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Contra Costa County’s health department is staring at a deficit of $730 million over the next five years because of federal and state funding cuts, county health officials said at last week’s Board of Supervisors meeting.
The agency is responsible for offering managed-care health plans and medical care for county residents, in addition to providing public health programs and regulating local industries that impact public health.
In the June election, county voters chose not to approve Measure X, a proposed sales tax that would have raised $150 million annually to backfill federal funding cuts to health care and other essential services.
The Board of Supervisors put the measure on the ballot, saying that the tax was necessary to maintain health care, supplemental food assistance, and other essential county services in the face of recent federal cuts.
“First, the good news: the short-term fiscal picture for Contra Costa Health has improved,” said Dr. Grant Colfax, director of Contra Costa Health Services, referring to the reduction in his department’s projected deficit for the 2026-2027 financial year from $80 million to $10 million.
“The long-term fiscal status of Contra Costa Health remains dire,” he told the board Aug. 25.
Colfax said that his department was able to cut down the short-term deficit by figuring out ways to increase revenue by streamlining service delivery and cutting costs through hiring changes.
But his department will require changes in federal and state funding and policy to overcome the long-term deficit, he said.
Federal cuts laid out in last year’s H.R.1 – also known as the “One Big Beautiful Bill” – will impact how much funding Contra Costa Health will receive for providing primary and preventative care to uninsured patients, and for emergency care.
Meanwhile, healthcare cuts in California’s budget will move 47,500 residents off a managed care Medi-Cal plan and will cut primary care reimbursements for some immigrants by 90% in 2027.
Throughout these changes, however, the county will be federally required to screen and treat anyone who visits the emergency department.
“We will continue to see people at the most expensive, the most intensive level of care at the hospital,” said Andrew Murrell, the chief financial officer at Contra Costa Health. “Our obligation to do that continues.”
The Contra Costa County Regional Medical Center in Martinez and its affiliated health clinics will be the worst hit by the funding cuts, said David Culberson, CEO of the Contra Costa Regional Medical Center & Health Centers.
The hospital saw more than 38,000 emergency care visits last year, and one in five county residents receive primary care there, Culberson added.
The way out, he said, was to find services where the demand exceeds supply and figure out ways to add appointment slots to increase the hospital’s revenues and also cut down on the delivery of some services.
“It’s important to realize that this is not a pure growth strategy,” said Culberson. “This is really taking a look at a balanced strategy: growth, sustainability, and reductions as necessary.”
Colfax said that Contra Costa Health will continue to refine its long-term plan to chip away at the fiscal deficit and return to the Board with updates on implementing it.
– Story by Tanay Gokhale, Bay City News Service
