Metro Health braces for cuts to diabetes prevention program
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San Antonio's Metropolitan Health District is warning of drastic cuts to programming, including its diabetes prevention workshops, as a funding stream it has relied on for more than a decade comes to an end.
Why it matters: Bexar County adults are more likely to have diabetes than adults across the U.S. The mortality rate for diabetes in Bexar County is 37% higher than in Texas overall, per U.S. Census Bureau data.
The big picture: The city's health department is facing a "perfect storm" of budget challenges, Metro Health director Claude Jacob tells Axios. COVID-era funding is disappearing, the Trump administration is cutting grants, and the city broadly has had to tighten its belt as tax growth has stalled.
- On top of it all, there's an expected wind-down of Medicaid funding.
The latest: Metro Health is budgeting for federal Medicaid funding that's managed through the state to run out in September 2026.
- It expects to lose about 10%, or $8 million, of its budget as a result of the program's end. It may need to cut 80 jobs department-wide.
Zoom in: Without the funding, Metro Health's Diabetes Prevention & Control program will lose 72% of its budget, Jacob says. If the gap isn't filled, the city expects to cut 9 of the 12 full-time jobs in the program, along with cutting the number of workshops it offers by 60%.
- The workshops offer education on physical activity and nutrition and help people manage their diabetes to avoid severe complications.
- From October 2024 through the end of this September, 562 people enrolled in the program's 65 workshops, with 80% of participants completing it.
Zoom out: Other Metro Health programs affected include those focused on teen pregnancy and STD prevention, oral health, community health workers, and gun violence prevention.
What they're saying: "Without access to these health care programs, our residents are going to suffer," District 7 Councilmember Marina Alderete Gavito said at a committee meeting last week about the coming cuts.
- "Money is tight. I think we're just going to have to be creative on how we find solutions."
Context: The federal Medicaid funding was first approved in 2011 for uninsured and low-income patients. Metro Health used the funds to establish its diabetes prevention program in 2013.
- But the funding was never meant to be permanent, and it ended in 2021.
- Metro Health continued to earn reserve payments that it budgeted through September 2026, Jacob says.
The bottom line: Metro Health is going to have to make hard decisions.
- "We're playing out all the scenarios. The reality is that the dollars just aren't there," Jacob says. "There will have to be some concessions."