The San Diego County Board of Supervisors has voted 4-1 to approve a resolution opposing federal Medicaid cuts and will send a letter to the Trump administration stating its concerns.
Board Chair Terra Lawson-Remer's measure "opposes nearly $1 trillion in federal Medicaid cuts and demands the immediate release of more than $2.1 billion in Medicaid funding being withheld from California," according to a statement from her office following Tuesday's meeting.
"More than 840,000 San Diegans rely on Medi-Cal, including approximately 280,000 children," her office added. "Beginning in January, roughly 327,000 local recipients could face new federal work-reporting requirements. More than 50,000 San Diegans also rely on in-home supportive services connected to the funding dispute."
Medi-Cal is the state's public health insurance program for residents who are of low-income status or have no income.
The county will send the resolution to President Donald Trump, Health and Human Services Secretary Robert F. Kennedy Jr., and Dr. Mehmet Oz, administrator for the U.S. Centers for Medicare and Medicaid Services.
In July, the Trump administration paused $1 billion in Medicaid payments to California and Minnesota over "suspected fraud and noncompliance."
Kennedy said at a news conference that if the states "want that money they need to provide documentation that these payments are legitimate," and that the administration "suspects much of the questionable California spending involves in-home services."
Lawson-Remer said the county has "fought for healthcare that is more affordable, more accessible and there when our community members need it."
Based on a friendly amendment by Supervisor Joel Anderson, the resolution will note that the county takes the misuse of public funds seriously.
"It would make it easier for me to get to yes," he added.
Lawson-Remer said she was fine with Anderson's suggestion, but added the type of fraud that most concerns her is committed by wealthy people who cheat everyone else.
These federal cuts are happening "because people like Elon Musk are not paying any taxes at all," Lawson-Remer added.
During public comment, the San Diego mother of a child with special medical needs became emotional as she discussed how Medicaid or Medi-Cal cuts could harm him.
"The most fragile in our community need to be protected," said Heather Russell, whose son Ethan has cerebral palsy and has endured numerous surgeries.
"If cuts are made to MediCal or Medicaid, it doesn't affect a number on a piece of paper — it affects my Ethan and so many more," she added.
A local United Domestic Workers member said the California program In- Home Supportive Services allows for her daughter to receive consistent care, but unstable funding means people with disabilities may lose that support.
"The county didn't create this crisis, but San Diego families will pay the price," she added.
Supervisor Jim Desmond cast the lone no vote on Tuesday. As he has with previous board member attempts to challenge federal cuts, Desmond stressed that those needing help will receive it. Medicaid will remain available to citizens, children and lawful, permanent residents, said Desmond, who added that the main changes to eligibility require able-bodied people without children to certify twice a year.
There's nothing wrong with an adult who wants government-funded health care benefits attending school or volunteering 20 hours a week as required, he added.
He said that "a lot of fear (was) built" into the resolution, and that his constituents are tired of fraud in the benefits system, including undocumented immigrants receiving Medi-Cal benefits.
In response, Vice Chair Monica Montgomery Steppe discussed her own experience as a seriously ill 20-year-old woman who received IHSS help. She said she would have given anything to have a normal life, but illness meant she had to leave college. Montgomery Steppe said IHSS allowed her to eventually return to a stable life, leading up to her role as a county leader.
"I know it's not personal, but it's hard to sit here and listen (to support of federal cuts) because I've been through it," Montgomery Steppe added. "We're talking about the fundamental idea of whether we believe our neighbors deserve our help."
