Yes on Measure A: Sales Tax Increase to Stabilize Health Care in Santa Clara County

On November 4, 2025, Santa Clara County voters will weigh in on a proposed measure to temporarily raise the county sales tax from 9.125% to 9.75%, estimated to generate $330 million per year until it expires in 2031. While sales taxes are regressive in nature, Measure A would directly benefit low-income and vulnerable communities by backfilling some of the deep federal funding cuts to social safety net services such as Medicaid.

SPUR recommends a YES vote on Measure A.
 

What the Measure Would Do

Measure A would impose a temporary increase of 0.625% to the county sales tax, to take effect April 1, 2026. It is estimated to generate an additional $330 million per year in revenue to the county’s general fund for five years, until it expires in 2031.
 

The Backstory

Federal bill H.R. 1, known as the “Big Beautiful Bill,” was enacted in July 2025 and will make heavy cuts to critical social safety net programs across the country, including Medicaid. Santa Clara County has estimated $1.4 billion in lost revenue by FY2029 if no action is taken. The cuts from H.R. 1 represent the most severe funding loss the county has faced since Proposition 13 passed more than 40 years ago.

Roughly 30% of Santa Clara County’s revenues come directly or indirectly from the federal government, representing $3.7 billion of the county’s total budget in FY 2024–25. Close to $2.3 billion of those federal dollars come from the federal Medicaid program and go directly to healthcare services, representing the largest single source of federal funding to Santa Clara County. While the county’s hospital and health clinics will be hit hardest, other critical county services such as food assistance and SNAP, behavioral health care, homelessness services, and public safety, will also see cuts due to the loss of federal funding and significantly constrained resources.

Revenue from Measure A will cover approximately one-third of the projected deficit, and the county administration anticipates that it will need to make additional service and job cuts over the next few years to offset the remaining losses. The sales tax is one part of County Executive James Williams’ “three-pronged approach” to filling the gap. The county executive also plans to expand partnerships with state leaders and reorganize services within the hospital system to increase efficiency.

Santa Clara County runs California’s second largest public hospital system, including four hospitals, 15 health clinics, two of the region’s three trauma centers, and the only regional burn center of its kind in the Bay Area. The public hospital health system is Silicon Valley’s largest and most accessible health care provider: 60% of 9-1-1 ambulance trips from San José are taken to a county hospital, and one in four of the county’s nearly two million residents are Medi-Cal enrollees.

The federal funding cuts from H.R. 1 affect the entire healthcare system — not just the nearly 500,000 Medi-Cal recipients who could lose coverage. Hospitals are legally obligated to provide care to people regardless of insurance coverage, so when they treat uninsured people, they will now absorb the full cost without reimbursement from Medi-Cal and Medicaid. H.R. 1 will result in significant revenue shortfalls and the possibility that hospitals will need to reduce services or close entirely. Emergency room wait times and the cost of health care will increase, while local access to care will decrease.
 

Measure A Would Raise the Sales Tax to the Second Highest Rate in the Bay Area

The proposed sales tax would increase the current sales tax rate from 9.125% to 9.75%, making Santa Clara County’s rate the second highest in the Bay Area, behind Alameda County and just higher than San Mateo and Sonoma counties.

The tax rate would be even higher in cities within the county where other tax measures have been approved locally. Three cities in Santa Clara County would see tax rates in double digits if Measure A passes: San José (10.00%), Campbell (10.50%) and Milpitas (10.00%).

Recent California Senate Bill 63 authorizes five Bay Area counties, including Santa Clara County, to place a half-cent sales tax increase on the November 2026 ballot to fill a public transit funding gap. If Measure A and the proposed new transit sales tax are both enacted, jurisdictions in Santa Clara County would see a combined increase of 1.125% for four years (2027–2031).

Due to the severity of the funding cuts from H.R. 1, Measure A was placed on the ballot unanimously by the Santa Clara County Board of Supervisors, who declared a fiscal emergency in August 2025. The measure needs a simple majority (50% plus one vote) to pass.
 

Equity Impacts

Medi-Cal and Medicaid are essential funding sources for lower-income people to access medical care, behavioral health, and supportive services. 80% of those accessing behavioral health services through the Santa Clara County Behavioral Health Services department rely on Medicaid. This measure would restore some of the funding losses to these programs. In addition, it would support the public hospital system, which uninsured and low-income residents rely on. At the same time, sales taxes are a regressive tool for raising revenue because they levy the same rate on consumers regardless of income. L ow-income households end up paying a higher percentage of their income because they have fewer resources to begin with.
 

Pros

• The passing of this sales tax would bring in $330 million per year of revenue to mitigate the drastic funding cuts to healthcare and other county services from H.R. 1 and to serve as a critical part of Santa Clara County’s larger strategy to counter federal funding cuts.
• The money generated from the sales tax will go to Santa Clara County’s general fund, allowing for spending and service flexibility.
• The measure terminates after five years.
• Strengthening the county health system would reduce emergency room wait times and alleviate the burden on private hospitals by providing more capacity and resources for patients who might otherwise overwhelm private facilities, benefiting the entire regional healthcare network.
   

Cons

• This would be a general sales tax, and therefore there are no legally binding restrictions on spending that guarantee that the dollars will be spent exclusively on health care.
   

Recommendation

While the possible revenue generated from Measure A would not close Santa Clara Count’s entire health care funding gap, it would serve as a crucial and time-sensitive action to counter drastic funding cuts from federal bill H.R. 1. The large regional benefits of preserving Santa Clara County’s critical healthcare infrastructure, including serving the most vulnerable populations who rely on Medicaid and Medi-Cal, justify supporting this emergency measure. Despite the regressive nature of sales taxes, Measure A would directly benefit low-income and vulnerable communities by backfilling some of the deep funding cuts to social safety net services. SPUR supports Measure A, and at the same time, we encourage the county to also pursue other funding solutions at the state and federal levels to continue providing essential services to Santa Clara County residents.

Vote YES on Measure A