In summary
A newly formed coalition wants to bring a half-cent sales tax before Angeleno voters in June to mitigate Medi-Cal losses
Facing federal funding cuts that could strip health coverage from hundreds of thousands of Angelenos, clinic leaders, union members and patients gathered in Inglewood Wednesday to boost a stop-gap proposal they want to put in front of voters: a county sales tax to stave off service cuts and keep more sick people from seeking primary care in emergency rooms.
A newly formed coalition, Restore Healthcare for Angelenos, is asking the Los Angeles County Board of Supervisors to place a five-year, half-cent sales tax measure on the June ballot in Los Angeles County.
“The ballot measure that we are proposing is an urgent and necessary step to stop the damage, to protect access to life-saving care,” said Louise McCarthy, president and CEO of the Community Clinic Association of Los Angeles County, one of the organizations in the coalition. “The stakes right now could not be higher.”
As the federal spending plan, H.R. 1, starts to take effect, Medi-Cal cuts and eligibility changes will affect millions of Californians. The state stands to lose $30 billion a year in federal funding.
According to the coalition, their proposal would raise about $1 billion annually for health care in Los Angeles County. The revenue would help create a local coverage program that would pay for primary and emergency care as well as behavioral health needs for people who fall off their Medi-Cal insurance and have no other coverage options, according to the coalition. When people are uninsured, uncompensated care at clinics and hospitals grow, threatening the availability of services for everyone, coalition leaders say.
The coalition is working with Supervisor Holly Mitchell, whose office on Wednesday presented the motion to the county — an initial step before public debate. The board is expected to vote next month; the deadline for placing a board-sponsored measure on the June ballot is March 6.
“I do not take lightly asking fellow residents to consider imposing a ½ percent retail tax,” Mitchell said in an emailed statement. “This option is on the table because what’s at stake are safety net services unraveling for millions of residents — which would come at an even greater cost for the largest county in the nation.”
She added that if the measure passed it would sunset on Oct. 1, 2031 and would be subject to public oversight and audits. “This is a last resort option for the times we’re facing and for voters to make the final call on,” Mitchell said.
If the board of supervisors does not approve the measure for a June vote, the coalition will gather signatures toward qualifying the initiative for the November ballot, said Jim Mangia, CEO of St. John’s Community Health, another coalition member.
Efforts to shore up health care access for poor Californians aren’t unique to Los Angeles. Pressure is building for state and county leaders to find new revenue streams to make up at least in part for the federal losses. In a legislative hearing Tuesday, health providers and advocates also urged state lawmakers to seek creative funding solutions.
Last November, voters in Santa Clara County approved a tax similar to the one proposed in Los Angeles County. Santa Clara’s Measure A will raise the local sales tax by five-eights of a cent for five years. The county projects that it will provide $330 million annually for local hospitals and clinics.
Both local proposals are separate from the push led by SEIU-United Healthcare Workers West for a one-time 5% tax on the wealth of the state’s approximately 200 billionaires, which would generate an estimated $100 billion to fund medical care and other social services at the state level. Gov. Gavin Newsom opposes the initiative, arguing that such a tax would drive wealthy people — who pay a significant portion of the state’s income taxes — from the state. That measure has not yet qualified for the November ballot.
Local and state tax proposals could seemingly compete for the attention of voters, since both are responses to the issue of federal funding cuts. And in L.A., voters may have to consider a number of other tax measures this election year from a city hotel tax in June to a sales tax to support the Los Angeles Fire Department in November.
Mangia sees the tax initiatives to fund health care as complementary. He said the state tax on billionaires would help restore some of federal cuts to Medi-Cal at the state level, while the L.A County measure would help shore up the local safety net.
“We’re doing this to make sure that no matter what happens federally, statewide, residents of L.A. County will have access to health care,” Mangia said.
Among the most prominent changes and cuts made in Trump’s major budget reconciliation law are a new requirement for enrollees to log 80 hours per month of school, work or volunteering starting in 2027; a rule that requires people to renew coverage every six months rather than annually; restrictions on taxes that the state places on insurers to help pay for the Medi-Cal program; and a reduction in how much the feds will pay for the emergency care of non-citizens.
State health officials estimate 3.4 million Californians could lose their Medi-Cal coverage over the next several years.
Under its own growing budget pressures, the state has also rolled back coverage for certain groups. Starting earlier this month state health officials froze Medi-Cal enrollment for undocumented people — the state foots most of the cost for this group because with the exception of emergency care, federal dollars cannot be used to cover individuals who are in the country illegally. This summer the state will also cut non-emergency dental care for undocumented adults already enrolled in the program.
Supported by the California Health Care Foundation (CHCF), which works to ensure that people have access to the care they need, when they need it, at a price they can afford. Visit www.chcf.org to learn more.
