San Diego County supervisors were scheduled to discuss the next phase of the Safety Net Bridge Program on Tuesday, a proposed 12-month pilot meant to catch residents who lose CalFresh or Medi-Cal benefits as federal changes loom. County estimates point to 68,761 San Diego Medi-Cal recipients who could lose coverage, according to Fox 5 San Diego & KUSI News.
The board letter details a 12-month pilot program built to provide short-term support for individuals experiencing a loss or interruption of CalFresh or Medi-Cal benefits, according to County News Center. The program was created in partnership with health care providers, advisory boards and community members, the county says. Supervisor Monica Montgomery Steppe, who has championed the effort, told Fox 5 San Diego & KUSI News that the decisions are having real consequences for people in San Diego County, and that the county is not waiting for the cuts to hit.
A Pilot Years in the Making
This latest discussion builds on a vote the Board of Supervisors took back on March 25, when it agreed to move forward with developing a Safety Net Bridge Program pilot. That earlier action, detailed in a release from the office of Supervisor Monica Montgomery Steppe, described a proposed system of free services to support residents at risk of losing health care, food access and prescription medication. County staff developed six potential Transitional Access Clinic models to deliver care in communities hit hardest by coverage loss, with the pilot targeting ZIP codes carrying the highest risk of Medi-Cal disenrollment. Staff were expected to return to the board within 180 days with detailed plans, per the same release.
Montgomery Steppe launched the Safety Net Bridge Program last November to try to prevent lapses in benefits amid potential cuts, and she has said the pilot would include funding for primary care, access to medications and linkages to social services, according to Jamie Beam, chief operations officer for San Diego County, as cited by Fox 5 San Diego & KUSI News. Dr. Suzanne Afflalo said the community should ensure no one falls through the cracks when the system shifts, per the same outlet.
Food Aid Already Underway
The county has already moved on one piece of the safety net. In June, the Board of Supervisors approved $1 million in one-time funding for food distributions and supportive services, a figure confirmed by County News Center. The county is partnering with the San Diego Food Bank and Feeding San Diego to hold regular food distribution events at six county locations through August 2027, with the effort designed to support about 93,500 people at risk of losing CalFresh benefits. Jamie Beam has said the county coordinated 22 food distribution events with food bank partners that served more than 3,000 households, and told Fox 5 San Diego & KUSI News that the recommendations before the board would add to the safety net for residents at risk of losing care.
Montgomery Steppe has also pointed to a less visible cost of coverage gaps: she said a lack of preventative care options leads people to emergency rooms, longer wait times, and added pressure on medical staff, according to Fox 5 San Diego & KUSI News. The county's push comes as the Trump administration's budget legislation is expected to cause cuts to federal healthcare benefits, a pressure point driving much of the urgency behind the pilot.
A Statewide Deadline Approaching
The timing is not incidental. Federal work requirements for Medi-Cal recipients are scheduled to take effect on January 1, with eligibility redetermined every six months instead of once a year, according to the Mercury News. Some enrollees will also be required to complete 80 hours per month of community engagement, such as work, training, education or volunteering, per the California Health Care Foundation. Researchers have projected that California's uninsured rate could nearly double, to almost 15%, by 2030 because of combined state and federal Medi-Cal cuts, with an estimated 2.2 million Californians potentially losing insurance over the next four years, according to CalMatters.
San Diego is not alone in scrambling to respond. In the Bay Area, Santa Clara County has moved to expand and rename its Primary Care Access Program as Valley Care to absorb up to 10,000 more uninsured people in 2027, after its budget reductions were projected to swell the county's uninsured population by as many as 70,000 people, the Mercury News reported. Contra Costa County, meanwhile, approved an expansion of its Basic Health Care Program to cover lower-income residents and eliminate small enrollment fees, a change expected to cost an additional $6 million and roll out by March, per the same report.
California's Department of Health Care Services has also said the state is a lead plaintiff in a multi-state lawsuit challenging provisions of the interim federal rule implementing Medi-Cal work requirements, according to the California Department of Health Care Services. For San Diego County residents watching the Safety Net Bridge Program take shape, the pilot represents one local answer to a set of federal and state changes still playing out well beyond county lines.
