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County panel warns HR 1 and other state/federal shifts will force deep local budget tradeoffs
Summary
County and statewide public‑health and social‑services leaders told Alameda County supervisors that federal HR 1 changes, state implementation choices and one‑time grants such as Prop 1 will shift billions in costs to counties, creating immediate pressures on hospitals, behavioral health and eligibility staff and requiring new state funding or local tradeoffs.
A panel of statewide health, hospital and welfare association chiefs told the Alameda County Board of Supervisors' budget work group on March 16 that recent federal and state policy changes — particularly the federal HR 1 Medicaid cuts and shifting state program decisions — will push substantial costs and workloads onto counties unless the state or federal government provides new funding.
During a panel moderated by Anika Choudhry, interim director of Alameda County Health, Carlos Marquez, executive director of the California Welfare Directors Association, said automation can cover part of the workload but counties will remain responsible for complex redeterminations. "About 2,800,000 current enrollees who are part of the ACA expansion population will ultimately be left to the county eligibility workforce," Marquez said, and he added that roughly 950,000 CalFresh recipients will require county support for exemptions or income verification.
The panel included…
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