Measure A, Santa Clara County’s proposed temporary sales tax increase of 0.625% effective April 1, 2026 and lasting five years is expected to generate $330 million a year for the county’s general fund to help counter large federal funding cuts (especially to Medicaid/Medi-Cal that threaten healthcare, hospital, clinics and other safety net services.)
The measure is on the Nov. 4 Statewide Special Election ballot. A simple majority is required for passage.
We urge voters to research the pros and cons of the measure before casting their ballot as there are some good aspects and some concerning ones as well.
First, the positives.
Its passage will help offset federal funding cuts as the county stands to lose more than $1 billion per year due to recent legislation (H.R. 1) and proposed changes to Medicaid and social safety nets. Measure A would fill a significant portion of that gap and help keep hospitals, clinics, emergency and trauma services, and other vital services operating.
It will protect vulnerable populations and health equity for low-income residents, people on Medi-Cal, seniors, kids, people with disabilities and other vulnerable members of the community. They are among those who will be most affected if healthcare services are reduced or unavailable.
It will preserve critical services. Without this revenue, there is risk of hospital closures, longer wait times, loss of specialized care (burn, cancer, etc.), mental health, trauma center services and more.
The Measure A sales tax would be temporary and time-limited. Because it’s only for five years, it’s not a permanent tax. Voters will have a chance later to decide if it should be renewed.
Maintaining health infrastructure benefits everyone. Even those with private insurance may see indirect benefits: less crowding in emergency rooms, fewer disruptions in services, etc. The health system’s stability is important not just for vulnerable groups but the general population.
Finally, it supports regional economic stability. Healthcare infrastructure influences economic stability. If hospitals and clinics reduce services or close, that could impact workers, employers and general public health, which has downstream economic effects.
The negatives of the proposed Measure A sales tax are:
This is a regressive sales tax that tends to hit lower-income households harder, because they spend a larger share of their income on taxable goods.
There is a lack of strict earmarking. Since Measure A is a general tax and not a special/emergency tax tied legally to healthcare, there’s no binding guarantee that all the revenue will go to the services being emphasized (hospitals, clinics, etc.). Some revenue could be redirected elsewhere.
Even if it passes, the funds raised are not enough as it covers only part of the estimated losses from federal cuts. Where will the rest of the funds come from?
Also, many residents are already facing higher costs of living, inflation and economic stress. An additional sales tax could exacerbate those challenges.
There is the possibility of misuse or mismanagement. Any large fund with flexible usage carries the risk of inefficiencies, oversight gaps or “mission creep.”
Critics are worried about accountability. While there are calls for audits and oversight, general tax status means legally there’s more leeway and it leads to the question of whether or not you trust the county’s Board of Supervisors.
Even though it’s technically temporary, sometimes temporary measures get renewed or extended. Voters may end up facing additional tax measures down the line if gaps persist.
Should it pass, we urge voters to ask the Board of Supervisors for real, enforceable auditing and reporting requirements; public reporting on revenue and spending, perhaps with dashboards or regular reviews; to ensure the five-year sunset is honored (no stealth renewals without public debate); to combine this measure with cost-cutting or efficiency measures in the healthcare system to maximize value; and to support low-income residents so they are not overly burdened (e.g. through exemptions, programs, subsidies).
