CSAC Mobilizes to Protect County Safety Net Services from H.R. 1 

H.R.1 dramatically reshapes how critical health and human services are funded and delivered across the country — shifting billions in costs and administrative responsibilities onto states and local governments. 

For California counties, the stakes are especially high. 

Because counties administer many of the state’s core safety-net programs — including Medi-Cal, CalFresh, behavioral health services, and indigent care — county governments would be on the front lines of implementing many of H.R. 1’s changes.  

In response, the County Family has launched a broad, coordinated campaign to educate policymakers, advocate for county resources, and prepare counties for what could become one of the most significant local government challenges in years. 

Here’s what CSAC has done so far: 

Released a statewide county impact analysis 

The County Family published a fact sheet estimating H.R. 1’s annual cost to California counties at up to $9.5 billion, helping lawmakers and stakeholders understand the scale of the proposal’s impact on local health care systems, eligibility operations, and county-administered safety-net programs. 

Brought county leaders to Sacramento 

CSAC organized an H.R. 1 Education Day at the Capitol, bringing together county supervisors, executives, and policy experts from across California to brief legislators and Administration officials directly on the bill’s local consequences and implementation challenges. 

Submitted a coordinated County Family Budget Request 

Recognizing the magnitude of the fiscal threat, CSAC submitted a multi-year County Family Budget Request to the Governor and Legislature focused on several key pressure points created or worsened by H.R. 1, including: 

• Indigent care  
• Public hospitals  
• Eligibility workload  
• Behavioral health services  

Advocated at Legislative Budget Hearings 

CSAC Health and Human Services advocates have testified at multiple legislative budget hearings, elevating the county H.R. 1 impacts to state lawmakers and urging state partnership.  They’ve also traveled to counties across the state to highlight the state budget request. At the time of writing, more than 40 counties have submitted advocacy letters to the governor and Legislature.  

Help us get to all 58 counties. Add your county’s voice by submitting a letter and joining this unified effort. View the template letters.

Launched the “Protect Our Safety Net” campaign 

Together with CSAC affiliates and the County PIO Network, CSAC launched a statewide public affairs campaign to raise awareness and build support for county priorities. The effort includes: 

• A dedicated campaign landing page  
• Web articles and informational resources  
• Social media outreach  
• Op-eds and media engagement  
• Coordinated messaging across counties  

The Work Continues 

County leaders and CSAC staff will continue meeting with lawmakers in the coming weeks to advocate for the resources counties need to maintain essential services and protect vulnerable Californians. 

Counties can help strengthen that effort by engaging directly with their legislative delegations. CSAC encourages county officials to meet with state lawmakers and share how H.R. 1 could affect local programs, county finances, frontline staff, and residents in their communities. Those local conversations will be critical as state leaders determine how California responds to the growing challenges posed by H.R. 1.