Commentary: The collateral damage from the ‘ugly’ bill is taking its toll

Since H.R. 1, also known as the “One Big Beautiful Bill Act,” passed in July 2025, it has directly restricted access to basic healthcare services in Orange County — and it is about to get much worse.

I recently spoke to 47th District constituents at a town hall with Rep. Dave Min. Along with leaders from the Orange County Asian and Pacific Islander Community Alliance and Latino Health Access, I fielded multiple questions about what H.R. 1 has done, and what comes next.

Here’s the ugly picture I had to share with them.

Last year, when H.R. 1’s provision “defunding” Planned Parenthood took effect, Planned Parenthood of Orange and San Bernardino Counties (PPOSBC) was forced to close its primary care division, Melody Health. About 13,000 patients had their trusted primary care doctor disappear overnight. They lost access to care including mental health counseling, diabetes and other chronic health condition management, cold and flu treatment, and vaccines.

H.R. 1 defunded Planned Parenthood because it provides abortion care, something more than 65% of voters in California voted to make a right in the state’s constitution. By doing so, H.R. 1 made it more difficult for patients to access lifesaving cancer screenings, wellness and preventive care, STI testing and treatment, contraception and birth control, and other critical healthcare.

California is not “safe” from the impacts of such extreme federal actions. The ripple effects of H.R. 1’s “defunding” of Planned Parenthood disproportionately impact California. Planned Parenthood health centers in California serve one-third of all Planned Parenthood patients nationally, and one in four Californians have accessed care at a Planned Parenthood health center. Over 80% of Planned Parenthood patients in California rely on Medi-Cal or other publicly funded programs for healthcare, compared to 55% of Planned Parenthood patients nationally.

The “defund” was for one year only, but the other changes to Medi-Cal in H.R.1, which have no expiration date, will directly impact our patients. These changes, coming Oct. 1 of this year and Jan. 1, 2027, include cuts to coverage for legal immigrants, which are expected to rip health coverage away from two million hardworking Californians over the next four years.

Even if you are not a Medi-Cal enrollee, you likely know at least one person who is. These friends, neighbors, coworkers and family members of yours are going to continue to lose healthcare access because of the federal government’s actions.

H.R. 1 will not only impact Medi-Cal patients. Health insurance companies have already begun to increase rates in anticipation of cuts to Medi-Cal reimbursement that they are absorbing. Uncompensated care at hospitals will increase, because people who cannot afford any other coverage will delay preventive care until they are forced to go to the emergency room. This strain on hospital systems will mean higher costs for commercially insured patients and longer wait times to see a doctor for everyone.

I hate to be the canary in the coal mine, but it’s my duty as a citizen and longtime healthcare advocate to share what is coming.

This is why it is so important to register to vote and vote early for candidates and policies that will protect healthcare access. Learn how your member of Congress voted on H.R. 1, and hold them accountable this November. If you are or have been impacted by the Planned Parenthood “defund” or the Medi-Cal cuts, share your story with your community and your members of Congress.

At PPOSBC, we will continue to do everything we can to keep health center doors open and protect access to reproductive health care for all of our neighbors in California. But we need your help to keep providing care to all, no matter what.

The “One Big Beautiful Bill Act” has done some ugly things, and things are going to get uglier. But we can stop it from doing even more damage this November.

— Krista Hollinger is the president and CEO of Planned Parenthood of Orange and San Bernardino Counties.