In a proactive step to safeguard essential services for San Diego County residents, the County Board of Supervisors passed a proposal at today's meeting with bipartisan support, prioritizing the region's most vulnerable residents exposed to potentially devastating impacts at the state and federal levels.

The measure, introduced by Acting Chair Terra Lawson-Remer and Supervisor Monica Montgomery Steppe, called for the County to begin urgent operational and fiscal planning in response to drastic cuts proposed in the so-called "One Big Beautiful Bill Act" (H.R. 1), passed by the U.S. House of Representatives. If H.R. 1 is enacted, the federal legislation would load hundreds of millions of dollars in healthcare, housing, and food assistance costs onto states and counties.

"These cuts are real, and the suffering they will cause is real," said Supervisor Lawson-Remer. "We laid out a clear-eyed plan to prepare for the real consequences coming out of Washington, and I'm proud that my colleagues are open to the conversation. We cannot leave San Diego unprepared with these looming cuts."

Under the proposal, County staff will return in July with a staffing and workload assessment to highlight how many additional workers would be needed to process Medi-Cal and CalFresh applications under new federal requirements. A second report in September will provide fiscal options to bridge funding gaps in food assistance, in-home care, and behavioral health services. In discussions, Supervisors also added interest of sending official letters to all State Legislative representatives and members of Congress to advocate for constituents within San Diego County.

"Our systems are already stretched to the breaking point," said Supervisor Montgomery Steppe. "This planning effort doesn't make the crisis go away, but we must prepare for the fallouts. Today's decision is discerning and prudent, and our region deserves to know what devastating consequences may be heading our way."

The urgency behind the measure stems from the projected impacts to the County of San Diego from of H.R. 1, which include:

• A projected $10 million shortfall in behavioral health funding due to changes in Medicaid cost-sharing;
• Administrative and coverage disruptions for over 900,000 Medi-Cal recipients under new eligibility rules;
• Potential cost shifts of $276 million for CalFresh if the state passes on federal reductions;
• Up to $20 million in annual housing support at risk, affecting low-income, HIV-positive, and unhoused residents;
• Proposed state changes to IHSS that could affect 7,000 caregivers and the individuals who depend on them for in-home support.

Without a robust assessment, the County lacks a clear roadmap to address anticipated impacts on healthcare, food assistance, and housing services. Today’s proposal introduces a planning measure to provide the Board with information and analysis to prepare for potential federal and state cost shifts.