California nearly achieved universal healthcare. Now, millions are losing coverage
This story was originally published by CalMatters. Sign up for its newsletters.
Two years ago, California hit a milestone decades in the making: Nearly every person in the state qualified for health insurance, regardless of immigration status and income, pushing the state’s insured rate to a record 95%. Now that progress is unravelling.
Facing budget shortfalls and new federal restrictions, state leaders have begun rolling back the coverage system they built. Analysis at the UC Berkeley Labor Center and UCLA Center for Health Policy Research project California’s uninsured rate could nearly double, to almost 15%, by 2030.
“I knew it was going to be bad, but seeing that doubling was shocking to me,” said Miranda Dietz, director of the labor center’s healthcare program.
An estimated 2.2 million people could lose insurance over the next four years from combined state and federal cuts, the researchers found. The losses will fall hardest on undocumented immigrants and low-income Californians, with the uninsured rate more than doubling among Black and Asian Californians. The southern part of the state will bear the brunt, driven by its larger share of low-income and immigrant residents.
Many Californians remember how difficult it was to get healthcare before the state expanded and improved insurance options.
In 2008, Kandi Hill had just given birth to her third child. When she started throwing up and experiencing irregular menstrual cycles with heavy bleeding she struggled to find a doctor who would run any tests other than a panel for infections spread through sex. In a matter of months, she died from Stage 4 cervical cancer. She was 31.
Cervical cancer has a 91% five-year survival rate if caught and treated early, according to the National Cancer Institute, but back then the Medi-Cal system was bare bones, and doctors didn’t seem to take poor Black patients seriously, said her husband, Ramonte Means.
Means was left to raise two small children and an infant alone. He has been the sole provider for his family ever since, often working part-time and frequently without insurance, stitching together multiple jobs — janitorial work, customer service, job coaching — to make ends meet. Usually, Means said, his employers won’t give him full-time hours so that they don’t have to provide benefits. With multiple part-time jobs, he tries to keep his income low enough to qualify for Medi-Cal and ensure his kids stay covered too. He’d rather get insurance through an employer, but he can’t afford a plan out-of-pocket.
“None of us want anything for free. I work two jobs. My kids go to school,” Means said. “We’re just asking for some dignity.”
Today’s Medi-Cal isn’t perfect, Means says, but it’s much better than when his wife died — patients have more benefits and can see specialists.
“I truly believe if all this happened now, she’d have been fine,” Means said. “The system failed my kids more than anything — failed the whole family.”
Millions gain coverageWhen the Affordable Care Act passed in 2010, California quickly expanded its Medicaid program. Previously, the program was reserved for women and children, seniors, and people with disabilities. Low-income adults were excluded unless they had dependent children. The law allowed California to open enrollment to childless adults and raised the income limit to 138% of the federal poverty level — about $22,000 for an individual today.
More than 5 million Californians gained coverage, including Means, who had occasionally earned too much money before the change.
“So 138% poverty is not a lot of money in terms of increasing income, but when you talk about how many people actually become eligible it has a significant impact,” said Nadereh Pourat, associate director at the UCLA Center for Health Policy Research.
An additional 1.7 million middle-income Californians bought insurance through the commercial Affordable Care Act marketplace known as Covered California.
“That’s a huge policy change,” said Rachel Linn Gish, spokesperson for Health Access California, a consumer advocacy group. “Millions and millions and millions of Californians covered in 10 years. No other state can say that.”
Still, one major group remained uninsured: undocumented immigrants. They account for about 2.3 million residents, according to the Public Policy Institute of California.
Newsom: The healthcare governorGov. Gavin Newsom campaigned on a promise to bring single-payer healthcare to the state. He pivoted to expanding access within the existing system — transforming Medi-Cal with new benefits and a focus on high-quality primary care.
The Democratic governor’s administration also launched the state’s second-largest coverage expansion, phasing in Medi-Cal eligibility for low-income undocumented adults until all adults and children qualified in 2024.
“We’re making sure that universal access to healthcare coverage becomes a reality here in California,” Newsom said in 2022 when the state allowed undocumented seniors to enroll in Medi-Cal.
Gov. Gavin Newsom listens to officials speak during a news conference in Hayward on March 2. Credit: Manuel Orbegozo for CalMatters
At its peak, the state-funded expansion covered 1.4 million adults and 217,000 children and cost more than $10 billion a year.
Republican lawmakers have sharply criticized that price tag, and increasingly, so have moderate Democrats.
“We need to have cost containment,” said Sen. Catherine Blakespear, a Democrat from Encinitas, when the state passed last year’s budget.
