"The tax was designed to combat cuts to Medicaid in H.R.1, the July federal budget reconciliation law dubbed the "Big Beautiful Bill", which supervisors feared would hurt the bottom line of the county's public hospital system. The bill cuts Medicaid spending by 14% over the next ten years, according to health policy news site KFF, while requiring able-bodied people between the ages of 18 and 64 to work at least 20 hours a week to qualify."
"The tax increase, which supervisors placed on the ballot in August, is expected to raise $330 million a year, according to a statement from the county. The funds raised by the tax won't go directly to the hospital system but to the county's general fund. Its proponents point out that measure requires the county to report how the money is spent, and that a tax targeted at raising money for the hospital system would have required two-thirds approval."
Measure A leads 57% to 43% with 317,707 votes counted. The 5/8 percent sales tax aims to offset Medicaid cuts in H.R.1, the July federal budget reconciliation law dubbed the "Big Beautiful Bill". H.R.1 reduces Medicaid spending by 14% over ten years and adds a work requirement for many adults. Medicaid is the largest funding source for the county's four hospitals; supervisors estimate the cuts could cost $1 billion annually and warn balancing the budget will require painful choices. The tax is expected to raise $330 million a year for the county general fund with reporting requirements; a hospital-specific tax would have needed two-thirds approval. Opponents note health already consumes over half of a $13 billion county budget.
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