California is considering a new billionaire tax to replace funds lost after US government cuts to Medicaid. The tax would charge 5% on assets over $1 billion owned by residents. Bernie Sanders will launch a campaign in Los Angeles to collect signatures to bring the tax to a vote in November. The tax would apply retroactively from January 1, 2026. The state faces a nearly $3 billion budget deficit partly due to these federal cuts. California has 14.5 million Medi-Cal recipients, the highest in the US, including many with complex medical needs. Under new law, patients like S, who has Down syndrome, must fill out eligibility forms every six months, a difficult task that may cause some to lose coverage. Billionaires including Google cofounders Larry Page and Sergey Brin are moving out of California or shifting companies to Florida amid the tax threat. Facebook founder Mark Zuckerberg is also reported to be buying a home in Miami. Business groups oppose the tax, warning it could hurt California’s economy and job market. Supporters argue the tax could help protect vulnerable patients by restoring lost Medicaid funds. Health worker Karen Sanchez, who cares for patients like S, collects signatures at a local brewery to support the tax. She said cuts could force people to travel long distances for hospital care. Governor Gavin Newsom has distanced himself from the tax proposal, calling billionaire moves out of state a risk, but he has not endorsed the ballot measure. Political experts expect strong debate and possible legal battles if the tax reaches the ballot. The billionaire tax debate reveals a deep divide in California between wealth and poverty. Nearly 200,000 may lose Medi-Cal coverage due to increased paperwork under the new federal rules. The outcome will impact the state’s future healthcare and economy.