Total Medi-Cal spending has more than doubled since Newsom took office in 2019, growing from about $96 billion to $217 billion this year. The nonpartisan Legislative Analyst’s Office attributes most of that growth to higher spending per recipient — added benefits, higher drug prices and some demographic changes — rather than enrollment alone. People are seeing doctors more, and each visit is more expensive.
Medi-Cal cuts loomOrlando and Lourdes are immigrants from El Salvador. CalMatters is using only their middle names because they fear being identified by immigration officials. Orlando has lived in Los Angeles for more than 20 years and works in construction with a work permit. Lourdes manages a store and is undocumented.
Recent federal immigration raids have already upended their lives. They’ve had to counsel their 6-year-old daughter that there are “good police” and “bad police.” Now Lourdes, who needs radiation therapy for cancer, worries about losing her Medi-Cal insurance.
To slow Medi-Cal’s growth, the state froze enrollment for undocumented adults starting in January; roughly 86,000 fewer undocumented immigrants are covered.
Starting next summer, immigrants without legal status will lose dental benefits and face new monthly premiums. These and cuts to coverage for some legal immigrants are expected to push about 800,000 people off insurance, according to the UC Berkeley Labor Center.
“We pay taxes every year. We deserve to have health insurance,” Orlando said.
Services have also been curtailed more broadly. Last year, the state dropped coverage of weight-loss drugs like Ozempic for people who are simply overweight, keeping them only for more serious diagnoses like diabetes. This year, lawmakers scaled back wraparound services, including case management and medical meal-delivery services for low-income patients. They also reinstated a wealth test that caps how much savings an enrollee can have, regardless of their income, which advocates say punishes people for building a financial cushion.
The cuts have stirred outcry from lawmakers on the left, some of whom want the state to raise revenue through corporate taxes or other means rather than shrink Medi-Cal.
Vanesa Duran, lead care manager at St. John’s Community Health, talks with patient Maria Gomez (right) at a group home in Compton. Credit: Jules Hotz for CalMatters
Sen. Lena Gonzalez, a Democrat from Long Beach and chair of the Latino Caucus, said she pressed Newsom and his team twice to save benefits for undocumented people.
“I said this is legacy work for you, and I don’t want you to ever forget that,” Gonzalez said. “For this to happen was just really surprising.”
Linn Gish credited Newsom with supporting healthcare access “from Day 1” but called the recent rollbacks disappointing: “We hoped he would be a champion until the end.”
Newsom’s office declined an interview request. In a statement, the Department of Health Care Services emphasized that the Legislature voted to approve the budget that included the cuts and said Newsom remains committed to “responsibly” supporting universal coverage.
“Gov. Newsom has consistently highlighted California’s coverage gains as central to his broader commitment to universal healthcare coverage and a more inclusive safety net,” the statement said.
Federal challengesMany Democrats, Newsom chief among them, blame President Donald Trump, whose One Big Beautiful Bill tax reform law rewrote Medi-Cal rules and cut federal funding to California. The law also let enhanced Affordable Care Act subsidies expire, contributing to a 140,000-person drop in Covered California enrollment. State officials estimate the Medi-Cal program could lose more than $30 billion annually once federal changes fully take effect in 2027.
The biggest change: Many adults must now prove they’re working or volunteering at least 80 hours each month. Research has shown most low-income adults already meet requirements but lose coverage anyway because of bureaucratic errors.
“All it takes is one piece of lost mail and all of a sudden you lose coverage … and things can snowball,” said Dylan Roby, a health policy researcher and professor at UC Irvine.
Combined with shorter eligibility periods, the state estimates this will cause 1.3 million people to lose insurance in the next four years.
Those losses won’t be spread evenly. Los Angeles and other parts of Southern California could see the steepest declines, according to the Labor Center, which also projects that Latino Californians will lose coverage faster than other groups.
Linnea Koopmans, CEO of Local Health Plans of California, which represents Medi-Cal insurers, said the combined cuts will create a two-tiered system of haves and have-nots.
“There’s a lot at stake and a lot to be lost,” Koopmans said.
But some Republican lawmakers counter that blaming Washington, D.C. is disingenuous. California has run deficits for four straight years, predating most federal restrictions, which haven’t even taken effect yet.
Sen. Roger Niello, a Republican from Roseville and vice chair of the budget committee, put the current impact of federal healthcare restrictions at $3 billion out of a $351 billion state budget.
“It’s difficult (to argue) that the woes are being caused by the federal government,” Niello said, calling the state’s spending problem structural. Revenues have grown, but spending has grown faster.
The current budget leaves the toughest healthcare decisions to the next governor.
“Gov. Newsom says he solved the deficit for the next governor. He hasn’t,” Niello said.
