Santa Clara County warns HR 1 will cut Medicaid and CalFresh funding, urges local response; council hears briefing

County Executive James Williams and county staff told the San Jose City Council on Sept. 16 that HR 1, the federal reconciliation bill signed July 4, will sharply reduce federal Medicaid funding and food-assistance aid and will have immediate and growing local impacts. The county estimates more than $1 billion a year of lost Medicaid-related revenue to its health system over coming years and warned that Santa Clara Valley Health Care — the county’s system and San Jose’s main safety‑net hospitals — depends on federal funding for more than half of its revenue.

Williams presented a packet of materials and said the cuts will unfold in stages: immediate freezes and caps that already affect state and county budgeting, then larger reductions tied to changes in eligibility verification and to cuts in specific supplemental payment pools that public hospitals rely on. “The magnitude of impact that we’re facing and the timeline with which we’re facing it is not one where we can just pivot the healthcare system on a dime,” Williams told councilmembers. He said the county will pursue a three‑pronged strategy of internal restructuring and revenue maximization, state advocacy, and a proposed local ballot measure to provide temporary local revenue.

The county and board of supervisors last month voted to place a five‑eighths‑cent general sales tax measure on a…