The Monterey Bay region has long stood as a place of resilience, hard work, and community care. From the agricultural fields to the neighborhoods of our cities and rural towns, our strength has always come from how we support one another, especially in times of need. Today, that commitment is being tested in very real and immediate ways.
The recently enacted federal H.R. 1 legislation presents serious challenges for counties like ours. While decisions made in Washington, D.C. may seem distant, their impacts are felt most acutely at the local level, where public health systems, safety-net programs, and essential services operate every day. In our region, those impacts will fall disproportionately on our most vulnerable residents: low-income families, seniors, children, immigrants, veterans and individuals already struggling to access basic care.
At the center of this concern is the strain H.R. 1 places on safety-net programs such as Medi-Cal and CalFresh (SNAP). These programs are not abstract line items in a federal budget, they are lifelines for thousands across the Central Coast. In Monterey County alone, more than 51,000 residents rely on CalFresh to put food on the table. Santa Cruz County has approximately 30,000 residents enrolled, and San Benito County has about 3,800. Statewide, more than 665,000 Californians are projected to lose CalFresh nutritional benefits.
Thousands more depend on Medi-Cal for preventive care, chronic disease management, and emergency services. Reductions in eligibility, funding, or federal support will not eliminate need, they will simply shift the burden to local governments and already constrained community systems. When individuals lose access to preventive care, they often delay treatment until conditions worsen, leading to higher-cost emergency interventions. When families lose food assistance, we see increased food insecurity, poorer health outcomes, and greater strain on local food banks and community organizations.
Nowhere will this pressure be felt more directly than in our public health systems, including Natividad Medical Center in Salinas, our state’s oldest public hospital and a cornerstone of care in the county. Natividad serves as a critical provider for Medi-Cal patients, the uninsured, and those requiring specialized, trauma and emergency care. According to the UCLA Center for Health Policy Research, 2.98 million Californians could lose their Medi-Cal coverage, with 41,000 across Monterey, Santa Cruz and San Benito Counties.
As federal support diminishes, public hospitals like Natividad face a dual challenge: rising demand for services coupled with shrinking resources. This is not a sustainable equation. Without adequate funding, counties will be forced to make difficult decisions that could impact staffing, reduce services, and limit access to care. The impacts will not be confined to those who rely on Medi-Cal, but all residents who depend on these hospitals for emergency and critical care. Other regional hospitals, including Watsonville Community Hospital and Hazel Hawkins Memorial Hospital in Hollister, are already facing financial instability that will be further exacerbated.
That is why it is critical, now more than ever, for the State of California to partner with counties to mitigate these impacts. Counties estimated that H.R. 1 will cost up to $9.5 billion annually. Without state partnership and investment, the consequences will be severe and far-reaching.
The only way to protect the safety net in our local communities is for our state’s leaders to step up, including our Governor Gavin Newsom and state lawmakers. Counties have a clear, fiscally responsible proposal to prevent the worst of H.R. 1’s devastating impacts. It would mitigate potential losses in Medi-Cal and CalFresh, support public hospitals, and ensure counties have the tools and the eligibility workers needed to continue serving our residents effectively.
California has consistently led the nation by investing in its people, and now is not the time to turn back. We must continue to lead the nation in advancing opportunity and protecting vulnerable populations. But leadership requires action. Counties cannot, and should not, bear this burden alone, and we look forward to partnering with the state to protect our communities across the Central Coast and throughout California.
Luis A. Alejo is a Monterey County Supervisor for District 1, representing most of the city limits of the City of Salinas, and is the first vice-president of the California State Association of Counties (CSAC).
