2025-2026: Jim Desmond Voted Multiple Times Against Protecting Health Services In Light Of The One Big Beautiful Bill, Including Voting Against Warning San Diego County Residents About Potential Funding Cuts To Medi-Cal

March 2025: Desmond Voted Against Notifying San Diego County Residents About Potential Funding Cuts To Medi-Cal And Said “There Are Gonna Have To Be Cuts Somewhere” At The Federal Level March 2025: Desmond Voted Against Sending Notice To More Than One Million San Diego County Residents Who Could Be Impacted By Potential Funding Cuts To Federal Programs Such As Medi-Cal

March 2025: Desmond Voted Against Sending Notice To More Than One Million San Diego County Residents Who Could Be Impacted By Potential Funding Cuts To Federal Programs. “A proposal asking San Diego County to send notice to more than one million residents who could be impacted by potential funding cuts to federal programs failed to advance Tuesday, after a tie vote by the Board of Supervisors. Board Vice Chair Terra Lawson-Remer presented a policy to instruct the county chief administrative officer to develop a strategy to send a ‘notice of funding at risk’ to all federally funded program beneficiaries, which would have included contact information for the White House and the Department of Government Efficiency. Lawson-Remer and Supervisor Monica Montgomery Steppe voted in favor, while Supervisors Joel Anderson and Jim Desmond were opposed.” [KPBS, 3/11/25]

Nearly 900,000 San Diego County Residents Get Health Care Coverage Through Medi-Cal. “A total of 1.2 million people in San Diego County receive support from at least one federally funded assistance program, including 50,000 who receive job training and financial assistance benefits, 400,000 who receive food assistance benefits, and nearly 900,000 who get health care coverage through Medi-Cal.” [KPBS, 3/11/25]

Desmond Said The Country Had A $36 Trillion Debt And “There Are Gonna Have To Be Cuts Somewhere”

In Discussing His Opposition To Warning Residents About Potential Federal Program Cuts, Desmond Said The Country Had $36 Trillion In Debt And, “There Are Gonna Have To Be Cuts Somewhere.” “A proposal asking San Diego County to send notice to more than one million residents who could be impacted by potential funding cuts to federal programs failed to advance Tuesday, after a tie vote by the Board of Supervisors. […] Desmond pointed out that the House of Representatives was voting Tuesday on a continuing resolution that if passed, would mean any cuts might not go into effect until September. ‘We're too much in flux,’ said Desmond, who added that the nation is $36 trillion in debt, and ‘there are gonna have to be cuts somewhere.’” [KPBS, 3/11/25]

Desmond: “Federal Government Has A Lane And We Have A Lane.” “He said it could cost $1 million for staff to send out such notifications in the form of mailers or flyers. Desmond said he didn't think the county has a role in terms of informing people about federal benefit changes. ‘Federal government has a lane and we have a lane,’ Desmond said. The board's discussion occasionally became heated. Lawson-Remer said Desmond didn't want to let people know about benefit changes, and Desmond responded that he didn't want her commentary on his statements, while some members of the audience booed.” [KPBS, 3/11/25]

Desmond Said The U.S. House Was Voting On A Continuing Resolution That Would Delay Any Cuts Until September. “Desmond pointed out that the House of Representatives was voting Tuesday on a continuing resolution that if passed, would mean any cuts might not go into effect until September. ‘We're too much in flux,’ said Desmond, who added that the nation is $36 trillion in debt, and ‘there are gonna have to be cuts somewhere.’” [KPBS, 3/11/25]

May 2025: Amid Looming Federal Budget Cuts, Desmond Voted Against A Proposal To Tap Into The County’s Reserve Funds To Prevent Cuts To Services

May 2025: Desmond Voted Against A Proposal To Tap Into The County’s Reserve Funds To Prevent Cuts To Services. “The San Diego County Board of Supervisors Tuesday rejected a proposal to tap into the county's reserve funds to prevent cuts to services being threatened by a budget crunch. After a robust debate and public feedback, the board voted 2-1-1, with the two sponsors Terra Lawson-Remer and Monica Montgomery Steppe in support, Jim Desmond opposed and Joel Anderson abstaining.” [KPBS, 5/9/25]

The Proposal Failed With Two Votes In Favor, Desmond Opposed, And One Abstention. “The San Diego County Board of Supervisors Tuesday rejected a proposal to tap into the county's reserve funds to prevent cuts to services being threatened by a budget crunch. After a robust debate and public feedback, the board voted 2-

1-1, with the two sponsors Terra Lawson-Remer and Monica Montgomery Steppe in support, Jim Desmond opposed and Joel Anderson abstaining.” [KPBS, 5/9/25]

The Proposal Came Amid Looming Federal And State Budget Cuts To Programs Administered By The County. “Lawson-Remer and Montgomery Steppe introduced the proposal to ‘safeguard public health, housing and vital care systems,’ citing looming state and federal budget cuts to multiple programs the county administers. […] Before the vote, Montgomery Steppe stressed the need to be ready for possible federal cuts, including billions to the Medicaid program. ‘I think we'd be crazy not to acknowledge that's what's going on, no matter what side we're on, no matter what (political) party we identify with, these are facts and they're right in front of our face,’ she added.” [KPBS, 5/9/25]

