Los Angeles County officials are warning of unprecedented budget cuts that could eliminate health benefits for more than 700,000 residents and force the closure of major county facilities as the region grapples with over $1.5 billion in anticipated federal funding reductions.
Chief Executive Officer Fesia Davenport told the Board of Supervisors recently that the county faces known federal cuts of approximately $714 million through fiscal year 2027-2028, plus additional projected cuts exceeding $800 million. The reductions primarily target health and social services programs that serve the county's most vulnerable residents.
"I do not believe based on what is before us that we will be able to continue service levels at the levels that the county has provided in the past," Davenport said during the board's weekly budget update.
The most severe impacts are expected to hit the county's safety net programs. New federal work requirements for Medi-Cal could eliminate benefits for more than 700,000 county residents by fiscal year 2027-2028 — roughly 20% of the 3.4 million people currently receiving the health coverage. An additional 47,000 lawfully present immigrants will see their Medi-Cal benefits reduced to emergency and pregnancy services only starting in fiscal year 2026-2027.
The CalFresh food assistance program also faces dramatic cuts, with new federal work requirements potentially causing more than 113,000 of the county's nearly 1.6 million recipients to lose access to benefits.
"Residents will be directly impacted as we expect federal policy decisions to significantly reduce the number of county residents who are able to access health care services through Medi-Cal and food benefits," Davenport said.
The Department of Health Services, which operates the county's four hospitals and numerous clinics, faces the greatest financial exposure. About 70% of DHS's $6.5 billion budget comes from federal funding, with only 6% from local revenue. The department has already implemented a hiring freeze as of July 21 and is exploring cost-cutting measures to avoid what Davenport described as the "worst-case scenario" of closing a major county facility.
Such a closure "would of course be a devastating blow to residents who depend on the county for care and could also lead to extensive layoffs," she said.
County officials are implementing what Davenport called a "season of austerity" to address the crisis. The board has already approved 3% budget cuts implemented in April, with an additional 5.5% reduction planned for September that will result in "more public facing impacts," including the two-day-per-week closure of regional parks and lakes.
Potential strategies under consideration include hiring freezes, furloughs for county employees, department mergers to achieve administrative savings, and facility closures. The county has instructed departments to request "only the most essential things" for next year's budget.
Supervisor Holly Mitchell characterized the situation as a"manufactured fiscal crisis," arguing that federal tax breaks for wealthy Americans are forcing cuts to essential services.
"We are in a crisis and I don't think we can have the luxury of pretending that it's not a crisis of very significant magnitude as painful as that is," Mitchell said. "I represent a district with 850,000 Medi-Cal recipients out of 2 million — 850,000 people who rely on Medi-Cal who have been told by the federal government you are not worthy."
The federal cuts compound other major financial pressures facing the county, including a $4 billion AB28 settlement for childhood sexual assault cases, costs from negotiated labor agreements, wildfire impacts, and potential probation receivership expenses.
Davenport emphasized that the projections remain fluid as departments continue revising their estimates. "This is very much a work in progress — these figures and impacts are estimates and county departments are continuing to revise their projections," she said.
The CEO urged community engagement to combat the federal policies driving the cuts. "Everyone should be involved and engaged," she said. "We absolutely should be banding together to push back on these cuts and curtailments that are driven by these policies."
Public comment during the meeting included passionate testimony from homecare workers represented by SEIU 2015, who argued the county should invest in its largest low-wage workforce rather than implementing austerity measures.