Mariposa County is bracing for major rollbacks in food programs for the poor, behavioral health funding for the mentally ill and Medi-Cal benefits for the sick.
All of the potential cutbacks are due to the Trump Administration’s so-called Big Beautiful Bill, also known as HR 1, which shifts the cost burden for those long established federally funded programs back to the states and then on to counties.
In Mariposa County, it will result in a 50 percent increase in the county’s share of administrative costs for CalFresh, which translates into a $600,000 price tag.
CalFresh, once known as Food Stamps, provides monthly food assistance to low-income families through Electronic Benefit Transfer (EBT) cards.
There are 2,295 people who receive CalFresh benefits in Mariposa County, about 14 percent of the total population. Among those recipients are 788 children and 562 seniors.
Kristina Keheley, Director of Mariposa County’s Health and Human Services Administration (HHSA), said the federal government is imposing new work requirements for the program and administrative hurdles.
She expects eligible individuals will be losing benefits not because they no longer qualify, but because of a new layer of bureaucracy involved.
Keheley expects there will be an additional demand on county-funded food and emergency services, which are already strained with food insecurity at an all time high.
Medi-Cal changes
The changes coming to Medi-Cal, California’s version of Medicaid, include cost shifts to the states with reduced federal matching funds, that is expected to result in delayed provider reimbursements.
There are also new work requirements that take effect Jan. 1, 2027, for low income adults ages 19 to 64, who were covered through the Affordable Care Act (ACA) Medicaid expansion.
Enrollees must work, volunteer or participate in training for at least 80 hours a month to keep coverage.
There are exemptions for the disabled, pregnant women and those with children under the age of 13.
Those who fail to respond to a 30-day notice will lose coverage. Eligibility must be renewed every six months rather than annually.
The prevailing concern among health officials is that people will become discouraged by the new requirements and will fall out of Medi-Cal enrollment.
Trickle down effects
The true impact may not be about any one specific program, but the cascading effect of multiple program cuts that could shred the social safety net.
“Of course we will see our clients impacted, our staff impacted with increased workloads, but also the greater community. These impacts all cause trickle down effects,” Keheley said in an email to the Mariposa Gazette.
Housing and homeless programs are expected receive less federal support with cuts in housing vouchers and grants.
Those cuts are expected to create an even greater demand in behavioral health services, which face their own shrinking funding sources.
Keheley, the head of HHSA, fears it could undermine progress made in the last three years with homeless camps and housing first initiatives.
Officials and the John C. Fremont Healthcare District anticipate higher rates of uncompensated care and more people deferring care until its an emergency situation.
“Community members will lose their health coverage so their only option will be to go to the emergency room for what might otherwise be routine care by a primary care provider, so now the emergency room is impacted with higher number of visitors,” Keheley explained.
For law enforcement, there could be greater demand on crisis services as behavioral health and psychiatric services lag behind.
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