County warns HR 1 could cut Medi‑Cal and CalFresh access, shift millions to local budgets

Summary

At a Sept. 3 workshop Sacramento County staff said federal HR 1 changes could reduce access to Medi‑Cal and CalFresh for tens of thousands locally, increase administrative burdens, and shift at least $9.3 million in county costs for CalFresh into upcoming budgets. Staff will return this winter with cost scenarios and mitigation options.

Sacramento County supervisors heard a workshop Wednesday on how HR 1, federal legislation signed July 4, 2025, could affect Medi‑Cal, CalFresh and other safety‑net programs and shift costs to state and county budgets.

Deputy County Executive for Social Services Shivang Kothari told the Board of Supervisors the changes are rolling out over the next three years and that many details remain in rulemaking and litigation, but some consequences are already clear. “Federal changes and cuts flow to states, and then states have to determine how they'll respond to them, and those responses become county realities,” Kothari said.

Kothari said the county is preparing scenarios because the state’s response will determine how much of the cost and administrative burden falls to counties. She said HR 1 alters eligibility and program rules for Medicaid (Medi‑Cal at the state level), SNAP (CalFresh) and public‑health grants, and will narrow exemptions and add work or community‑engagement requirements that could mean reporting, verification and participation burdens for people who now receive benefits.

County staff offered…

County warns HR 1 could cut Medi‑Cal and CalFresh access, shift millions to local budgets

Summary

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