Desmond: “Just Like Any Family Tightening Their Belt During Tough Times, The Government Must Rein In Spending And Stop Funding Programs That Don’t Directly Serve Our Residents, Not Spend More Money.” “Anderson and Desmond also oppose tapping into reserves. ‘While I always support getting the highest and best use of the tax money that our constituents have entrusted us with, we can’t follow the state government’s lead of raiding every account for pet special interest projects,’ Andersons said in a statement this week. ‘Over the past few years, the county workforce has grown by 2,500 new positions, and several new departments have been created — departments we simply cannot afford,’ Desmond told the Union-Tribune last month. ‘Just like any family tightening their belt during tough times, the government must rein in spending and stop funding programs that don’t directly serve our residents, not spend more money.’” [San Diego Union-Tribune, 5/1/25]

June 2025: Desmond Cast The Lone Vote Against Directing County Staff To Prepare For Anticipated Cost Shifts In The Budget In Light Of The One Big Beautiful Bill Working Its Way Through Congress

June 2025: Desmond Cast The Lone Vote Against A Proposal Directing County Staff To Prepare For Anticipated Cost Shifts In The Federal Budget. “The San Diego County Board of Supervisors Tuesday voted 3-1 in favor of an amended proposal directing county staff to prepare for anticipated cost shifts in the federal budget. […] Lawson-Remer, Montgomery Steppe and Joel Anderson voted yes, while Jim Desmond voted no.” [KPBS, 6/24/25]

The Proposal Came In Response To The One Big Beautiful Bill Working Its Way Through Congress, Which Would Reduce Federal Medicaid Assistance, Add New Requirements For Medi-Cal Eligibility, And Shift CalFresh Food Benefits To Counties. “Supervisors Terra Lawson-Remer and Monica Montgomery Steppe issued a board letter in response to the proposed federal budget, which is now awaiting approval in the U.S. Senate. […] According to Lawson-Remer and Montgomery Steppe, the so-called One Big Beautiful Bill Act, a budget reconciliation bill backed by President Donald Trump, would: — reduce the federal medical assistance percentage for Medicaid's Affordable Care Act expansion population, causing an estimated $10 million shortfall for behavioral health services; — call for new requirements, including on work status, for Medi-Cal eligibility, which could potentially disrupt coverage for almost 900,000 San Diego County-area residents and increase the administrative burden; and — shift more CalFresh food benefits and administrative expenses to states and counties, potentially costing San Diego County an extra $276 million and affecting over 400,000 residents who rely on the program.” [KPBS, 6/24/25]

Desmond Said Federal And State Budget Deficits Were The “Whole Reason We’re In This Mess ... So We Either Raise Taxes On Everybody To Make Up For That, Or Make Some Cuts.” “Desmond said federal and state budget deficits are the ‘whole reason we're in this mess ... so we either raise taxes on everybody to make up for that, or make some cuts.’ Desmond said deliberations over the federal budget aren't done.” [KPBS, 6/24/25]

In Opposing The Proposal, Desmond Said The County Needed To Protect Its Resources “For The People Who Need Them Most — American Citizens Who Are Struggling To Make Ends Meet.” “In a statement after the vote, Desmond said the county needed to protect its limited resources ‘for the people who need them most — American citizens who are struggling to make ends meet.’ ‘California is already facing a $12 billion deficit, and even Governor (Gavin) Newsom has acknowledged the cost by proposing a freeze in Medi-Cal enrollment for undocumented immigrants, Desmond added.” [KPBS, 6/24/25]

September 2025: Desmond Voted Against Establishing A Subcommittee To Develop A Strategy To Address Fiscal Threats, Including Those Caused By The One Big Beautiful Bill

September 2025: Desmond Voted Against Establishing A Subcommittee To Develop A Strategy To Address Fiscal Threats, Including Those Caused By The One Big Beautiful Bill. “The federal administration has withdrawn critical financial support, especially for the safety net programs that protect San Diego's most vulnerable. The recently passed ‘One Big Beautiful Bill Act’ (OBBBA), introduced as H.R. 1, cuts federal spending by $1.4 trillion over the next 10 years, including $187 billion from SNAP and $917 billion from Medicaid. OBBA will cost the County at least $300 million per year in lost funding and increased administrative expenses alone, putting 400,000 San Diegans at risk of losing health insurance and 100,000 San Diegans at risk of losing food assistance. […] 1. Establish an ad hoc subcommittee of this Board, entitled the Ad Hoc Subcommittee on Sustainable Fiscal Planning (Subcommittee), and appoint Supervisor Terra Lawson-Remer and Supervisor Monica Montgomery Steppe for the purpose of exploring, studying, planning, and developing a strategy to address emerging fiscal threats in order to sustain County services and invest in the well-being of all San Diegans. […] ACTION: ON MOTION of Supervisor Lawson-Remer, seconded by Supervisor Montgomery Steppe, the Board of Supervisors took action as recommended. AYES: Aguirre, Lawson-Remer, Montgomery Steppe NOES: Anderson, Desmond” [San Diego County Board of Supervisors, Meeting Minutes, 9/30/25]

