Federal Impacts

86,185


County Residents Relying on MEDI-CAL for Health Care

43,778


County Residents Relying on CALFRESH for Food Support

43%


Of Local Births Covered by MEDI-CAL

$200M


Annual losses in local MEDI-CAL spending

H.R. 1 and How it Impacts County Residents

Public funding touches everyday life in ways many people don't see. Changes to federal and state funding can affect not just health care and food assistance, but can also impact support for parks, arts, roads, housing, emergency preparedness and many other services that help communities thrive.

H.R. 1 (“The One Big Beautiful Bill Act”) changes how several federal health, nutrition and safety-net programs are funded and administered. Some changes took effect immediately, while others will be implemented over the next several years. Because counties help administer many of these programs, the changes will affect both residents and local service providers.

How Federal Funding Supports Santa Cruz County Residents

Federal Government

Congress allocates funding for health care, nutrition assistance and other safety-net programs.

State of California

The state receives federal funds and administers programs and sets rules for eligibility and payment.

County Programs

Counties help administer programs, partner with local providers, and deliver services in our communities.

Residents

Residents and families receive essential services that support health, stability and well-being

When federal funding or rules change, it affects the services available to our community.

 

Why does this affect me?

H.R. 1 is reducing federal funding for essential Santa Cruz County programs by more than $25 million each year, with even more severe funding cuts felt throughout the community’s network of providers and nonprofits. Additional federal policy changes have resulted in the loss of access to reproductive care, funding to address wildfire threats, the elimination of emergency family housing vouchers, and much more.

These effects will grow over time, threatening the delivery of services in many areas. Combined with related state policy changes, these developments place increasing pressure on the services and partnerships that have helped Santa Cruz County reduce homelessness, expand behavioral health care, improve food security and strengthen the community safety net.

Medi-Cal provides $1 billion and CalFresh provides $75 million in annual spending in Santa Cruz County. Reductions not only affect our neighbors, but they also affect our economy and the local businesses we all depend on.

What could residents notice?

Collectively, these changes threaten to weaken the interconnected network of healthcare, nutrition, housing and other services that many vulnerable residents rely on. That could mean:

  • More people without health coverage
  • Busier emergency rooms
  • More people without enough money for groceries
  • Fewer people able to afford their housing
  • Increased homelessness
  • Greater pressure on hospitals and community clinics
  • Increased demand for behavioral health services

Although some H.R. 1 provisions took effect immediately, many of the most significant changes will be implemented over the next several years. As those changes are phased in beginning in 2027, healthcare providers, counties, and community organizations will continue adapting to new eligibility rules, increased administrative requirements, and reduced federal funding. Because hospitals, community health centers, behavioral health providers, food assistance programs, housing organizations and local governments work together to support residents, changes affecting one part of the safety net can create ripple effects throughout the broader system, influencing access to services across the community.

How can we help?

To mitigate these impacts, the County is proposing a temporary, half-cent sales tax to shore up the safety net, support community partners, lift up residents and address impacts from federal policy changes. All funding stays local. The Board has adopted priorities that are intended to guide future budget decisions if the measure is approved. These priorities focus on helping preserve residents' access to essential services as federal and state funding changes affect the local safety net.

Emergency and urgent healthcare Ambulance response, emergency departments, hospitals, community health centers
Mental health and substance use care Crisis services, treatment, youth behavioral health, mobile crisis response
Food assistance Programs that help residents access nutritious food and nutrition assistance
Housing stability Homelessness prevention, outreach, shelter and housing stabilization
Essential community services Public health and other County-administered safety-net services
Coordinated local response Partnerships that help healthcare providers, nonprofits and public agencies work together

How Is Santa Cruz County Already Responding?

Anticipating widespread reductions in federal funding, the County is increasing efforts to help eligible residents enroll in and maintain Medi-Cal and CalFresh benefits, coordinating with healthcare providers and community organizations, supporting regional planning, and pursuing available state and federal resources. The County is also working to control its own costs through hiring controls, operational efficiencies, expenditure reductions and long-term financial planning.

The County remains committed to supporting communities impacted by HR1 and other state and federal policy changes and has taken steps to increase its commitments. Click on the menu below to learn more.

The County is working to monitor changes, share information and help eligible residents enroll in and keep benefits such as Medi-Cal and CalFresh through outreach, eligibility assistance, and public information. Residents can visit the Human Services Department's Get & Keep Your Benefits page for current guidance on federal and state eligibility changes, including how changes such as the Public Charge rule might affect you.

When federal disruptions threatened food assistance, Santa Cruz County partnered with local governments and community organizations to provide $500,000 for Second Harvest Food Bank as part of a regional effort exceeding $1 million to help families facing increased food insecurity. See FoodSupport.11042025.pdf.

The County continues to partner with nonprofit organizations that deliver food, housing, behavioral health, youth, senior and other community services. These organizations are often the first point of contact for residents experiencing hardship and play a critical role in maintaining the local safety net.

The Board of Supervisors created the S.H.I.E.L.D. Ad Hoc Subcommittee to coordinate the County's response to changing federal policies, safeguard access to essential services, develop operational recommendations, and work with community partners to protect residents while ensuring lawful County operations.

The County maintains a Sanctuary information hub with updates on health care, food assistance, community resources, and County policies so residents can continue to feel comfortable accessing services regardless of changing federal policies.

TOP