MODESTO – House Resolution 1, dubbed the Big Beautiful Bill by President Donald Trump, is projected to cost Stanislaus County millions of dollars and interrupt key Health and Human Services programs, according to a report presented to the Board of Supervisors on Tuesday.

Passed last July by a slim 218-214 margin in the House of Representatives, the legislation is estimated to add $3.3 trillion to the deficit over the next decade and cause nearly 12 million Americans to go without health insurance, according to the nonpartisan Congressional Budget Office.

According to the Stanislaus County report, the bill will cause significant changes in Medi-Cal (health coverage), Cal Fresh (food assistance), work and reporting protocols, and program funding responsibilities, with most of the changes happening between 2026 and 2028.

“As the board is aware, these are considered critical safety net programs centered around health coverage and food assistance than many residents of our county rely on every single day,” said Raul Mendez, a county assistant executive officer.

According to Mendez, the California State Association of Counties is working with counties across the state on a coordinated response to the impact of H.R. 1.

“Counties are concerned about cost increases, coverage losses, and workload impacts to county organizations,” said Mendez, who listed the Community Services Agency, Behavioral Health and Recovery Services, and the Health Services Agency as departments that will feel the squeeze.

According to the report, 90,000 county residents receive Cal Fresh benefits and 217,000 receive Medi-Cal benefits. The legislation includes new work requirements, more frequent renewals, shorter coverage periods, changes to eligibility, and new paperwork requirements.

H.R. 1 also changes who is eligible for Cal Fresh benefits.

“In order to be eligible for federal Cal Fresh benefits, one must be a U.S. citizen, a lawful permanent resident who has maintained status for five or more years, a Cuban or Haitian entrant, and individuals residing in the U.S. under a compact of Free Association Agreement,” said Christine Huber, director of Community Services Agency. “Those that have been receiving Cal Fresh, but will no longer be eligible, are (lawfully present non-citizens) asylees, refugees, immigration parolees, battered non-citizens, or trafficking victims. This begins in May of 2026, and as somebody’s renewal date comes to date, we will be assessing for their immigration status and at that time making determinations if they qualify.”

Huber said the county is expecting 5,000 county residents to be affected.

Beginning in June 2026, Cal Fresh recipients between 18 and 64, with no children under 14, need to log a minimum of 80 hours per week working, in school, or engaged in a community service project.

Nearly 40,000 residents are expected to be affected by the new requirements.

Beginning in October 2026, one must be a U.S. citizen, a lawful permanent resident who has maintained status for five or more years, a Cuban or Haitian entrant, and individuals residing in the U.S. under a compact of Free Association Agreement to qualify for Medi-Cal. Renewals will go from 12 months to every six months, impacting more than 70,000 county residents.

According to Ruben Imperial, director of BHRS, the Big Beautiful Bill would cause an estimated $2.3 million in Medi-Cal revenue loss for fiscal year 2027 and up to $12 million total treatment cost impact annually.

Under the state guidelines, counties are required to provide care for medically indigent residents. Funding the Indigent Health Care Program over the next three fiscal years could cost the county anywhere from $37 million to $66 million.

House Democrats unified against the bill as a tax giveaway to the rich paid for on the backs of the working class and most vulnerable in society, what they called “trickle down cruelty.”

“I want to thank Republican congressmen and women, because what they did is incredible,” Trump said after the partisan vote.

The president complained that no Democrats supported the bill.

“They hate Trump,” the president said. “But I hate them too.”

The Associated Press contributed to this story.