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County staff warn federal and state SNAP/Medicaid changes could shrink benefits and shift costs to St. Louis County
Summary
Public health and human services staff briefed commissioners on forthcoming SNAP and Medicaid policy changes — higher SNAP work‑requirement age, utility deduction changes, a reduction in federal administrative reimbursement and possible state cost shifts based on error rates — and estimated local impacts and workloads.
Deputy Director of Public Health and Human Services (name not specified in the transcript) briefed the St. Louis County Board on a set of impending federal and state changes to Supplemental Nutrition Assistance Program (SNAP) and Medicaid that staff said could reduce benefits for some households and increase workload and county costs.
On SNAP, staff told the board that work requirements will expand (raising the exempt age from 54 to 64 and changing which caregivers are exempt) and that the standard utility deduction calculation will change from a flat $649 deduction to actual household utility expenses. "We anticipate that this will be about less than a thousand individuals in St. Louis County," the deputy director said of the SNAP population likely affected; the county currently serves roughly 16,000 SNAP recipients. Staff estimated 6,752 households in the county receive Low Income Home Energy Assistance Program (LIHEAP) and could be affected by the utility‑deduction change.
County staff described a major administrative funding shift: federal reimbursement for SNAP administrative costs would fall from 50% to 25%, leaving the county responsible for a larger share. Staff estimated the local financial impact at about $1.5 million in staff costs beginning in 2027, and approximately $300,000 in 2026. They warned of an additional potential $3 million annual exposure tied to how states choose a payment error rate for SNAP compliance beginning in October 2027; staff noted the statewide error rate could shift significant costs to counties unless reduced.
On Medicaid, staff outlined several changes that would increase county workload and affect recipients: more frequent renewals for the Medicaid expansion population (from annual to semiannual renewals), reductions in retroactive coverage (from three months to one month for expansion population, and from three months to two months for other groups), and new Medicaid work‑or‑community engagement requirements under conditions yet to be clarified by state and federal guidance. Staff estimated about 8,170 county residents would be affected by the renewal frequency change. Deputy Director and Administrator Gray urged the board to expect greater call volume and to plan outreach.
Commissioners asked for additional county‑level demographic data and pressed staff to pursue state and federal clarification about implementation timelines and system updates. Commissioner Nelson and others emphasized the county’s relatively low SNAP error rate, noting St. Louis County had been selected for a federal audit because of its approach to training and quality controls, and recommended the county push the state for system modernization and for the state to accept a larger share of the statewide compliance costs.
Deputy Director and Administrator Gray said the county will increase outreach to hospital partners, long‑term care providers, VSOs and community organizations to help residents understand the changes and to reduce negative impacts where possible. Staff noted many specifics remain unresolved, including federal guidance on verifying community engagement or volunteering hours for work requirements and the exact timeline for implementation.
"Beginning this fall, you know, there could be an impact to benefits received," Administrator Gray told the board, adding that notices and new benefit amounts could prompt constituent calls in the months ahead.
County staff recommended continued advocacy with state and federal partners and that the board consider legislative priorities to limit county liability for statewide error rates and administrative cost shifts.
