H.R. 1’s Impact and Our Path Forward

Congress last week passed House Resolution 1, the sweeping federal budget bill that includes significant cuts to Medicaid. Combined with changes in the state budget, these cuts could result in more than 50,000 Contra Costa residents losing healthcare coverage over the next several years.

Our health department is anticipating budget reductions of up to $200 million per year, which will be gradually implemented, with the most significant impacts beginning in 2027. This will directly impact our community.

At a time when our patients need a strong community healthcare system the most, we will be challenged by the loss of thousands of insured patients and hundreds of millions in revenue, as funding for outpatient and emergency care is reduced or eliminated. We also expect that many of our clients will be affected by reductions to CalFresh (SNAP), deepening hardship for the communities we serve.

Despite these challenges, our mission remains unchanged. We must care for those who need us most. We are actively planning for these impacts – improving efficiency, strengthening partnerships, and aggressively advocating for the resources we need to keep our community healthy.

That includes working closely with the Employment & Human Services Department to help ensure as few residents as possible lose coverage. We are also creating a cross-divisional working group to reinforce the basic health care program – our county program that helps serve the medical needs of those with no insurance.

I want you to know that leadership is fully aware of the stress these changes cause on all of us – both our community and our staff. I also want you to know that at least for the immediate future, we do not anticipate layoffs or large-scale, budget-related reductions in service.

Contra Costa Health employees are the beating heart of our county’s healthcare system, and your work matters now more than ever. We are committed to supporting you and protecting the vital services our community depends upon, no matter the challenges.

With Appreciation,

Ori Tzvieli, MD MS | He/Him

Chief Executive Officer and Health Director (Interim)

Health Officer, Contra Costa County