San Jose officials support sales tax measure to offset health care impacts, but concerns linger

Despite lingering concerns about affordability and a desire for better long-term planning, the vast majority of San Jose city leaders support the upcoming sales tax measure proposed to counter the effects of the Trump Administration’s budget bill on Santa Clara County’s health care system.

During cold and flu season, the youngest kids really are the germiest

How leaders of the MAHA movement benefit from anti-science advocacy and promise profits to industry

Wave of anti-science bills pushed by Robert F. Kennedy Jr. allies hits statehouses, endangering health protections

What Americans think about rising health care costs, according to a new poll

Opinion: Cuts to Medicaid and insurance subsidies will push ERs past the brink

On Tuesday, the City Council approved a resolution in support of Measure A — the five-year, five-eighths of a cent tax proposal that will appear on the Nov. 4 ballot — by a 9-1 vote, with District 10 Councilmember George Casey casting the lone dissenting opinion.

County officials had warned that the trillion-dollar nationwide cuts to Medicaid over the next decade would translate into $4.4 billion in revenue losses through 2030, which could result in higher premiums, increased costs and greater strain placed on the health care system.

Although the prospect of higher sales taxes — bringing San Jose up to 10% — was a difficult pill to swallow, elected officials opined that it presented a more palatable alternative to doing nothing to offset the devastating impacts.

“San Jose’s District 6 has more county hospital beds and specialty services than any other district in our city,” Councilmember Michael Mulcahy said. “If this measure does not pass, we could see significant reductions in critical health care infrastructure that directly serves our residents.”

The budget bill has the potential to significantly impact California and Santa Clara County, which already face financial challenges that have led to hiring freezes and the elimination of vacant positions. The federal government has also impacted many local government services by canceling or failing to pay out grant awards.

Along with imposing new requirements that could impact the Medicaid eligibility of millions of Californians, one-fourth of county residents utilize Medi-Cal. The insurance program is also the largest revenue provider for the county’s health care system.

If passed, Measure A would run for five years and raise approximately $330 million annually.

Representatives for East San Jose noted the importance of preserving healthcare for their constituents. They referenced the advocacy efforts to protest HCA Healthcare’s decision to downgrade and close key services at Regional Medical Center, which led to the county swooping in to purchase the hospital.

“Measure A represents the next step in protecting the hard-won safety net gains and protecting our residents and ensuring our community has the care it deserves from birth on,” District 5 Councilmember Peter Ortiz said.

But several aspects of the sales tax measure have rankled Casey and organizations focused on fiscal responsibility.

Casey noted that the ballot measure is a general sales tax “sold as a hospital rescue,” but it does not obligate or ensure those revenues will be put to that use. He questioned how the county intends to use the money, noting that the $330 million annual revenue is insufficient to plug the billion-dollar deficits, and accused organizers of using “slogans that play off emotions and ignore logic.”

“The gap doesn’t close; it festers,” Casey said. “Meanwhile, new regional taxes are around the corner that will make the rates we pay and taxes even higher. Measure A offers no structural roadmap, no multi-year redesign of the health system, no governance or partnership strategy, no cost control plan, no workforce pipeline or diversion plan, and no primary care expansion targets.”

Casey also said the county has used the budget bill as a red herring to distract from the preexisting challenges it faced after buying up several hospitals.

“This idea that H.R. 1 suddenly caught them with their pants down is a misnomer,” Casey said.

The county did not immediately respond to a request for comment in response to Casey’s critiques.

While he did not announce his voting intentions until earlier this month, Mayor Matt Mahan said he struggled with supporting the measure because of his belief that governments should be working to get better, not bigger.

But in his conversations with county leaders, Mahan stated they have acknowledged the need for a more efficient system and are working to better integrate homelessness and behavioral health systems with the city.

“We’ve done a lot over the years to make government bigger here in our desire to provide a lot of services, amenities, infrastructure, but at some point we price out working with families,” Mahan said. “We contribute to the cost of living (and) there is a breaking point. At the same time, the extensive cuts that H.R. 1 presents for our county are too much, too fast to mitigate in a short period of time.”

Following Tuesday’s vote, the Republican Party of Santa Clara County and fiscally conservative organizations blasted the City Council.

“The Council’s endorsement of Measure A displays a troubling lack of business sense,” said Pat Waite, Treasurer of the Silicon Valley Business Alliance. “Businesses of all sizes — but especially small local merchants — struggle in San Jose. And Measure A will just make a bad situation even worse. It’s tone-deaf to business realities, as it will raise costs for business while making the city even less affordable for residents.”