Santa Clara County is on the edge of a financial cliff due to devastating federal and state cuts to its health care and safety net services. If the county falters, San Jose won’t be left unscathed.
All 15 municipalities in the county will feel the impact of $1.4 billion in federal cuts to Medi-Cal through 2030, with one in four of the county’s nearly 2 million residents enrolled in the insurance program. But no city will feel it more than San Jose, which claims the lion’s share of the county’s services due to its sheer size.
The ripple effect will be severe starting in 2026-27. The county will need to pull general fund dollars to cover hospital services. By doing so there will be less money available for other services and programs.
To mitigate the cuts, the county is asking voters to approve a five-eighths cent sales tax increase in a Nov. 4 special election to protect the public hospital system. It’s going to need San Jose Mayor Matt Mahan to help get the measure over the finish line, since 50% of county residents reside in his city.
But lately, the relationship between the two governments has turned prickly. Mahan is demanding more support from the county to get homeless people with mental health and substance use challenges off his streets. He blames the county for not doing enough to keep drug dealers in jail, and lacks confidence in the county’s ability to operate four public hospitals. Yet three of the four are in San Jose.
Mahan said at a town hall meeting last week government officials will have to push themselves out of their comfort zones. It’s going to mean doing uncomfortable things. Well one of those uncomfortable things might be a general sales tax which could bring in $330 million in annual revenue.
No one wants to pay more for taxes, but the situation is unprecedented.
The federal government has slashed critical support services and the state has piled on with its Medi-Cal cuts. The cost of living in Santa Clara County is already one of the highest in the nation. Yet, imagine hundreds of thousands of county residents losing critical health care services if emergency departments or a hospital closes.
This is where the mayor’s uncomfortable, hard work begins.
He is right about neither the city nor county having all the tools to effectively solve these problems alone. But together they have a chance of making it through until federal funding is restored.
This is where Mahan can show his mettle. Explain to his residents how this tax could help buffer health care services. This is not a 20- or 30-year tax. It’s a five-year tax to give county hospitals a lift.
Saving lives has to be a priority. People shouldn’t die because they can’t receive proper or timely health care. Government officials throughout the county need to be all in on combating this problem.
The mayor said it’s time for a reset. He needs to push that button now and find a middle ground with the county. Coming to the table and hashing out solutions will benefit everyone — and time is short.
Moryt Milo is an editor at San José Spotlight. Contact Moryt at [email protected] or follow her at @morytmilo on X. Catch up on her editorials here.
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