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County staff warn HR 1 could strip coverage from tens of thousands and strain hospitals
Summary
Riverside County officials told supervisors that implementation of HR 1 could remove coverage for roughly 100,000 patients, reduce hospital visits and bed days, and leave county hospitals and clinics with large funding shortfalls unless state or federal backfill is secured. The board heard staff advocacy plans and potential local budget impacts.
County staff told the Board of Supervisors on April 28 that state and federal changes known as HR 1 could have severe near‑term effects on local health care and human services.
During a presentation on the county’s legislative report, a county legislative staff member summarized estimated impacts the county is using for advocacy: about 100,000 fewer people enrolled in medical coverage locally, roughly 1,000,000 fewer clinic visits, 25,000 fewer hospital bed days and an estimated $300 million drop in hospital revenues, alongside increased indigent‑care loads the county would be required by law to cover. “We predict that we'll have a 100,000 patients lose medical,” the staff presenter said while walking supervisors through the modeling.
The presentation separated effects on hospital and public‑health services from the administrative burdens on benefit programs such as CalFresh and Medi‑Cal. Staff said HR 1’s re‑enrollment requirements — including re‑verifying eligibility every six months — would substantially increase caseload and workload while decreasing staffing levels; one slide projected a local workforce loss equivalent to hundreds of eligibility workers and large increases in caseloads. The county’s state budget request slides cited examples of funding the county and its partners are seeking, including requests framed at the statewide level for indigent care, public hospitals and behavioral‑health support and a local ask of roughly $373 million to hire eligibility workers.
Board members and the county CEO’s office framed the problem as both a funding and an operations challenge. A county executive office representative said the county will advocate in Sacramento and in Washington, D.C., with partner counties and statewide associations to try to secure mitigation funding and regulatory relief. The board also heard that without state backfill, the county will face difficult choices across services, because county law requires provision of emergency and indigent care.
Why this matters: supervisors and staff said the changes would not only affect patients who lose coverage but could increase strain on emergency rooms, delay care and increase pressure on county budgets for safety‑net services. Staff said the county will bring a communications and advocacy plan to the board before key state budget milestones and will pursue coalition work with other counties.
What happened next: staff said members of the board and county leadership will travel to Sacramento for advocacy in early May and will present follow‑up briefings on the county’s strategy as the May revise and final budget process unfolds.
