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State updates: advocates warn HR 1 changes could cost counties and strip Medi‑Cal coverage for nearly 1 million
Summary
Amy Costa of Full Moon Strategies told the committee that federal changes proposed in HR 1 and related state budget shifts could force counties to backfill costs, risk Medi‑Cal enrollment reductions of about 1,000,000 beneficiaries, and affect CalFresh and carrier-of-last-resort policy debates; staff outlined potential revenue options including changes to the MCO tax.
Amy Costa of Full Moon Strategies briefed the Alameda County Personnel Administration and Legislation Committee on Nov. 17 about state-level developments that could affect county budgets and health and nutrition programs.
Costa said the U.S. Department of Justice has joined a lawsuit challenging California's Prop. 50 congressional map, and she noted leadership changes in the state Senate. She emphasized recent hearings examining how HR 1 — federal proposals that would tighten work requirements and alter eligibility — could affect Medi‑Cal and CalFresh, noting that CalFresh serves over 5,500,000 residents and injects about $1.1 billion into California's economy each month. "A key takeaway from the hearing was the anticipated loss of coverage for nearly 1,000,000 beneficiaries," Costa said, and she warned that counties that operate indigent health programs or county-run hospitals could face higher uncompensated care costs.
Costa also updated the committee on a carrier-of-last-resort (COLR) debate and AB 470 (Assemblywoman McKenna), which previously would have allowed telecommunications providers to remove copper landlines in well-served areas. She said AB 470 failed to pass out of the Senate Appropriations Committee and that the California Public Utilities Commission is pursuing a rulemaking that could determine obligations for basic landline service if the Legislature does not act.
On revenue, Costa said alterations to the managed care organization (MCO) tax could be worth about $12 billion annually for California and that several tax measures (extensions of Prop. 30/55 or a new millionaire's tax) are under discussion to address potential state shortfalls. Committee members expressed concern about ballot timing in an election year.
Why it matters: county budgets and health providers could face increased costs and administrative burdens if federal or state policy tightens eligibility or shifts fiscal responsibility to local governments.
The committee received the report, asked clarifying questions, and heard no public speakers on the state update at this meeting.
