Santa Clara County Govt James Williams sums up the most important challenge going through California’s sixth-largest county in 2026 in three phrases: “price range, price range, price range.”
The previous 12 months ushered in a brand new age of fiscal challenges for the county as President Donald Trump and a Republican-controlled Congress handed laws final summer season that triggered unprecedented cuts to the federal Medicaid program. Often called Medi-Cal in California, this system offers medical insurance to low-income and disabled people.
Because the operators of the second-largest county well being and hospital system within the state, Trump’s landmark tax-and-spending invoice has left an enormous gap in Santa Clara County’s rising price range for the approaching years.
2025 noticed the county act swiftly to answer the problem, putting a common gross sales tax improve on the November poll to backfill a portion of the misplaced revenues, which make up roughly a 3rd of the price range. Voters in the end authorised the gross sales tax improve, which can take impact in April. However the projected $330 million it is going to elevate yearly will solely plug a part of the $1 billion annual hole, putting price range challenges — and well being care — on the forefront of the county’s priorities.
Williams mentioned in an interview that price range constraints will “tremendously” affect coverage selections the Board of Supervisors would possibly need to pursue this 12 months to make sure that baseline companies are preserved. Along with the fiscal challenges stemming from the federal authorities’s actions, the county can be impacted by “a rare set of coverage challenges” as properly, based on Williams.
“The mixture of the 2 consumes an incredible quantity of our power as a result of we now have an obligation to handle these most in want in our neighborhood and to do the whole lot that we will that’s inside our management to assist be certain that Santa Clara County residents proceed to have entry to crucial companies and that Santa Clara County residents continued to be cared for,” he mentioned.
The county government mentioned they plan on innovating domestically, advocating for extra funding from the state and pursuing litigation the place crucial. The county sued the Trump administration 9 instances in 2025 on a spread of government orders, such because the president’s makes an attempt to revoke birthright citizenship to pulling federal funding from native governments which have deemed themselves as “sanctuaries” for immigrants residing within the nation illegally.
Supervisor Otto Lee, who’s the president of the Board of Supervisors, mentioned in an interview its lawsuits in opposition to the federal authorities are crucial to defending each residents’ rights and key funding streams.
“It’s a kind of issues in life that we simply should proceed urgent on to guarantee that we will maintain our work as a county,” he mentioned. “With out the federal funds, with out the state funds, we’re not capable of do our primary core job.”
Whereas the price range will dictate lots of the county’s coverage actions in 2026, Lee — who can be serving as president of the board for the second 12 months — mentioned he would really like the county to focus extra on emergency preparedness, working extra deeply with San Jose officers to sort out the unsheltered homeless disaster and guaranteeing faculties have clear ingesting water.
Supervisors Sylvia Arenas, who serves because the vp of the board, mentioned her priorities give attention to “constructing on the momentum of the Latino Well being Evaluation.” The county launched the detailed report final 12 months, which discovered that whereas Latinos, who make up one in 4 residents within the county, usually face worse well being outcomes than their white and Asian counterparts.
“We’ve an actual alternative to show information into motion by addressing persistent social determinants that has led to Latinos having a two-year shorter life expectancy than their counterparts,” Arenas mentioned in a press release. “Rising well being entry this 12 months is significant as we face the realities of H.R. 1 and assist the rising variety of households counting on the county’s security‑internet applications.”
A few of the county’s coverage work within the upcoming 12 months, nevertheless, could rely upon what sort of funding it receives from the state. Gov. Gavin Newsom launched his annual price range proposal earlier this month that goals to shut a projected $2.9 billion shortfall, which doesn’t appear promising for the county’s fiscal challenges.
Williams referred to as the preliminary proposal a “established order price range,” saying that it’s “principally non-responsive to the assault that H.R. 1 has introduced on Californians.”
The county government mentioned the proposal “dumps the burden” of the Medicaid cuts onto California’s 58 counties.
“One of many issues that was disappointing concerning the governor’s preliminary price range proposal is there was nothing in there to answer the devastating impacts on our public hospital methods throughout the state,” Williams mentioned. “It’s completely incumbent on the legislature and the state authorities to step up and be certain that all Californians retain entry to those crucial companies.”
