County officials warn HR1 cuts would strip more than $1 billion from local health services; Santa Clara places Measure A on November ballot

Santa Clara County officials told the Mountain View City Council on Sept. 23 that federal budget cuts enacted in H.R.1 will immediately and substantially reduce Medicaid (Medi‑Cal) and SNAP (CalFresh) funding to the county, creating a revenue shortfall that grows to more than $1 billion annually in coming years. County Executive James Williams and Supervisor Margaret Abakova described a three‑part response that includes cuts and restructurings, state engagement, and a November ballot measure (Measure A) that would add five‑eighths of a cent in county sales tax and is expected to generate about $330 million a year.

County Executive James Williams said Medi‑Cal is the single largest revenue source for the county’s public health system, Santa Clara Valley Health Care, and that the county expects more than $1 billion a year in lost revenue once H.R.1’s Medicaid reductions fully phase in. “If you lose your single largest revenue source, having that cut so dramatically would have catastrophic impacts on your ability to operate the entire range of services,” Williams told the council.

The county’s presentation outlined how the cuts would affect hospitals, behavioral health, supportive housing services and the food safety net. Williams said nearly 14,000 Mountain View residents rely on Medi‑Cal and about 3,400 receive CalFresh; county clinics logged about 10,000 visits in Mountain View during the reporting year. He described specialty services — two trauma centers, the South Bay’s only comprehensive burn center and a West Coast‑ranked rehabilitation center — that rely heavily on Medi‑Cal reimbursement.

Supervisor Abakova said H.R.1’s cuts to SNAP and Medicaid will increase demand for local food banks and make county service delivery more challenging. “We are the social safety net for the community,” she said, adding the county would have to redesign service delivery and “figure out ways to fill the hole.”

To partially offset the loss, the Board of Supervisors unanimously placed Measure A — a five‑eighths cent, five‑year county sales tax — on the Nov. ballot. Williams said the measure is legally limited to the sales tax vehicle available to counties and that it would provide roughly $330 million annually, far short of the full estimated loss but “a very meaningful and impactful amount that would make a difference for the services that we provide.” He also said the measure would include independent oversight and auditing modeled after prior county oversight bodies.

Mountain View council members and residents pressed county officials on specifics: how the cuts would be phased, how the county would prioritize services and what accountability mechanisms the tax would include. Williams said the $1 billion figure reflects recurring annual losses once the H.R.1 cuts are fully implemented and that the county is already taking steps — hiring freezes, service reorganizations and a mid‑year package the Board will consider — to mitigate immediate impacts.

City Council members asked whether the county had discussed splitting Measure A revenues with cities; Williams denied any negotiations to carve up Measure A funds and said conversations have focused on sustaining countywide programs and integrating city‑run temporary housing into a county network. He also explained why a bond was not legally feasible for ongoing operations: state law restricts bond proceeds to capital acquisition or improvements, not operating costs such as staffing and supplies.

Several Mountain View residents and local workers addressed the council during public comment, urging the City to endorse Measure A and highlighting narrow local impacts: longer ER waits, pressure on El Camino and other private hospitals, effects on homeless health outreach, and the broader community consequences of reduced Medi‑Cal and CalFresh services. The Measure A campaign manager provided a website (saveourlocalhospitals.com) and emphasized oversight and exemptions for groceries and essential services from the sales tax.

Council members did not take a formal vote to endorse Measure A during the meeting. County staff provided a web resource (scc.info/federalfunding) for residents seeking more detail on projected cuts and the county’s mitigation plan.

Why it matters: Santa Clara County’s public hospital and safety‑net system delivers critical, specialized care to the South Bay. County leaders say sudden, deep federal cuts to Medicaid and SNAP will affect everything from emergency rooms and trauma care to behavioral health and supportive housing. Measure A is framed by county officials as an emergency fiscal response that would blunt — but not erase — long‑term funding losses.

Next steps: The county will pursue state and local strategies alongside restructuring measures; the Board has placed Measure A on the November ballot. City residents can find county materials at scc.info/federalfunding and campaign information at saveourlocalhospitals.com.