It’s scarcely been three months since the One Big Beautiful Bill Act was signed into law, but its anticipated $911 billion cuts in Medicaid spending over the next decade have already started reshaping how California thinks about spending. Consider:
- Voters in southern Alameda County will have an opportunity on the November ballot to pass Measure B, generating $13 million annually for 12 years to improve emergency department and trauma services in Washington Township Health Care District.
- Santa Clara County is pushing support for Measure A on the November ballot, which would generate an additional $330 million for the county’s general fund each year for the next five years.
- The City of McFarland has asked voters to consider Measure C, a new 1% local sales tax to support city services, including first responder services, roadway improvements, and senior services.
- The City of Delano meanwhile is seeking to extend the existing 1% sales tax that would otherwise expire in 2028, taking with it a key source of revenue to support general city services, improvements, and utilities.
With federal purse strings tightening, responsibility for caring for Californians is falling to the state and counties — and that response is as varied as the 50 counties that comprise Hospital Council. The November election will be a turning point: Will counties step up to provide the support necessary to continue patient care? How will hospitals do more with less? And, most importantly — how much more can hospitals take?
From the most rural counties in Northern California to the densely populated urban areas in the Bay Area, no answer is the same — but hospitals’ mission of caring for those in need is as constant as ever.