Fresno County supervisors Garry Bredefeld (left) and Luis Chavez joined other California county officials in saying the state needs to release $1.9 billion this year or social service programs would be in jeopardy. (GV Wire Composite)
- The California State Association of Counties says the state needs to provide $1.9 billion this year to mitigate losses from the One Big Beautiful Bill.
- Fresno County officials say added costs and increased cuts jeopardize social services programs such as Medi-Cal and CalFresh.
- Between 11,000 and 30,000 people may turn to the county for indigent care after Medi-Cal changes kick in, county says.
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Fresno County leaders joined other California counties in saying $1.9 billion from the state of California is needed this year to withstand anticipated cuts and higher cost burdens brought on by President Donald Trump’s Big Beautiful Bill.
In addition, the county is calling for $4.5 billion next year as those cuts and expenses could grow.
Higher cost burdens for state and counties from social programs such as Medicaid and SNAP caused by Trump’s landmark bill begin this year.
The county expects between $68 billion and $295 billion in added medical expenses as people losing Medi-Cal coverage turn to the county for medical care.
Moreover, safety net programs such as Medi-Cal and CalFresh “are at immediate risk” without additional funding, county officials said.
“Fresno County is ground zero for the impacts of H.R. 1,” said Paul Nerland, county administrative officer in the release. “The state must act now to provide sustainable funding, or counties will be forced into decisions that put critical services at risk.”
Complicating the situation: the state is dealing with a budget deficit of at least $3 billion.
Indigent Care an Unfunded Mandate: Bredefeld
In a presentation to supervisors on March 17, county directors said they expect to pay for indigent care for between 11,000 and 30,000 people, an expense the county has not covered for years, said Public Health Director Joe Prado.
“If the state fails to respond, our most vulnerable residents will pay the price,” said Supervisor Luis Chavez. “These are individuals and families who depend on access to care and support services. This is not theoretical — this will have immediate and dire consequences in our community.”
California law puts the cost of providing indigent care in the area on the county. Prado said that after the Affordable Care Act was passed, California stopped funding the program.
Board of Supervisors Chair Garry Bredefeld called the rules an unfunded mandate.
“The state has imposed mandates without providing the funding to meet them,” Bredefeld said. “That approach is not sustainable. Counties cannot continue to shoulder the burden of unfunded state requirements while trying to maintain essential services for our communities.”
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