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Board backs CSAC request for state funding after briefing on HR 1 effects

El Dorado County Board of Supervisors · April 7, 2026

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Summary

The board heard a detailed presentation from the California State Association of Counties on federal HR 1 and its likely impacts on Medi‑Cal, CalFresh, county indigent care and rural hospitals; supervisors authorized letters asking the governor and legislative leaders to include mitigation funding in the May state budget revision.

Graham Knaus, CEO of the California State Association of Counties, briefed the El Dorado County Board of Supervisors April 7 on federal HR 1 and related state budget implications. CSAC estimates that up to 1.4 million Californians could lose Medi‑Cal coverage under HR 1 and that counties will see large cost and workload shifts—returning a portion of indigent‑care responsibility to counties, increasing eligibility workload and imposing strains on rural hospitals.

After the presentation and board discussion, supervisors voted to authorize letters to the governor, the Senate president pro tem and the Assembly speaker urging the May budget revision to include funding to mitigate county impacts. CSAC’s initial statewide budget ask totals billions across two years, with specific near‑term requests to rebuild indigent‑care capacity, support rural hospital stability, and fund additional eligibility workers to handle more frequent reviews. Supervisors discussed outreach to their legislative delegations and public messaging to explain ramifications at the local level.