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Seedlings of Inspiration
TED LASSO Season 4: Good News? It’s Fine! Bad News? It’s Fine
- How you feel about Ted Lasso season four will greatly depend on your expectations, because the good news and bad news are the same – it’s fine.
How you feel about Ted Lasso‘s return on Apple TV will greatly depend on your expectations. Your own expectations will also likely depend on how you felt about the show’s second and third seasons. If you liked or even loved them you have almost nothing to worry about; you’re going to love season four. It features much more logical, better paced scripts. It’s also (on the whole) a lot less saccharine than its trailers indicated. However, if you hated seasons two and three, and were instead hoping for a return to form from the show’s sublime first season, you’re going to be disappointed. Because the new Ted Lasso is totally fine. It’s not great or terrible, it’s just fine.
Apple TV made Ted Lasso season four’s first five episodes available to critics. After just seven minutes into the premiere I had my headline ready to go: “I Understand Why Ted Lasso’s Wife Divorced Him.” I felt the same way by the end of the unbearable first installment. It’s a well-made, humorless melodrama of sadness that annoyed me to no end. It’s the best version of a season three episode, which means it’s still really bad. But still, a more logical script and thoughtful plot is technically an improvement than most of the nonsense we got the last time the show was on. The problems came from the overly serious tone rather than illogical plot points and painful attempts at unearned earnestness
Being an improvement over the last two seasons is the very definition of damning with faint praise. Here’s actual praise: the second episode is legitimately good. It even made me laugh, something I had started to think Ted Lasso could no longer do. It was infinitely more fun and silly than the first. It’s as though the show remembered it’s supposed to be a comedy with some dramatic elements and not a drama that can’t tell a joke. Unfortunately, it couldn’t maintain that level for long.
Apple TV
Episodes three through five all have good moments. They also (mostly/not entirely) avoid many of the pitfalls that turned the show from one of TV’s best into one of its most frustrating. But they’re held back by far too many boring storylines. Keeley and Roy are, somehow, still in a will they/won’t they situation. It’s beyond tiresome. Keeley also finds herself once again fretting about her new business endeavor. In this case, her worries are promoting AFC Richmond’s new soccer team, the Lady Greyhounds. It’s nothing we haven’t seen from her character or the show before. Meanwhile, Hannah Waddingham’s Rebecca feels so underutilized in her dual stories I sort of can’t believe it. She splits her time between the most boring relationship in history and her fears over the economic feasibility of her new football club.
Brendan Hunt’s Coach Beard is also back and dealing with an old problem, his abusive relationship with Jane. It will either work for you or it won’t. It mostly doesn’t for me, but at least he gets to have fun with some truly over-the-top scenes.
Apple TV
As for Ted… he’s there. He’s there. He doesn’t have much of an arc, but he sure is charming just being a football manager again. Technically his son is also there with him in London, as the show makes sure he doesn’t abandon his child after that was so important to him returning home at the end of season three. But once his son and ex-wife both move across the pond with him, Ted Lasso basically abandons any sort of father and son relationship so it can focus on the coaching part of Ted’s life. It’s ridiculous but also fine. It’s more fun watching Ted deal with his players than his kid.
That might all sound relatively boring, and it is, but the Lady Greyhounds do give the show a much needed new energy. They have much different problems than the (invisible) men’s team. The new characters also have, by default, the most interesting storylines because they are new. They’re not all treading old ground or running in place like the returning stars.
The absolute standout of Ted Lasso season four is newcomer Tanya Reynolds. She’s easily the best part of the first five episodes. She plays the rough, overly serious assistant manager, Alice Chilton. Coach Chilton is dryly funny and the perfect foil for Jason Sudeikis’s overly folksy Ted (who is always at his best when he has a non-believer to play off). She also is clearly hurting under her ever-cracking service, which provides natural opportunities for Ted’s enduring goodness to shine through without it feeling forced. Reynolds is part of most of my favorite moments from the first half of the season and I’m excited to see where her story goes. The same is true for the Lady Greyhounds, who are an interesting bunch.
Apple TV
The other great new addition is, no surprise, Tracey Ullman. She’s a whirlwind of barely controlled chaotic energy. I was happy every time she appeared on screen and can’t wait to see more from her. The show does a great job establishing her as a fascinating character while teasing even more interesting developments.
Good, bad, and lots of in-between, that’s Ted Lasso season four. It’s not a return to form, but it’s clearly also trying to fix many of the problems that sank it before. It just does so with mixed results. The result is a TV show that is absolutely fine. Whether or not you’ll be happy with that depends on if you were expecting more or less than that.
