Counties Elevate Unified Call to Address H.R. 1 Impacts Across California

Counties across California are converging on a shared message: H.R. 1 is the most pressing challenge facing local communities, and sustained state partnership is needed to protect California’s safety net.

Thirty-six counties have called on state leaders to support the county family’s multi-year, countywide H.R. 1 budget request so far, demonstrating broad alignment across regions and political perspectives.

“We need them [the state] to understand how frail our systems are and how vulnerable our populations are,” said Lake County Supervisor Jessica Pyska.

Here are a few examples from throughout the state:

• Lake County stands out as one of the most federally reliant counties in California, with more than half of its 68,000 residents enrolled in Medi-Cal and roughly a quarter relying on CalFresh. Officials say that level of dependence leaves the county especially vulnerable to any reductions or disruptions in federal support for health and nutrition programs.
• Del Norte County leaders point to workforce shortages and rural geography that will be compounded by new administrative requirements under H.R. 1. With Medi-Cal covering roughly 44% of residents and Eligibility Worker vacancy rates exceeding 36%, officials warn of increased workload pressures, delayed approvals, and risks to benefit continuity.
• Fresno County officials project between $68 million and $295 million in additional medical costs as residents losing Medi-Cal coverage turn to county-funded care. Leaders say safety net programs such as Medi-Cal and CalFresh are “at immediate risk” without additional funding and describe the impact as an unfunded mandate that will force counties to absorb rising demand.
• San Joaquin County officials estimate H.R.1 could reduce federal revenue to the county by $50.9 million to $76.9 million annually, straining hospitals, public health programs, and other social services. Leaders warn the changes will shift costs and administrative responsibility to counties, creating a structural funding gap while increasing demand.
• San Luis Obispo County warns H.R.1 will cause a “surge in pressure on the county’s indigent health care system.” This rise in uncompensated care will strain local hospitals and providers, which will be felt by all residents, not only those relying on indigent care.

Taken together, these examples reflect a broader statewide reality: H.R. 1 is reshaping the cost and responsibility of delivering core safety net services without providing the resources needed to sustain them.

“Counties do the hard work,” San Joaquin Supervisor Sonny Dhaliwal said. “We run the hospitals, protect public health, care for vulnerable children and keep families fed. H.R.1 shifts costs to the county and adds administrative responsibility for several programs, resulting in a loss of money coming to the county for services and increasing the cost of services already provided. That is not sustainable.”

CSAC continues to provide tools and resources to support this effort, including template letters, background materials, and advocacy guidance. Counties are encouraged to access these resources and join the growing coalition working to “Protect Our Safety Net.” Strengthening participation will be critical to ensure lawmakers understand both the scale of the challenge and the urgency of a sustained, multi-year investment.