County sources said they\u2019re aiming to meet the Aug. 8 deadline to get the ballot question consolidated with the Nov. 4 special election to replace former Assessor Larry Stone<\/a>, who stepped down in July. Sources confirmed Valley Health Foundation, the private nonprofit set up to raise money and lobby for the county health system, has started fundraising for the ballot campaign as the county faces a short runway to November. Sources say the foundation has received at least $1 million in pledges in just the last few days for a forthcoming campaign committee.<\/p>\n Residents have also reported being polled on their position for a tax measure. County officials said they\u2019re aware of the poll, but denied paying for it.<\/p>\n The county is specifically looking to propose a general sales tax, which sources said requires a simple majority to pass. While a special sales tax could better protect hospital funds from a future board of supervisors with different priorities, it requires a higher threshold of two-thirds approval to pass.<\/p>\n \u201cH.R. 1 has cut a seismic tear into our social safety net \u2013 especially our public hospital and health care system,\u201d County Executive James Williams told San Jos\u00e9 Spotlight. \u201cThe county is facing more than a $1 billion budget shortfall, putting at risk critical care that keeps our community healthy and safe. Together, we must pursue all solutions to support the services and life-saving care that everyone in our community relies on.\u201d<\/p>\n Sources said the tax measure would make a meaningful difference if approved, but still wouldn\u2019t solve the county\u2019s biggest fiscal crisis since Proposition 13\u2019s limits on property taxes. Officials anticipate losing more than $1 billion in revenue over the next few years after President Donald Trump\u2019s Fourth of July signing of H.R. 1, his watershed \u201cbig beautiful bill\u201d that makes heavy cuts to the nation\u2019s most critical social safety net programs.\u00a0The county\u2019s losses will mostly come from federal cuts to Medicaid, the public health insurance program known as Medi-Cal in California, which is the largest federal revenue source<\/a> for the county health system of four hospitals and 15 health clinics.<\/p>\n Heath care after Medi-Cal cuts<\/strong><\/p>\n Santa Clara County runs two of the region\u2019s three trauma centers and the only burn center in the Bay Area. The county hospitals are Silicon Valley\u2019s largest and most accessible health care provider and the only option for working-class, uninsured patients. One in four of the county\u2019s nearly 2 million residents are Medi-Cal enrollees. Half of the county hospital system\u2019s patients pay through Medi-Cal. The rest pay through a mix of other means and Medicare, a separate federal program serving patients 65 and older and patients of all ages with certain disabilities.<\/p>\n Community health and patient advocates are welcoming the idea, arguing the county should look at every option available to keep the hospital system robust. Jeffrey Buchanan, director of policy and public affairs for the community group Working Partnerships USA, said public hospital cuts won\u2019t just impact county hospital patients.<\/p>\n \u201cIt\u2019s going to impact the quality of care for everyone, whether you\u2019re on Medi-Cal or not,\u201d Buchanan told San Jos\u00e9 Spotlight. \u201cIf people are no longer able to access primary care or no longer have access to our health clinics, they may be left all of a sudden with no choice but to head to the emergency room \u2014 and what happens to the care of our loved ones who have a higher-level emergency need as doctors are triaging through folks?\u201d<\/p>\n But the health care system is also the county\u2019s largest budget strain \u2014 inextricable from the county organization itself. A majority of county workers are health system employees, and it costs roughly 30% of the county\u2019s $14 billion budget to run the hospitals and clinics.<\/p>\n Silicon Valley Taxpayers Association President Mark Hinkle said he will argue against the measure.<\/p>\n \u201cSales taxes are regressive taxes \u2014 the poor get hit hardest,\u201d Hinkle told San Jos\u00e9 Spotlight. \u201cEvery time they make a purchase they\u2019re going to be taxed. Those who care about the poor and downtrodden should be on our side.\u201d<\/p>\n The proposed tax could open the door for debate over the county\u2019s obligation to the health of its residents, Hinkle said.<\/p>\n \u201cIs it appropriate for the government to be involved in the medical field at all? No, it is not,\u201d Hinkle said. \u201cThey do not have the incentive to cut costs or be more efficient. My philosophical overview is government does not solve problems \u2014 they perpetuate problems.\u201d<\/p>\n The county\u2019s hospital costs, driven mostly by payroll and supplies, routinely outpace revenue by hundreds of millions of dollars. That requires the county to make up the difference every year out of its general fund, the county\u2019s largest discretionary fund fed by taxpayer dollars. In the last fiscal year, the county had to come in with nearly $600 million in taxpayer money. This investment allows the county system to provide services beyond those offered through a traditional health care system, such as the Child Advocacy Center,<\/a> a sexual assault forensic examiner,<\/a> the Valley Homeless Health Care Program and the Saludos Clinic migrant farmworker health program.<\/p>\n The county received nearly $2 billion in federal Medi-Cal funding this fiscal year. The announcement of anticipated cuts comes just months after a period of elation, when supervisors approved the purchase of Regional Medical Center<\/a> in East San Jose, restored services and expanded the hospital system<\/a> in April. Darcie Green, an advocate for uninsured patients and director of Latinas Contra Cancer, said public health care benefits those who don\u2019t rely on it.<\/p>\n \u201cWhen our public hospitals are underfunded, everyone suffers. ER waits get longer, costs go up and care gets delayed for everyone regardless of where you get your care,\u201d she told San Jos\u00e9 Spotlight. \u201cWe all have a stake in saving our public hospitals. It\u2019s imperative that our entire community support the board of supervisors in exploring a sales tax and join community leaders in building a campaign to win in November.\u201d<\/p>\n![\"\"](\"https:\/\/www.europesays.com\/us\/wp-content\/uploads\/2025\/08\/Santa-Clara-County-Health-care-doctor-with-maternity-2-1024x558.png\")
A Valley Medical Center doctor in the hospital\u2019s maternity ward. Image courtesy of Santa Clara Valley Healthcare YouTube channel.<\/p>\n![\"Keep](\"https:\/\/no-cache.hubspot.com\/cta\/default\/44356355\/interactive-184632509590.png\")
<\/a>The county hospital system includes a level 1 trauma and burn center that would otherwise not be available to residents in the county or Bay Area during emergencies. The burn center is one of only three regional centers of its kind between Los Angeles and the Oregon border, according to county leaders.<\/p>\n