⭐ (3 of 5)
Mikey Walsh is a staff writer at Nerdist. He thinks Ted Lasso should let Hannah Waddingham be silly a lot more often. You can follow him on Bluesky at @burgermike. And also anywhere someone is ranking the Targaryen kings.
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Watsonville activists use Strawberry Festival stage to protest pesticides

Adela Naranjo Bernabe holds a sewn banner that reads ‘No Pesticides’ alongside two hosts and three other winners of the annual Queen of the Patch pin up contest at the Watsonville Strawberry Festival on Aug. 1. (Nik Altenberg — Santa Cruz Local)
WATSONVILLE >> At the annual Watsonville Strawberry Festival on Saturday, one contestant of a pin-up contest used her time on stage to speak out on the issue of pesticide use and the health harms it can expose farmworkers to.
Adela Naranjo Bernabe is a teacher at Cabrillo College and longtime Watsonville resident. When it was her turn to take the stage for “Queen of the Patch” under the name Chicana de Corazón, she blew kisses, did a twirl and untied a large sewn banner that was wrapped around her dress. As the big yellow letters spelling “No Pesticides” became clear, the crowd erupted in applause and shouts of support.
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To one side of the stage, activists gathered holding banners, flags and signs that read things like “1-mile buffer zones!!!” and “Protect schoolchildren from pesticides.” Pesticide activists in Watsonville have for years pushed for a larger buffer zone around schools, claiming that the current quarter-mile regulation is not sufficient to protect children from pesticide drift.
“We don’t want to spread pesticides in our schools no more,” said Chloe, a middle schooler, when asked about her sign.
As Bernabe was onstage answering her question for the contest — “If you were a strawberry dessert, what would you be and why?” — she said, “I think it’s important to have a dessert that is sweet but also that recognizes the hard labor of our campesinos.”
She also said that she would be a strawberry shortcake.
“My parents are farmworkers, my dad has worked in the strawberries all his life,” Bernabe said in an interview with Santa Cruz Local, adding that she thinks the community could be doing more to support farmworkers and prioritize the issue of pesticide exposure. “If we didn’t have farmworkers we wouldn’t have any strawberries.”
After the 10 contestants had their moment on stage, the three judges deliberated. A third place, second place and first place Queen of the Patch were crowned. Then, Bernabe as Chicana de Corazón was declared an honorary Queen of the Patch and was crowned alongside the other winners.
Watch a video version of this story on Instagram.

Adela Naranjo Bernabe, under the stage name Chicana de Corazón, was crowned Queen of the Patch. (Nik Altenberg — Santa Cruz Local)

Araceli Gonzalez, one of the hosts of the event, wore a hand-painted dress that paid homage to farmworkers and included anti-pesticide messages. (Nik Altenberg — Santa Cruz Local)

Pesticide activists held banners and signs protesting the use of pesticides near schools. (Nik Altenberg — Santa Cruz Local)
Read the investigationHow pesticides endanger pregnant farmworkers in Pajaro Valley
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Judge Sets Paramount-Warner Bros. Trial for March 2027
- The antitrust trial concerning the sale of Warner Bros. to Paramount will start in March 2027, meaning Paramount has to pay over a billion dollars.
If there’s one thing I’m really tired of thinking about, it’s the ensuing Hollywood nightmare of the Paramount-Warner Bros. merger. I would rather it not happen at all, of course. But at the very least it’s not going to be an easy prospect for Paramount CEO David Ellison. After the recent postponement following a 12-state coalition subpoenaed to stop the sale due to antitrust laws, we assumed a trial date would come shortly. Paramount was pushing for November. But to the chagrin of Ellison and his company’s pocketbook, the trial will instead start in March of 2027.
Paramount/Warner Bros. Discovery
This, according to The Hollywood Reporter, will be roughly five months after Paramount has to start paying Warner Bros-Discovery for not buying them. Part of the agreement about the merger was that Paramount would to pay $7 million per day to WBD beginning October 1 if the deal hadn’t closed by then. So confident were they that the justice department would let it skate through. If the trial began in early November, Paramount would only have to pay $220-ish million. Now, with the trial beginning March 2 and lasting 12 days, plus the time it takes to reach a decision and close, Paramount will have to pay something like $1.5 billion.
And—let’s say—the deal isn’t closed by June of 2027. Like maybe the judge sides with the 12 states. Or if they just can’t get it together before then. Well, WBD then has the option to terminate the agreement and collect a $7 billion fee from Paramount. While the coalition team wanted the trial to start in April, March is definitely more on their side than the November Paramount wanted.
