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Alameda County committee warned of possible deep Medicaid cuts as Congress resumes budget work
Summary
County advisers told a Board committee that House budget instructions could force roughly $880 billion in cuts the Energy and Commerce Committee must find — cuts many expect would hit Medicaid — while state officials flagged up to $6.2 billion in short‑term Medi‑Cal loan requests.
The Alameda County Personnel Administration and Legislation Committee was warned Monday that congressional budget negotiations and state Medi‑Cal financing strains could put local health programs at risk.
Emily Baca De Silva of lobby firm CJ Lake told the two‑member committee that Congress returned to session this week and is rushing toward a budget and reconciliation agreement before an Easter recess. "One of the things we are tracking is the fact that the House budget resolution had directed the Energy and Commerce Committee ... to come up with $880,000,000,000 in cuts," she said, adding that those reductions have generally been understood to fall largely on Medicaid because few other program areas can absorb cuts of that magnitude.
Amy Casa of Full Moon Strategies delivered the state update and stressed that California officials are already seeing pressure on Medi‑Cal finances. She said the administration requested a $3,400,000,000 loan to address caseload projections and that press reports indicate an additional $2,800,000,000 request could follow, "bringing the total amount to $6,200,000,000," which she described as a significant figure for state program solvency.
The briefing tracked several drivers of higher costs: eligibility expansions, retroactive effects tied to a managed‑care financing change discussed in the briefing as "Prop 35," and general health‑care cost growth. Casa said the Department of Health Care Services had limited data when preparing the governor's budget and is seeking more realistic projections for the May revise.
Supervisor Tam asked whether a proposed federal reorganization or the possible closure of the U.S. Department of Education would affect local services such as summer lunch programs or supports for disabled students. Baca De Silva said details remained unclear and that any abolition of a federal department would require action by Congress; she noted Senate discussion and that some members, including Sen. Cassidy, have signaled intent to introduce related legislation.
Scott Dickey, assistant county counsel, advised the committee it could proceed with informational briefings and forward agency recommendations to the full Board without taking formal committee action when fewer than a quorum were present. The committee did not take votes on legislative positions but agreed to advance the county's recommendations to the Board for consideration.
County staff and advisers said they will continue to monitor both the federal reconciliation process and the state's Medi‑Cal financing discussions and will report back to supervisors as more details and formal proposals emerge.
