Mariposa Community Health Center officials briefed the Santa Cruz County Board of Supervisors in a study session on impending changes to Medicaid and marketplace insurance that, they said, could reduce coverage for many residents and increase pressure on local primary care and hospitals.

Amy Taylor, CEO of Mariposa, and Dr. Pereira (Mariposa) described a range of federal and state changes and local consequences. Taylor said roughly 1.9 million Arizonans are covered by Medicaid and that changes to enhanced premium tax credits and Medicaid eligibility could lead to a large enrollment drop. She summarized the consequences the center expects: fewer insured patients, higher emergency-department use by people without primary care and a loss of navigator assistance for marketplace enrollment.

Dr. Pereira said the clinic anticipates a “significant loss” of Medicaid enrollees over the coming enrollment cycles and warned rural hospitals and clinics would be especially affected. He said patients without access to primary care often seek care in emergency departments rather than preventive or specialty settings.

Mariposa described local mitigation plans: expanding community education about eligibility and enrollment, using the clinic’s sliding-fee program and financial assistance, pursuing grants to address unpaid medical debt, and working with workforce and community partners to help certain recipients meet new community-engagement work requirements tied to eligibility.

Board members said they would help with public outreach channels and asked Mariposa to return with updated impact projections after the federal and state changes take effect. Mariposa recommended the county coordinate community education now to reduce the risk of large coverage losses in 2026–2027.

No formal board vote was required; the item was a study session.