“We respect the court’s decision and continue to believe a trial on the merits is the best and most direct way for us to prove what we’ve said from the start – this transaction is lawful, pro-competitive, and raises no antitrust concerns,” a Paramount spokesperson said in a statement. “The lawsuit against us has no basis in fact, economics or antitrust law. We will continue to vigorously defend the transaction and remain committed to closing as soon as possible so its benefits for the creative community and consumers can be realized.”
We will, of course, keep you up to date on this whole thing. Hopefully we get a few months of peace while we wait.
Kyle Anderson is the Senior Editor for Nerdist. He hosts the weekly pop culture deep-dive podcast Laser Focus. You can find his film and TV reviews here. Follow him on Letterboxd.
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Voters to decide on new half-cent sales tax
The Santa Cruz County Board of Supervisors on Tuesday unanimously voted to place a half-cent sales tax measure on the November ballot that would fund an array of “safety net” services in the face of looming state and federal cuts.
The board also declared the county to be in a state of “fiscal distress.”
If approved by a simple majority of voters, the measure would generate approximately $27 million annually for five years, and would apply to sales in the unincorporated areas of the county.
The funds would be used for emergency medical and mental health services, food security, housing stability, homelessness response and other safety net services.
Santa Cruz County Executive Officer Nicole Coburn said the impacts of state and federal cuts are already evident.
“Federal reductions are already reaching our local services, and we’re starting to see the impacts,” she said.
Those costs have shifted onto local jurisdictions, with no increase in funding to help pay for them.
The biggest challenge, Coburn said, comes from H.R. 1, also called the One Big Beautiful Bill Act, whose changes have not yet been felt locally.
“This is going to ripple across the entire local safety net,” she said.
This includes impacts on emergency rooms, ambulance and emergency medical services, nutrition services, safety net clinics, mental health services, as well as food security and housing programs.
“We have estimated that potentially there is more than $200 million in potential annual loss to the local provider network, including the county and our community partners,” Coburn said.
County officials say a combination of new federal laws, executive actions and related state budget decisions is expected to place a larger financial burden on counties. State estimates indicate about 1.1 million Californians could lose Medi-Cal coverage, while some independent analyses project the total could approach 3 million by 2028.
The Central California Alliance for Health expects Medi-Cal enrollment to fall by 27% across the five counties it serves, a decline that could ultimately reduce funding for Santa Cruz County’s health care provider network by more than $200 million each year.
Meanwhile, the California State Association of Counties estimates H.R. 1 could cost California counties and county-operated health systems between $6 billion and $9.5 billion annually through reduced federal funding and increased local obligations.
The county estimates these changes will result in more than $150 million in increased costs and reduced revenues for the county and its community partners over the next five years.
While the measure was seen as a sound move by both county staff and the board, two speakers expressed frustration with the tax.
Becky Steinbruner said it will hurt residents whose ongoing financial troubles are a fiscal crisis in themselves.
“This is a regressive tax that will hurt the very people that you’re saying need the help,” she said. “My family needs to live within our means, and I think the county needs to do the same.”
Carol Bjorn agreed.
“We can’t keep implementing a quote-unquote solution that creates the problem that we’re trying to solve,” she said. “Any tax that you’re proposing is creating the problem.”
Supervisor Manu Koenig called the tax measure an “essential action.”
“I don’t think that anyone is thrilled about the idea of paying more taxes at a time when the cost of living is already high,” Koenig said. “At the same time, we all depend on the emergency room to be there. We don’t know if we’re going to need it today or tomorrow or maybe not at all, but we need it to be there.”
Koenig pointed out that the funds brought in by the measure, if passed, will not pay for an expansion of services, but will instead help preserve what is already there.
“This is a moment when the best way to help yourself is in fact to help others,” he said. “Because preserving those emergency services means ultimately ensuring that they’re only being used when they have to be.”
Supervisor Kim De Serpa, who spent her career in the health care field, said the industry is facing a crisis, pointing to the recent loss of 20 providers from Dignity Health and many residents losing their doctors.
“The county is experiencing a crisis, and if there is something we can do to stabilize people that are the most vulnerable in our community, we must do that,” De Serpa said.
Board Chair Monica Martinez said the proposed tax was created in response to actions by the federal administration affecting vulnerable populations and the Affordable Care Act.
“This is an opportunity for our community to step up and say that we support those who are vulnerable in this community. We do not want our safety net to fall apart. We do not want people to fall through the cracks.”
The measure will appear on the ballot only if SB 762 becomes law. The bill, which authorizes the local ballot measure, is supported by numerous local agencies, organizations, cities and health care providers, including the largest union representing county workers.
The Senate approved the bill Monday, and it is now headed to Gov. Gavin Newsom’s desk.

