Paz-Cedillos: Measure A is a lifeline for Santa Clara County

The moment we are in is unlike any I’ve experienced as a nonprofit leader.

The so-called “Big Beautiful Bill,” signed into law this summer, will devastate communities like ours. It strips billions of dollars from the social safety net, cutting Medicaid and other federal programs that have kept millions afloat. For Santa Clara County, the projected loss is staggering: $4.4 billion in revenue by fiscal year 2029-30.

The consequences won’t just fall on the poor. They will ripple outward, weakening the very systems we all rely on. Consider this, 60% of 911 ambulance trips from San Jose already go to a county hospital. It doesn’t matter if you carry the best private insurance or if you’re in a car accident or suffer a heart attack, chances are you’ll be taken to one of the county’s trauma centers. If we fail to protect this system, your access to lifesaving care could vanish when you need it most.

The county operates California’s second-largest public hospital system — four hospitals, 15 health clinics, two of the region’s three trauma centers and the Bay Area’s only burn center. One in four County residents, nearly 500,000 people, are Medi-Cal enrollees who depend on this system for care.

And here’s the reality, when uninsured or underinsured patients show up in crisis, hospitals are legally required to treat them whether or not the federal government provides reimbursement. That gap doesn’t disappear, it gets absorbed into the system we all share.

Measure A is not perfect. It raises the sales tax by 0.625% for five years, pushing  the county’s rate to 9.75% and San Jose’s to 10%. Sales taxes are regressive. They hit low-income households hardest. But perfection is not on the ballot. Survival is.

This measure will generate $330 million annually, enough to close about one-third of the county’s deficit. Without it, we face cuts that will lengthen emergency department wait times, shutter treatment beds and increase homelessness.

For those who believe wealth insulates them from the consequences, think again. You may not see the suffering on our streets, but you cannot wall yourself off from systemic collapse. A county without functioning hospitals, without shelter beds, without behavioral health services is a county on the brink. And when the middle class starts to hurt, history tells us unrest follows.

For communities like Mayfair, where poverty, housing instability and health inequities already weigh heavily, the consequences will be even more severe. This is why the Sí Se Puede Collective, a coalition of five East San Jose organizations, has endorsed Measure A. We know our families will be among the first to feel the effects if the county’s health and safety net services unravel.

The scope of the challenge is immense. More than half of the county’s budget, 55%, goes to the health and hospital system. In the last decade, those costs have more than doubled, from $2.2 billion in 2015 to more than $6.1 billion today. Measure A won’t fix everything, but without it, the math simply doesn’t work.

The private sector must also step up. Silicon Valley corporations that profit here must reinvest here, through quality jobs, child care and health care access for their employees and neighbors. Philanthropy and high-net-worth individuals must do more than write checks when convenient. They must recognize that a thriving economy is impossible without a functioning public safety net.

This election is not about abstract policy. It is about whether an underfunded trauma center has the staff to save your child after a crash. It is about whether your elderly parent gets timely behavioral health care or is left to deteriorate. It is about whether the most innovative region in the world allows its public health system, the one thing that binds us all together, to collapse in the name of ideology.

My call to you is simple: Vote. Vote like your life depends on it—because in very real ways, it does.

San José Spotlight columnist Jessica Paz-Cedillos is the co-executive director at the Mexican Heritage Plaza. Her columns appear every first Monday of the month. Contact Jessica at [email protected] or follow her on LinkedIn.