Several East Bay hospitals that serve Alameda County's most vulnerable residents have issued layoff notices to staff, citing major federal cuts to Medicaid that administrators say will significantly affect their finances.

Alameda Health System (AHS), which oversees five major public hospitals, including Highland Hospital in Oakland, said the layoffs are largely the result of a $1 trillion reduction to Medicaid under the Trump administration. In California, the program is known as Medi-Cal. According to AHS, about 60 percent of its patients rely on the program.

Longtime Alameda Health System patient Benny Middlebrooks said he worries the staffing cuts will jeopardize care for patients like him.

"I've had a couple of seizures, a couple of strokes here. I've had a lot of health issues here, and they keep me intact," Middlebrooks said.

Middlebrooks credited doctors and nurses at Fairmont Hospital with saving his life and said he fears the consequences of potential layoffs.

"They'd been keeping me alive, man. Keeping me together. I love my nurses. I don't want to lose none of them. We don't need no layoffs," he said.

Alameda Health System officials said the financial situation has left them little choice. The system estimates it will lose more than $100 million annually by 2030 as a result of the Medicaid cuts. In a statement, AHS confirmed it will eliminate 247 positions across all departments. Layoff notices have already been sent.

AHS also operates John George Psychiatric Hospital in San Leandro, where staff members said the cuts are already taking a toll on morale.

"I'm depressed. It's disgusting. I'm angry," said Tawanda Gilbert, a mental health specialist at the facility.

Gilbert blamed Congress for the funding reductions and described the layoffs as premature.

"AHS has not lost one single dollar. The money is there. The jobs that are currently being affected — they are currently in budget for," Gilbert said. "So these are very premature, and it is definitely, definitely unnecessary."

While Gilbert acknowledged that a long-term budget deficit exists, she said Alameda Health System should do more to reduce the impact on frontline workers and patients. She warned the cuts will disproportionately affect low-income communities.

"It will hurt the low-income Black and Brown community. It will hurt the patients who are depending on AHS," Gilbert said.

Middlebrooks echoed those concerns, emphasizing the importance of the services provided by the health system.

"We don't need any cuts. They keep a variety of people alive here," he said.

Alameda Health System officials said they are not alone in facing financial strain, noting that nearly all health systems across the country are affected by the so-called "Big Beautiful Bill" signed by the president. Health experts said hospitals serving inner-city and low-income populations are likely to experience the deepest cuts and the most severe consequences.