax Credits — the very lifelines helping working families make ends meet.

Medi-Cal doesn’t just provide health care — it supports housing navigation services that help people move off the streets and into stable housing. Without that funding, we’ll see more encampments and more pressure on already overburdened emergency systems.

We heard this firsthand during a recent hearing. The Sacramento Fire Chief said it plainly: “You can’t do more with less. You do less with less.” A local clinic leader echoed that while they never turn people away, they can only serve patients if there’s funding to keep doctors on staff. Without adequate Medicaid reimbursement, that model collapses—fewer ambulances, fewer clinics, longer wait times and people falling through the cracks.

At the Sacramento Business Journal’s Healthcare Leadership Forum, experts warned of a return to emergency rooms as default primary care, with surging wait times and rising costs. Cuts to Medi-Cal don’t just affect vulnerable populations—they raise premiums and reduce care for everyone.

California’s quality of life is at stake: Nearly 15 million Californians — including half of all children — depend on Medi-Cal. Over 5 million rely on CalFresh. Millions more count on tax credits to help with rent, gas and child care. Nationwide, nearly 11 million people could lose health coverage if this bill passes.

These are working Californians — grocery clerks, bus drivers, caregivers — who still struggle to make ends meet. When they fall behind, our entire region feels the strain.

Budgets are moral documents. They show who we value — and who we’re willing to leave behind. When systems show up, communities get stronger. That’s what’s at stake. 

We’re living proof that investing in people works. Californians have a role to play in shaping what comes next. Visit uwccr.org/preserveandprotect to learn how you can raise your voice.

EDITOR’S NOTE: Dr. Dawnté Early is president and CEO of United Way California Capital Region and a city council member in West Sacramento. She holds a doctorate in human development from UC Davis and previously worked with the Department of Public Health and Mental Health Services Oversight and Accountability Commission. Dr. Ami Bera represents California’s 6th Congressional District in the United States House of Representatives. Serving Sacramento County since 2013, Bera brings over two decades of medical and public health experience to Congress.