U.S. health care sheds jobs as H.R. 1 dismantles safety net

The AHS Index is a new way to look at data that illuminates a snapshot of our world today. Its goal is to bring inequities into focus and encourage solutions that advance health for all.

Estimated reduction in federal health care spending over the next 10 years embedded in H.R.1: $1 trillion

Portion of the $1 trillion cut to federal health care spending that is attributed to Medicaid funding cuts: $911 billion

Estimated jobs projected to be lost nationwide in 2029 as a result of H.R. 1, according to a preliminary analysis by The Commonwealth Fund: 1.22 million

Estimated jobs projected to be lost in California as a result of H.R. 1, according to The Commonwealth Fund analysis: 181,000

Number of hospitals and health systems that announced workforce reductions in 2025, according to Beckers Hospital Review: 93

In California: 12

In the Bay Area: 5

Number of vacant positions that Santa Clara Valley Healthcare, the county's public health care system, expects to eliminate in 2026 due to funding reductions from H.R. 1: 218

Number of jobs that Pomona Valley Hospital Medical Center, a not-for-profit safety-net health system in southern California, expects to cut in 2026 due to a $40 million projected budget shortfall because of H.R. 1 (128 of which are already-vacant positions, and 137 are layoffs or reductions in hours ): 265

Number of jobs that UCSF cut in June 2025, citing rising operating costs and low reimbursements: 200

Number of jobs that Stanford Medicine's Lucile Packard Children's Hospital in Palo Alto cut in 2025, in part due to reduced funding because of H.R. 1: 87

Number of jobs that Kaiser Permanente cut in 2025: 158

Number of jobs that Alameda Health System (AHS) expects to cut in 2026 due to adverse budgetary conditions, the most significant being the passage of H.R.1: 231*

*Data provided by AHS