What The Big Beautiful Budget Means For Contra Costa County

CONTRA COSTA COUNTY, CA — Contra Costa County residents should prepare for hard times ahead as the result federal and state budget cuts that single out safety-net programs and immigrants.

At stake are cuts to hospitals, healthcare, food, and social safety-net services for hundreds of thousands of Contra Costa residents, leaving the county to absorb the impact.

The 2025 federal budget reconciliation bill — the so-called One Big Beautiful Bill — represents a significant shift in the relationship between the federal government and state and local municipalities, according to a county administrators office report presented Tuesday to Contra Costa Supervisors.

The bill introduces major fiscal and policy changes over the next decade, including reductions in access to and funding for hospitals, healthcare, food, and a variety of social safety net services, according to the report from senior deputy county administrator, Emlyn Struthers.

The federal reconciliation bill includes a $911 billion cut to Medicaid, and a $193 billion cut to SNAP — Medi-Cal and CalFresh in California.

New federal policies modify eligibility and benefits for low- and middle-income individuals and families, as well as immigrants.

The shift in costs to state and local governments reduces overall resources and funding flexibility.

Estimating these impacts, in terms of enrollment as well as costs, is challenging for a variety of reasons ranging from administrative uncertainty due to pending guidance, to general economic factors.

Changes to eligibility criteria will cause the most harm by reducing the number of people who are eligible to enroll in the services.

These reductions in enrollment are particularly harmful for Medicaid/Medi-Cal, where the County retains certain responsibilities to provide care, regardless of coverage status. This increases the amount of unreimbursed care being provided, while also reducing the pool of resources to provide medical care, according to the report.

Food insecurity is expected to increase in the next 10 years as a result of the budget.

CalFresh serves nearly 110,000 people in Contra Costa County each month and, based on statewide data, about 30 percent risk losing their benefits. On top of the new eligibility requirements, benefits amounts are also changing.

Benefit amounts will stay flat for participants over time and their purchasing power will decrease.

Together, the losses in eligibility coupled with the declining purchasing power of SNAP benefits will harm participants and increase demand for other safety net services.

New costs will be shifted to the State and Counties through several mechanisms.

Starting Jan. 1, Medi-Cal coverage changes for immigrants and non-citizens include an enrollment freeze for adults 19-59 years old with "unsatisfactory immigration status."

People who fall into this gorup will pay monthly premiums beginning Jan. 1, 2027.

Refugees, humanitarian parolees, asylees, and survivors of human trafficking and domestic violence will no longer qualify for Medi-Cal as of Oct. 1, 2026.

This is an ongoing story. Check back for updates.