Marin County staff warn HR 1 could strip benefits for thousands as supervisors set aside one‑time funding

Marin County Health and Human Services warned the Board of Supervisors on June 8 that federal changes known as HR 1 and parallel proposals in the California budget could sharply reduce access to Medi‑Cal and CalFresh, increasing demand for local services and county costs.

At a public budget hearing, county staff said they are proposing $1.5 million in one‑time local funding to help respond to emerging HR 1 needs, plus an added $500,000 to expand immigrant support services (bringing the total local immigrant services allocation to $1,500,000 over the past year). Health and Human Services staff emphasized the scale and timing of the risk: under a worst‑case scenario staff estimated as many as 2,500 people could lose CalFresh and as many as 5,200 people could lose Medi‑Cal if work‑requirement and eligibility changes are not mitigated. Staff stressed these were contingent, worst‑case figures and said outreach, exemptions and careful case management could reduce losses.

Health and Human Services said key federal and state implementation details remain unsettled — including which groups will qualify for county safety‑net programs such as the County Medical Services Program (CMSP) — and asked the board to receive the update and provide policy and communication direction. Staff described several near‑term actions: (1) an internal HR 1 workgroup to track policy changes and operational impacts; (2) closer coordination with federally qualified health centers and hospital partners through the Healthy Marin Partnership; (3) deployment of community resiliency teams for targeted outreach; and (4) technical work to speed eligibility processing and CMSP enrollment if eligible.

Community health providers and nonprofit partners told the board they welcome the county’s proposed local funding but said the sums are likely insufficient to meet projected clinic and service shortfalls. The county’s budget presentation also noted a roughly $4.2 million increase in ongoing county administrative cost for CalFresh in coming years under the proposed state budget methodology changes, and highlighted that final state trailer bills and federal guidance are expected in the coming weeks.

Board members pressed staff for clearer short‑ and medium‑term metrics (for example, CMSP enrollment, Medi‑Cal caseloads and clinic revenue impacts) and for a timeline to return with refined cost estimates and options for replenishing any reserves used. Staff said they will return with more precise projections and recommended next steps once state and federal trailer‑bill language and federal guidance are available.

The hearing included extensive public comment that echoed the staff concerns and pressed the board to prioritize food‑security, immigrant legal services and early‑childhood mental‑health supports. County leadership said the proposed FY 2026–27 budget is balanced under current assumptions and retains a set of reserves, including a $14 million stabilization reserve intended to be available for short‑term backfill of state or federal revenue losses.