The San Diego County Board of Supervisors is considering a proposal directing county government to prepare for anticipated cost shifts in the federal budget.
Supervisors Terra Lawson-Remer and Monica Montgomery Steppe issued a board letter in response to the proposed federal budget, which is now awaiting approval in the U.S. Senate.
“If enacted, the bill could shift hundreds of millions in costs onto counties like San Diego, requiring the county to absorb new responsibilities for programs that help residents stay healthy, housed and fed,” the two supervisors stated.
The recommendations come as supervisors are also scheduled Tuesday to vote on the county’s $8.62 billion recommended budget for 2025-2026.
According to Lawson-Remer and Montgomery Steppe, the so-called One Big Beautiful Bill Act, a budget reconciliation bill backed by President Donald Trump, would:
reduce the federal medical assistance percentage for Medicaid’s Affordable Care Act expansion population, causing an estimated $10 million shortfall for behavioral health services; call for new requirements, including on work status, for Medi-Cal eligibility, which could potentially disrupt coverage for almost 900,000 San Diego County-area residents and increase the administrative burden; shift more CalFresh food benefits and administrative expenses to states and counties, potentially costing San Diego County an extra $276 million and affecting over 400,000 residents who rely on the program.“While many of these changes would take place in phases beginning at the earliest in January 2026, the operational impact would begin far earlier, through increased workload, system strain, and the need to hire and train additional eligibility workers,” according to the offices of Lawson-Remer and Montgomery Steppe.
The supervisors said the Trump administration’s proposed Housing and Urban Development budget would eliminate or scale back core programs, such as Section 8 and emergency housing vouchers, along with support for low-income and HIV-positive residents, “representing an estimated $20 million annual funding loss to the county.”
“Our county budget is balanced for the moment but it doesn’t yet reflect the scale of what’s coming,” said Lawson-Remer, board vice chair and acting chair.
Montgomery Steppe said systems “are stretched thin as it is.”
She noted that too often, local governments are reactive and “after the damage is done, we’re left wishing we had done more to prepare.”
“If we don’t act now, it’s working families, seniors and kids who will pay the price,” Montgomery Steppe added.
Two ensure readiness when any federal changes take effect, Lawson- Remer and Montgomery Steppe recommend that by July 22, Chief Administrative Officer Ebony Shelton present a report that outlines:
how many additional self-sufficiency workers may be needed to process Medi-Cal and CalFresh under potential new federal rules while maintaining quick wait times; a communications plan to prepare affected residents; and ways to avoid coverage delays or benefit loss.Lawson-Remer and Montgomery Steppe are also asking for a fiscal analysis, along with funding options for services, by Sept. 30.
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