County of Monterey leaders are raising urgent concerns about the far-reaching impacts of H.R. 1, federal legislation that would impose new work and community engagement requirements for Medi-Cal enrollees while shifting significant costs to local governments.

County officials report that between 12,500 and 19,000 Monterey County residents could lose Medi-Cal coverage due to the new work and community engagement requirements under H.R. 1. These coverage losses are expected to have cascading effects across the County's health care system, social services, and overall fiscal stability.

"This proposal creates real risks for our community-both in terms of residents losing access to care and the County facing significant new financial obligations," said Roderick Franks, Director of the County of Monterey Department of Social Services.

Significant Increase in Indigent Care Costs
The Department of Social Services estimates that if approximately 33% of those who lose Medi-Cal coverage because of the new work requirements become eligible for county indigent care services, between 4,125 and 6,270 residents would shift into the County's safety net system.

At an estimated cost of $421 per person per month, this would result in an annual cost to the County of Monterey of approximately $20.4 million to $31.2 million, costs that are not currently funded and would place significant strain on local resources.

These estimates do not include additional individuals who may become ineligible for full-scope Medi-Cal due to Federal and State eligibility status changes but still require care, further increasing pressure on the system.

Health Department Highlights Community Impact and Outreach Efforts
The County of Monterey Health Department emphasized that the County currently serves approximately 40,000 patients, the majority of whom rely on Medi-Cal for their care. Officials warned that disruptions in coverage could jeopardize access to essential services for thousands.

To mitigate impacts, the County has launched an outreach pilot program in partnership with community-based organizations to help residents understand eligibility requirements and maintain coverage. However, officials stress that sustained investment will be necessary.

"We want our community to stay informed and ask questions," said Elsa Jimenez, Health Department Director. "If residents are unsure whether they are impacted, we encourage them to seek assistance so they can remain connected to Medi-Cal, CalFresh, and other vital benefits."

Natividad Medical Center Warns of System-Wide Consequences
Natividad Medical Center, Monterey County's public hospital system and a cornerstone of the local safety net since 1844, warned that H.R. 1 could have devastating consequences for access to patient care and system sustainability.

"Natividad has long been committed to serving all residents, especially the most vulnerable," said Dr. Chad Harris, CEO. "H.R. 1 threatens the stability of the safety net that our community depends on. Protecting access to coordinated, affordable, high-quality care is essential to our mission and to the health of Monterey County."

Broader Impacts Across County Services
In addition to health care impacts, H.R. 1 will significantly increase administrative burdens on county departments responsible for verifying eligibility and monitoring compliance with new federal requirements. These changes are expected to result in eligible residents losing benefits due to procedural barriers, while increasing demand for county-funded services.

Without additional state support, the County of Monterey may be forced to make difficult decisions that could affect public safety, homelessness programs, and other core services.

Call for State Partnership

The County of Monterey joins counties across California in calling on the Governor and State Legislature to establish a multi-year funding partnership to address the impact of H.R. 1 and protect critical safety net services.

"Maintaining access to care is not only a moral responsibility, but also fiscally prudent," said Supervisor Luis Alejo, "Without action, the costs both human and financial will only grow."