November 2025: Desmond Cast The Lone Vote Against Exploring Options To Provide No-Cost Medical Care In Response To The One Big Beautiful Bill

November 2025: Desmond Cast The Lone Vote Against Directing County Staff To Explore Options To Provide No-Cost Medical Care And Improve Food Security Efforts In Response To The One Big Beautiful Bill. “Shifts in federal policy, including the implementation of H.R. 1, have created new barriers for residents seeking access to social safety net services. Revised Medi-Cal and CalFresh eligibility requirements will put thousands of San Diego County residents at risk of losing vital services. […] 1. Direct the Chief Administrative Officer to: a. Explore partnership opportunities between County-operated clinics at one or more of the County's Live Well Centers or other County locations and local healthcare providers to provide no-cost primary care medical services co-located with access to additional social services, as a Transitional Access Clinic. […] 2. Direct the Chief Administrative Officer to explore recommendations from the Office of Sustainability and Environmental Justice's Food Justice Community Action Plan including, but not limited to: a. Expanding partnerships across public, private, and community sectors to strengthen and innovate local food security efforts. […] ACTION: ON MOTION of Supervisor Montgomery Steppe, seconded by Supervisor Aguirre, the Board of Supervisors took action as recommended. AYES: Aguirre, Anderson, Lawson-Remer, Montgomery Steppe NOES: Desmond.” [San Diego County Board of Supervisors, Meeting Minutes, 11/4/25]

November 2025: Desmond Voted Against A Partnership With The San Diego Foundation That Would Free Up About $13 Million In The County’s Budget Amid Potential Rising Costs Due To New Medicaid Rules

November 2025: Desmond Voted Against A Partnership With The San Diego Foundation That Would Free Up About $13 Million In The County’s Next Annual Budget. “San Diego County will see about $13 million freed up in its next annual budget under a new partnership that supervisors approved Tuesday with the San Diego Foundation. Under the agreement, the foundation will cover $18 million of bills the county has with its social services contractors. […] Supervisors voted 4-1 in support of the partnership, with Supervisor Jim Desmond voting against it.” [San Diego Union-Tribune, 11/18/25]

San Diego County Estimated It Could Cost $300 Million A Year To Administer New Rules For Medicaid And SNAP. “Philanthropic leaders see threats to those needs from Republican-led legislation signed by President Donald Trump that cut funding for Medicaid and food stamps, while imposing new eligibility and work requirements for some people who use the programs. […] County estimates indicate it could still cost the county up to $300 million a year to administer the new rules, and to cover potential cost-sharing for food stamps.” [San Diego Union-Tribune, 11/18/25]

2026: Desmond Cast The Lone Vote Against Directing County Staff To Analyze And Recommend Targeted Reforms To The County Medical Services (CMS) In Light Of Anticipated Federal And State Health Care Coverage Changes. “ACTION: ON MOTION of Supervisor Montgomery Steppe, seconded by Supervisor Lawson-Remer, the Board of Supervisors took the following actions: 1. Waived Board Policy A-72 Agenda and Related Process, Section 2.C.2.ii, which establishes required timelines for review when preparing a Board Letter. 2. Directed the Chief Administrative Officer (CAO), in collaboration with the Health and Human Services Agency (HHSA), to analyze and recommend targeted reforms to County Medical Services (CMS) in light of anticipated federal and state healthcare coverage changes and evaluation of the feasibility, fiscal implications, and equity impacts of any proposed recommendations. […] AYES: Aguirre, Anderson, Lawson-Remer, Montgomery Steppe NOES: Desmond.” [San Diego County Board of Supervisors, Meeting Minutes, 3/3/26]

The Legislative Overview Noted Federal Changes Under H.R. 1 And State Actions Were Expected To Increase Health Care Coverage Loss. “San Diego County is at a critical inflection point in the evolution of our safety net health systems. Federal changes under H.R. 1, coupled with related State implementation actions beginning in 2026, are expected to increase healthcare coverage loss and administrative barriers for residents enrolled in Medi-Cal and other public programs. As eligibility standards tighten and redetermination requirements expand, more San Diegans are likely to experience temporary or long-term gaps in healthcare coverage.” [San Diego County Board of Supervisors, Meeting Minutes, 3/3/26]

H.R. 1 Was Known As The One Big Beautiful Bill. “More stories have been published across the country in recent weeks detailing how the federal cuts to health care passed last year by Congress and signed into law by President Trump in H.R. 1, ‘The One Big Beautiful Bill’, are affecting communities.” [Georgetown University McCourt School of Public Policy, Blog, 5/1/26]

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