Facing potential federal funding cuts that threaten healthcare for hundreds of thousands of residents, a coalition has emerged in Los Angeles County advocating for a new sales tax measure. The group, known as Restore Healthcare for Angelenos, is urging the Los Angeles County Board of Supervisors to place a five-year, half-cent sales tax on the ballot for the upcoming June election. This initiative aims to prevent cuts to essential services and ensure that more individuals receive necessary care without resorting to emergency rooms.
Louise McCarthy, president and CEO of the Community Clinic Association of Los Angeles County, emphasized the urgency of the situation. “The ballot measure that we are proposing is an urgent and necessary step to stop the damage, to protect access to life-saving care,” she stated. The coalition’s proposal is particularly critical as the federal spending plan, H.R. 1, begins to take effect, which includes cuts to Medi-Cal and changes to eligibility that will impact millions of Californians.
The coalition estimates that the proposed tax could generate approximately $1 billion annually for healthcare services in the region. This revenue would support a local coverage program designed to provide primary and emergency care, as well as behavioral health services, to individuals who lose their Medi-Cal coverage and have no alternative options. As coalition leaders pointed out, when individuals become uninsured, the burden of uncompensated care increases at clinics and hospitals, jeopardizing service availability for all residents.
Holly Mitchell, a county supervisor, is collaborating with the coalition on this initiative. Her office presented the motion to the county on Wednesday, marking the initial step before public debate. The Board of Supervisors is slated to vote next month, with a deadline of March 6, 2024, to place a board-sponsored measure on the June ballot. “I do not take lightly asking fellow residents to consider imposing a ½ percent retail tax,” Mitchell remarked in an emailed statement. “This option is on the table because what’s at stake are safety net services unraveling for millions of residents.”
Mitchell clarified that if the measure passes, it would sunset on October 1, 2031, and be subject to public oversight and audits. She described the initiative as a last resort, allowing voters to have the final say on a crucial issue. If the Board of Supervisors ultimately does not approve the measure for a June vote, the coalition plans to gather signatures to qualify the initiative for the November ballot, according to Jim Mangia, CEO of St. John’s Community Health.
Efforts to secure healthcare access for low-income Californians are not limited to Los Angeles County. There is mounting pressure for state and county leaders to identify new revenue streams to offset the anticipated federal losses. During a recent legislative hearing, health providers and advocates urged state lawmakers to explore innovative funding solutions. Notably, last November, voters in Santa Clara County approved a similar tax measure, raising the local sales tax by five-eighths of a cent for five years, projected to generate $330 million annually for local hospitals and clinics.
The proposals in Los Angeles County are separate from a broader push led by SEIU-United Healthcare Workers West for a one-time 5% tax on the wealth of the state’s approximately 200 billionaires. This initiative could potentially generate an estimated $100 billion for medical care and other social services at the state level, though Governor Gavin Newsom has expressed opposition, arguing that such a tax could drive wealthy individuals out of California.
As voters in Los Angeles prepare to consider various tax measures this election year, including a city hotel tax in June and a sales tax to support the Los Angeles Fire Department in November, Mangia views the healthcare funding initiatives as complementary rather than competing. He believes that while the state tax on billionaires would help alleviate some of the federal cuts to Medi-Cal, the Los Angeles County measure would bolster the local safety net. “We’re doing this to ensure that no matter what happens federally or statewide, residents of L.A. County will have access to healthcare,” he stated.
Recent changes and cuts instituted under the federal budget reconciliation law have raised concerns about the future of Medi-Cal. Some of the most significant alterations include a new requirement for enrollees to log 80 hours per month of school, work, or volunteering starting in 2027, and a rule mandating coverage renewals every six months instead of annually. These changes, along with restrictions on state-imposed taxes on insurers funding the Medi-Cal program, threaten to strip coverage from an estimated 2 million Californians over the coming years.
Under growing budget pressures, the state has also begun to limit coverage for specific groups. Earlier this month, state health officials froze Medi-Cal enrollment for undocumented individuals, as the state covers most of the costs for this demographic, with federal dollars unavailable for non-emergency care. Additionally, this summer, the state plans to cut non-emergency dental care for undocumented adults already enrolled in the program.
As the coalition advocates for the sales tax measure, it highlights the urgent need to protect healthcare access for the most vulnerable populations in Los Angeles County and to offset the impending impacts of federal funding cuts.
