Pima County supervisors advance budget talks amid warning of deeper cuts to public health and road projects

Pima County supervisors advanced budget discussions Tuesday amid warnings of deeper cuts to public health and road projects. Officials said the county is reassessing spending due to uncertainty over federal funding, with roughly $150 million in grants at risk following recent federal actions and a freeze on some federal dollars.

The Pima County Health Department is among the county agencies most vulnerable to potential funding cuts, officials said, due to its heavy reliance on state and federal grants. County leaders noted that about 30% of Pima County residents are enrolled in AHCCCS, Arizona’s Medicaid program, raising concerns about the impact on services such as acute medical care, behavioral health, substance use treatment, long-term care, and KidsCare. County officials also flagged broader public health risks if state pass-through or federal formula funding is reduced or frozen, according to County Administrator Jan Lesher.

About 30% of Pima County residents are enrolled in AHCCCS, Arizona’s Medicaid program, raising concerns about the impact on services such as acute medical care, behavioral health, substance use treatment, long-term care, and KidsCare.

Transportation and infrastructure projects are also under scrutiny amid the federal funding uncertainty. Officials confirmed that at least one grant, the $2.8 million Safe Streets for All grant from the Federal Highway Administration, has already been paused. The county is monitoring the effects of newly implemented tariffs and the potential for delayed or reduced federal support on road and public safety improvements. Sarah Davis, senior advisor in the Pima County Administrator’s office, described the situation as “fast and furious,” with county staff evaluating risks to projects and services “minute by minute.”

The county’s review of grants covers approximately 150 awards totaling about $150 million in expenditures across 20 departments, including the Grants Management Innovation division and Community Workforce Development, officials said. The grants represent a significant portion of the county’s budget, with some programs funded through formula-driven dollars allocated via the state based on population and services. Lesher described these formula funds as totaling roughly $56 million annually.

The Board of Supervisors has responded by voting unanimously on Feb. 18, 2025, to receive regular updates on federal funding changes and directives. Supervisor Steve Christy characterized the situation at that time as “pure speculation,” noting that most funding cuts had been temporarily paused. However, the ongoing federal executive orders and a memorandum from the Office of Management and Budget signaling potential review pauses or freezes on federal dollars continue to cause uncertainty, officials said.

In response to the growing fiscal concerns, the county has also explored internal budget mechanisms. On April 21, 2025, the Board of Supervisors voted 4-1 to place an Expenditure Limit Adjustment question on the Nov. 3 ballot, asking voters to raise the county’s spending ceiling. Officials discussed the possibility of increasing the primary property tax rate by 48 cents to offset potential revenue shortfalls. These fiscal responses are being considered as federal funding threats overlap with state-imposed budget limits.

The timeline of key developments includes the public acknowledgment on Feb. 18, 2025, that about $150 million in federal grants were at risk, followed by the unanimous board vote to monitor federal funding changes. County officials noted on March 14, 2025, that the continuing resolution H.R. 10545, known as the American Relief Act, was set to expire, potentially affecting federal spending. Despite these uncertainties, the county approved a Regional Housing Strategy and Funding Plan on March 3, 2026, indicating ongoing budget and planning activities.

County officials emphasized that the grant exposure affects a wide range of departments beyond health and transportation. They are tracking the impact of federal executive orders, budget proposals, and spending caps on county operations, including potential effects on staffing, capital projects, and program continuity. Lesher and Davis both highlighted the complexity and rapid pace of changes at the federal level, which continue to shape the county’s budget planning and service delivery strategies.