San Diego supervisors ask county to plan for sweeping federal cuts to food, housing and health programs

SAN DIEGO — The San Diego County Board of Supervisors on June 11 directed the county chief administrative officer to develop a comprehensive strategy to prepare for potential federal changes that would reduce funding and increase administrative requirements for health care, food and housing programs.

The board’s action — passed by a 4‑1 vote with Supervisor Jim Desmond opposed — asked county staff to assess staffing and operational readiness, estimate fiscal shortfalls and identify options for funding, including midyear adjustments, intergovernmental cost‑sharing and philanthropic partners. A separate recommendation to prepare a notification plan for CalFresh recipients only if and when the federal bill becomes law was bifurcated and failed on a tie vote.

The board’s letter responds to proposals in a federal package discussed in Congress (referred to in the meeting as the “1 Big Beautiful Bill Act” or HR 1) that supervisors and county staff say could shift substantial costs and red tape to counties. Vice Chair Lawson R. Reimer, who led the item, summarized the local stakes: “The bill … slashes housing and food assistance, shrinks Medicaid funding, and adds massive new red tape without giving us any tools, strategies, or funding to manage the fallout.”

Why it matters: County staff told supervisors that an outcome like the one in HR 1 could require twice‑yearly eligibility redeterminations for Medi‑Cal, new work‑verification rules and shorter retroactive coverage periods, all of which create heavy paperwork and risk that eligible people temporarily lose benefits. Supervisors and public commenters warned that disrupted benefits would hit low‑income residents, seniors and people with serious health needs.

County staff figures cited on the dais: roughly 900,000 San Diegans rely on Medi‑Cal; more than 400,000 depend on CalFresh and about 130,000 of those are children; roughly 10,000 households in the county use Section 8 vouchers. County staff also said a worst‑case shift of CalFresh administrative and benefit costs could reach hundreds of millions of dollars, with separate administrative responsibilities of about $50 million.

County staff and experts outlined likely operational impacts. Rick (county self‑sufficiency lead) told the board the proposed changes — work requirements and twice‑annual redeterminations — would be “unprecedented” for Medicaid and would increase churn, paperwork and the risk that eligible people lose coverage. Nadia (county behavioral health staff) said reductions in federal Medicaid match could force either cuts in outpatient and crisis stabilization services or the reallocation of county‑funded recovery‑residence and long‑term care beds.

Public comment on the item was extensive. Workers and nonprofit leaders urged the board to prepare: “Keep those community members and your workers in the center of every decision,” SEIU representative James Calloway told supervisors. Maureen Glaser of a no‑cost senior transportation program said cuts would “leave hundreds of vulnerable seniors … without the lifeline they depend on.” Several county eligibility workers described current heavy workloads and asked the board to plan for additional staff or other mitigations.

What the board approved: The CAO was directed to return by July with a staffing and operations readiness assessment and by September with a fiscal strategy that identifies potential funding sources, implementation options and legal constraints. The board also agreed to send letters to federal and state elected officials urging them to protect critical programs.

What failed: Supervisors voted 2‑2 on a separate recommendation to develop a notification plan to alert CalFresh recipients of service‑level changes if and when HR 1 is finalized and signed into law. The board left that recommendation to be reconsidered at a future meeting; staff said it would be placed on the July 22 agenda if not otherwise scheduled.

Context and next steps: Supervisors said the action is preparatory — not a change in benefits — and emphasized staff must return with concrete cost estimates and options. County leaders and nonprofits said they will press the region’s federal delegation and the state to preserve funding and to limit the administrative burdens counties would shoulder if the federal bill becomes law.

“I want the plan in place so that we’re able to rise to the moment,” Vice Chair Lawson R. Reimer said on the dais. The CAO will report back to the board as directed.