SAN DIEGO — The San Diego County Board of Supervisors today voted 3-1 in favor of an amended proposal directing county staff to prepare for anticipated cost shifts in the federal budget.
Supervisors Terra Lawson-Remer and Monica Montgomery Steppe issued a board letter in response to the proposed federal budget, which is now awaiting approval in the U.S. Senate.
“If enacted, the bill could shift hundreds of millions in costs onto counties like San Diego, requiring the county to absorb new responsibilities for programs that help residents stay healthy, housed and fed,” the two supervisors stated.
Lawson-Remer, Montgomery Steppe and Joel Anderson voted yes, while Jim Desmond voted no.
Based on a suggestion from Anderson, the board letter will also include the county sending letters to its Congressional delegation and state elected officials on how possible cuts would impact residents.
However, an order directing staff on notifying constituents of potential cuts will not be part of the plan, although supervisors could consider it at a future meeting.
Supervisors are also scheduled Tuesday to vote on the county’s $8.62 billion recommended budget for 2025-26.
According to Lawson-Remer and Montgomery Steppe, the so-called One Big Beautiful Bill Act, a budget reconciliation bill backed by President Donald Trump, would:
— reduce the federal medical assistance percentage for Medicaid’s Affordable Care Act expansion population, causing an estimated $10 million shortfall for behavioral health services;
— call for new requirements, including on work status, for Medi-Cal eligibility, which could potentially disrupt coverage for almost 900,000 San Diego County-area residents and increase the administrative burden; and
— shift more CalFresh food benefits and administrative expenses to states and counties, potentially costing San Diego County an extra $276 million and affecting over 400,000 residents who rely on the program.
“While many of these changes would take place in phases beginning at the earliest in January 2026, the operational impact would begin far earlier, through increased workload, system strain, and the need to hire and train additional eligibility workers,” according to the offices of Lawson-Remer and Montgomery Steppe.
The supervisors said the Trump administration’s proposed Housing and Urban Development budget would eliminate or scale back core programs, such as Section 8 and emergency housing vouchers, along with support for low-income and HIV-positive residents, “representing an estimated $20 million annual funding loss to the county.”
“Our county budget is balanced for the moment, but it doesn’t yet reflect the scale of what’s coming,” said Lawson-Remer, board vice chair and acting chair.
Montgomery Steppe said systems “are stretched thin as it is.”
She noted that too often, local governments are reactive and “after the damage is done, we’re left wishing we had done more to prepare.” “If we don’t act now, it’s working families, seniors and kids who will pay the price,” Montgomery Steppe added.
To ensure readiness when any federal changes take effect, Lawson-Remer and Montgomery Steppe recommend that by July 22, Chief Administrative Officer Ebony Shelton present a report that outlines:
— how many additional self-sufficiency workers may be needed to process Medi-Cal and CalFresh under potential new federal rules while maintaining quick wait times; and
— ways to avoid coverage delays or benefit loss.
Lawson-Remer and Montgomery Steppe also requested a fiscal analysis, along with funding options for services, by Sept. 30.
Before the vote, Lawson-Remer said federal cuts could “mean more paperwork … essentially a death by red tape.”
The acting board chair added she wasn’t asking staffers to fix all the problems connected with the federal budget, which are too large on their own, and also praised her colleagues for talking through a difficult issue.
Montgomery Steppe said that if federal cuts happen, “we will be paying for people to go in and out of our system,” whether it’s jail or something else, she added.
Montgomery Steppe noted that in her personal life, government programs “have been stepping stones to a better quality of life and have provided people an opportunity to give back to society.”
Anderson took issue with notifying people if leaders are uncertain about federal budget cuts.
“I have 200,000 people roughly that live in the unincorporated area, and my phones will be ringing off the hook and I’ll have to explain to them, ‘Well, it may happen,”’ he explained.
Desmond said federal and state budget deficits are the “whole reason we’re in this mess … so we either raise taxes on everybody to make up for that, or make some cuts.”
Desmond said deliberations over the federal budget aren’t done. “I wish we had unlimited funds to pay for all those things, but we don’t,” said Desmond, who added he supports better verification for Medicaid and MediCal programs to prevent fraud and waste.
In a statement after the vote, Desmond said the county needed to protect its limited resources “for the people who need them most — American citizens who are struggling to make ends meet.”
“California is already facing a $12 billion deficit, and even Governor (Gavin) Newsom has acknowledged the cost by proposing a freeze in Medi-Cal enrollment for undocumented immigrants, Desmond added.
During the public comment period, most speakers were in favor of the original proposal.
Maureen Glaser, who oversees a no-cost transportation program, said budget cuts will leave vulnerable seniors “without the rides they depend on to access medical appointments, get to the grocery store and connect with their community.”
One county healthcare employee said there was “nothing ‘beautiful’ about slashing Social Security, Medicaid and veterans’ benefits programs.
“This isn’t about party lines, it’s about an ideology that says, `I’m fine, your suffering doesn’t matter,” she added.
