San Francisco, United States – Karen Sanchez has seen S, a man in his 30s with Down syndrome, every few months for the last 10 years that she has worked in an outpatient laboratory in a hospital in Antelope Valley, a rural part of Los Angeles County.S comes with an official caretaker and breaks into a smile when he sees Sanchez, with her now familiar purple hair, waiting in the lobby. She shows him in to get his bloodwork done, and then they do not meet for the next few months.Recommended Stories list of 4 itemsend of listSanchez said she has been staying up late thinking of S and other patients with complex medical conditions, many of whom she has seen since their childhood. United States President Donald Trump’s One Big Beautiful Bill Act (OBBBA), passed in July 2025, would require S and other such patients to fill out paperwork every six months to determine their eligibility for Medi-Cal, the California version of the federally funded medical coverage programme known as Medicaid.This is a complex task for patients like S, whose name is being withheld to protect patient privacy.“It is hard for him to even grasp the changes,” Sanchez said.The OBBBA sought to save $100bn in expenses by asking patients to fill out eligibility paperwork more often, increasing work requirements to maintain coverage for those who …
