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Health and Health Care

Community Voice

Federal cuts impact on Medi-Cal and CalFresh

Federal policy changes including Medicaid and SNAP overhauls with work requirements and eligibility checks are projected to affect hundreds of thousands of San Diego County residents, forcing the county to absorb tens of millions in first-year admin and backfill costs while debating immigrant service protections within the larger budget.

How should San Diego County respond to federal Medi-Cal and CalFresh eligibility changes?

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Sources

San Diego Union-Tribune — https://www.sandiegouniontribune.com/2026/06/25/san-diego-county-inks-9-2b-budget-with-support-for-social-programs-voters-will-get-a-say-on-taxes-in-november/
Overhauls to Medicaid (Medi-Cal) and SNAP (CalFresh) include work requirements, eligibility checks (especially immigration-related), and cost shifts. County estimates hundreds of thousands of residents affected... first-year costs absorbed at ~$68 million
CBS8 — https://www.cbs8.com/article/news/local/san-diego-county-supervisors-approves-916b-annual-budget/509-f30065e1-aa36-4c02-b0a6-ce164d932290
fiscal pressures from federal policy changes... This requires more staff for eligibility determinations and safety-net backfills
San Diego County — https://www.sandiegocounty.gov/content/sdc/cao/edga/county-legislative-advocacy/2026.html
Immigration-related service impacts and legal defense programs (debated in budget)
Positions on this issue  ·  liberal → conservative
  1. Maximize local backfills, legal defense, and staff to fully protect all affected residents
  2. Absorb admin costs and expand county safety-net programs to cover benefit losses
  3. Provide targeted transitional help while complying with new federal work rules
  4. Implement required eligibility checks efficiently with minimal extra local spending
  5. Limit county role to mandatory admin; avoid new local entitlements or immigrant extras
  6. Reduce safety-net scope and reject added legal defense funding amid federal shifts
  7. Strictly enforce all new federal restrictions and cut any non-mandated local supports