{"id":360554,"date":"2026-06-14T17:48:12","date_gmt":"2026-06-14T17:48:12","guid":{"rendered":"https:\/\/www.newsbeep.com\/us-ca\/360554\/"},"modified":"2026-06-14T17:48:12","modified_gmt":"2026-06-14T17:48:12","slug":"county-tax-measures-show-limits-of-local-responses-to-medicaid-cuts-in-california","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/us-ca\/360554\/","title":{"rendered":"County tax measures show limits of local responses to Medicaid cuts in California"},"content":{"rendered":"

\u00a0This article<\/a> was produced by Capital & Main. It is published here with permission.<\/p>\n

The Republican-led assault\u00a0on federal Medicaid funding was always going to be a nightmare for the states. Even in California, one of the nation\u2019s wealthiest states by most definitions, experts are broadly predicting a\u00a0health care crisis<\/a>\u00a0for millions due to the federal cuts.<\/p>\n

But there\u2019s another kind of chaos afoot in California: the scrambling attempts by individual counties to do what the state says it can\u2019t and backfill some of those funding losses.<\/p>\n

And as the results of votes on two similar county-level proposals in last week\u2019s primary election make clear, no easy answers are forthcoming.<\/p>\n

In Los Angeles County, a measure to add a half-cent to the existing sales tax to primarily fund health care services holds a\u00a0razor-thin lead<\/a>, with votes still being counted. The proposal, Measure ER, could generate as much as $1 billion a year in revenue for the county if passed.<\/p>\n

Voters in the Bay Area\u2019s Contra Costa County, meanwhile, have\u00a0crushingly defeated<\/a>\u00a0a similar idea. That proposal, Measure B, would have added a little more than six-tenths of a cent per dollar to the tax paid on certain purchases, and could have raised about $150 million a year. At last tally, it was failing by 57% to 43%.<\/p>\n

Both counties lean heavily Democratic. In fact, their party voter registration breakdowns are nearly identical, with L.A. County and Contra Costa County both roughly 52% Democrat and 19% Republican. Both also already have high sales taxes; the new measures would push the sales tax in most cities in both counties above 10%.<\/p>\n

Yet one proposal is competitive among voters, the other not remotely so. That points to the inherent risk in asking California\u2019s counties to try to attack these funding gaps on their own.<\/p>\n

And it raises the question of whether voters in November might instead turn to the only statewide health care relief proposal currently in play \u2014 and one that won\u2019t come directly from them: a one-time tax on the state\u2019s billionaires that could raise $100 billion over five years.<\/p>\n

*\u00a0 \u00a0*\u00a0 \u00a0*<\/p>\n

Los Angeles County\u2019s\u00a0Measure ER trailed in early returns before surging into the lead as more mail-in ballots were counted, but it was always predicted to be a close vote. These aren\u2019t easy times in which to ask consumers to pay more.<\/p>\n

\u201cThere really are no other viable and timely options,\u201d Los Angeles County Supervisor Holly Mitchell\u00a0said<\/a>\u00a0earlier this year, after the supervisors approved putting the measure on the June ballot by a 4-1 vote. \u201cTrust me, I looked high and low.\u201d<\/p>\n

The stakes are incredibly high. The UC Berkeley Labor Center has estimated that as many as\u00a03 million Californians<\/a>\u00a0are at risk of losing Medi-Cal coverage by 2028 as a result of\u00a0policy changes<\/a>\u00a0and funding cuts to the program under the so-called One Big Beautiful Bill Act. (Medi-Cal is the state\u2019s version of Medicaid.) The potential annual hit to California\u2019s Medi-Cal funding has been put at\u00a0$30 billion<\/a>.<\/p>\n

Still, a sales tax increase is a difficult proposition, even if some residents will benefit from keeping county health and safety net services afloat. Such taxes are regressive, meaning they hurt poor people more than they do those who are better off.<\/p>\n

Lower-income families spend most of what they make on the basics, and most of those items, like food and transportation, become more expensive when local sales taxes rise. In L.A. County\u2019s case, the sales tax would increase to a minimum of 10.25% if ER passes. (Some cities within the county tack on additional local sales taxes.)<\/p>\n

\u201cI continue to believe that [solutions] should be led by state policymakers and funded through responsible statewide action, not through a regressive tax that puts more strain on working people,\u201d Kathryn Barger, the only Republican on the board and only supervisor to vote against placing Measure ER on the ballot, told Capital & Main by email.<\/p>\n

In Contra Costa County, opponents of that sales tax measure reminded voters that they\u2019d already passed a\u00a0similar, ongoing tax<\/a>\u00a0in 2020, and questioned how transparent officials would be with revenues from a tax that technically goes into the county\u2019s general fund.<\/p>\n

\u201cThey could spend Measure B\u2019s millions on whatever they consider \u2018governmental,\u2019 as they\u2019ve already been doing\u201d with the previous tax increase, the opponents wrote.<\/p>\n

*\u00a0 \u00a0*\u00a0 \u00a0*<\/p>\n

The rejection in Contra Costa\u00a0County was firm, while the fate of Measure ER in Los Angeles County remains uncertain. What isn\u2019t changing in either place, or anywhere else in California, is the coming storm of federal health care funding reductions.<\/p>\n

That brings the conversation back to the proposed\u00a02026 Billionaire Tax Act<\/a>, a one-time, 5% levy on the accumulated wealth of California\u2019s estimated 200 richest people. The resulting infusion of cash, roughly $20 billion per year for the next five years, would help the state\u2019s besieged health care systems and hospitals weather the storm of the GOP\u2019s attack on Medicaid funding \u2014 until, at least in theory, a friendlier administration takes over in Washington, D.C., years hence.<\/p>\n

The proposal\u2019s chances for passage in November aren\u2019t really known yet. Recent polling shows the billionaire tax with\u00a054% support<\/a>, with Democrats mostly approving and Republicans opposed. But the heaviest spending on the campaign is yet to come.<\/p>\n

What\u2019s clear is that without\u00a0some\u00a0funding, health services will continue to deteriorate. Los Angeles County has already\u00a0closed seven clinics<\/a>, while Planned Parenthood shuttered at least\u00a0five clinics<\/a>\u00a0in the state. A recent report by the consumer rights group\u00a0Public Citizen<\/a>\u00a0concluded that federal cuts put 83 California hospitals at risk of closing, reducing services or laying off staff.<\/p>\n

Mitash Popat, CEO of the Venice Family Clinic in L.A. County, called Measure ER an imperfect but necessary solution in a time of crisis. Popat described the county tax as \u201ca kind of Band-Aid or a transition\u201d to other funding \u2014 but such funding won\u2019t be coming from the state any time soon.<\/p>\n

On the contrary, Gov. Gavin Newsom has been\u00a0walking back<\/a>\u00a0previous expansions of Medi-Cal. Sacramento lawmakers, meanwhile, have repeatedly said the state budget cannot make up for federal health care funding cuts.<\/p>\n

The recent vote results in two different parts of the state strongly suggest that county tax solutions are uncertain and, even if passed, likely fleeting. If a billionaire tax sounds like a big swing, that\u2019s because it is \u2014 but it might also buy the state enough time to find longer-term solutions to the basic question of how to keep its people well.<\/p>\n

Capital & Main<\/a> is an award-winning nonprofit publication that reports from California on the most pressing economic, environmental and social issues of our time, including economic inequality, climate change, health care, threats to democracy, hate and extremism and immigration.\u200b<\/p>\n

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