On Nov. 13, the City Council in Santa Fe, New Mexico, voted to integrate the cost of housing in its calculation of the citywide minimum wage going forward. According to the UC Berkeley Labor Center, this marks the first time in the U.S. that a city has factored local housing costs directly into setting its minimum.

That would include the loss of plenty of health care jobs — up to 145,000, according to an April estimate by the UC Berkeley Labor Center.

“I think the totality of our report is about how hard these unions continue to work to organize and provide benefits to their workers,” Lopezlira said. “Given all these headwinds — housing, health care affordability, technology, AI — the resiliency of California unions to look for innovative ways to help workers is critically important.”

“If the full effect of tariffs comes into place, and if the labor market indicators continue to show weakness and eventually more significant downturn, then I don’t see how those future tax benefits will help workers right now or for the rest of the year,” Lopezlira said.

The state budget signed into law on June 27 would require most undocumented adults — those between the ages of 19 and 59, who currently get free health care — to start paying as much as $360 annually for Medi-Cal coverage. The new premium for undocumented adults with very low incomes is slated to go into effect at the start of 2027.

More than half a million undocumented Californians still earn too much to qualify for Medi-Cal yet don’t have employer-based coverage, rendering them effectively uninsured, according to research by the University of California, Berkeley, Labor Center.

“If federal Medicaid spending is cut,” Lucia said, “it would affect health care providers and health care jobs.” Less funding means less service, fewer providers getting paid, and/or those providers’ rates for service being slashed.

Over the past year, though, undocumented immigrants have grown more trusting of the health care program, which has helped California’s least insured group gain coverage.

“This is part of a long-term project to eliminate the labor movement and unions. What is new, though, is the acceleration — doing something so massive, so quickly and chaotically, with no regard to the law nor humanity,” said Danielle Mahones.

During Trump’s first term, congressional Republicans proposed slashing Medicaid funding, though the measure did not clear the U.S. Senate. Had it passed, “California would have lost tens of billions of federal dollars,” Lucia said. Should the Trump administration go after the program on a similar scale in 2025, California wouldn’t be able to fill the resulting revenue hole with state funds.

The Biden-era policies contributed to the lowest rate of uninsured U.S. residents in history. If they are allowed to expire next year, experts such as Miranda Dietz said they worry that health insurance costs and the rate of uninsured Americans will increase significantly.

About one third of California workers — 5.6 million in all — are defined as low-wage earners by the UC Berkeley Labor Center. And the leading occupation of low-wage earners isn’t fast food worker, but rather home health care and personal care provider.

“Anything that enhances (workers’) ability to organize and lower the power imbalance that now exists will ultimately result in better working conditions, including wages,” said Enrique Lopezlira, director of the Low-Wage Work program at the UC Berkeley Labor Center.

“Increases in the state minimum wage have never been paused,” and the delay is “very unusual,” said Ken Jacobs.

The UC Berkeley Labor Center reported in August that 18 campus strikes occurred over the previous year and half, as unions seized a tight job market to press for greater gains.

The University of California, Berkeley’s Labor Center projected a smaller impact from the new health care worker wage law, estimating it will cost the state in the “low hundreds of millions of dollars in fiscal 2025,” according to a report published in February.

“There are about half a million folks who are undocumented but earn too much for Medi-Cal, so they are uninsured,” Dietz said. “They’re also not part of DACA, because that program no longer accepts new applicants.”

Researchers estimate there are 2.2 million undocumented people in California. There may be 520,000 people who earn too much to qualify for Medi-Cal but don’t have employer-provided health care, said Laurel Lucia, the health care program director at the UC Berkeley Labor Center.

“Raising the minimum wage is a simple, direct way that we can improve the incomes of low-wage workers, pull many poor families out of poverty and pull many children out of poverty,” Ken Jacobs, co-chair of the UC Berkeley Labor Center, said in a 2021 release accompanying one of the center’s studies.

“I think we know that health care is unaffordable, but to see how much that problem has gotten worse in 20 years is really something,” said Miranda Dietz, a policy research specialist at the UC Berkeley Labor Center and co-author of the report. “The costs are taking up more and more of a family’s budget.”

According to research by the UC Berkeley Labor Center, more than 450,000 workers will be affected by the raises, and the impact will be most significant for workers of color, who make up more than 70% of health care workers in the state, and women, who account for 75% of that workforce.

California may have an active labor movement and labor-friendly political leaders in control of its Legislature and many city councils. But almost one in three California workers — 4.3 million people — are employed in a job that pays less than $18.02 per hour, according to a UC Berkeley Labor Center data explorer.

California’s revived Industrial Welfare Commission will prioritize those industries that have 10% or more of their workers living in poverty. About 15% of fast-food workers live in poverty, twice the rate of the overall workforce, according to a 2021 study from the UC Berkeley Labor Center.

What the conversation around SB 525 really underscores is just how many of California’s health care workers aren’t making enough to get by.

Under Biden’s proposed rule, “There is a very strong case that gig workers are misclassified,” Jacobs wrote in an email to Capital & Main. “The proposed rule would make it easier to prove misclassification in industries with a long history of misclassification, like janitorial, trucking and construction.”