The Trump administration is changing the way government operates at a breakneck speed, and many in local governments are struggling to even understand where it all may be going.  

On Saturday, state, local and federal lawmakers met at the Santa Clara County government center for a community meeting to talk about the coming impacts of the "big, beautiful bill."

Santa Clara County has the largest and most diverse population in the Bay Area. So when you talk about the biggest human impact at the county level, you're talking about healthcare.

"They run the second biggest hospital system in the state. A very large percentage of their revenue is from the Medicaid program, which has been drastically reduced in the so-called 'big, beautiful bill,'" said Congresswoman Zoe Lofgren. "We need to talk about how we can prevent worst-case scenerios."

Lofren was one of many elected officials who spoke at a community meeting at the Santa Clara County board chambers, organized by Supervisor Betty Duong.

"There are severe, severe detrimental cuts and I don't think even the word 'cuts' is an accurate portrayal of the level of gutting and decimation of our nation's public healthcare system," said Doung. "You will face crowded emergency rooms, longer wait times for healthcare services, because of the ripple effects of HR 1."

At this point, the full impact of the budget law is hard to quantify. Opponents say even if Medicaid coverage, known in California as MediCal, isn't directly cut, access to healthcare will get harder as the system itself is shrunk by defunding.

"It's scary. It's a dumpster fire every other day for us in the disability community," said Michele Mashburn.  

The disability rights advocate said she has no doubt that the cuts will lead to deaths.

"There are people that wait to get on disability benefits that no longer work, that become unhoused, and then they die," Mashburn said.  "There are many people waiting for benefits that die. There are family members that will lose the supports that they need to take care of their kids. People will be institutionalized, and those institutions are being defunded also. So, the care and services available they're inhumane. They're not just. And with these cuts, that's what's going to happen more."

The law also includes cuts to housing and food assistance. But, at the same time, the United States Immigration and Customs Enforcement will be getting an increase in funding, making it the largest law enforcement agency in the country. State Assemblymember Ash Kalra sees a dark motive behind that.

"Tens of billions going into ICE is basically for Trump to create his own Gestapo," he said.  "So that he can enforce and do whatever he wants. He's starting by taking over D.C. right now. He made efforts in L.A. and other places. We have to be very honest about what's happening right now. Immigrants are being used as the scapegoat. We must focus on protecting our immigrant community, but we must recognize it's not going to stop at the immigrant communities."

Under the new budget law, it's projected that Santa Clara County alone will face funding cuts of a billion dollars. Congressman Sam Liccardo said California can do what it can, but ultimately, there is no way for the state to replace what is being taken away.

"The truth is there's no entity that can supplant trillions of dollars, and that's what we're talking about, literally one trillion dollars in Medicaid funding," said Liccardo. "And so, these kinds of massive impacts can't be filled by local cities or counties--they're just too large--nor states, which many are struggling just as California is."

The Democrats are pinning their hopes on the 2026 midterm election to return control of Congress back to them. But Liccardo said he thinks it's possible there could be breaks in the Republican ranks even before then.

"We're going to see these impacts nationally. And as the impacts start to roll out, I expect you're going to see more of those colleagues of mine with wobbly knees," he said. "And that will be our opportunity.  And maybe this conversation will be much more fruitful about, 'hey, how can we actually reverse some of this damage?'"

The Republicans realize that, so they've timed the major cuts to the healthcare system to kick in a month after the election. That's why local leaders aren't waiting to get the word out to the voters about what's coming for them.