West Valley cities in Santa Clara County are grappling with the anticipated impact of federal budget cuts stemming from President Donald Trump’s HR1, known as the “Big Beautiful Bill.” Signed into law on July 4, 2023, this legislation is projected to deprive the county of over $1 billion in federal funding over the next five years, primarily affecting essential health services.
The loss of funding poses significant challenges for Santa Clara County, where approximately 465,000 residents rely on Medicaid, and 133,000 receive food assistance through the Supplemental Nutrition Assistance Program (SNAP). The county’s hospital system, which serves as a critical healthcare resource, is heavily reliant on Medicaid funding, with nearly $1 trillion slated to be cut from the program nationwide.
In response to these looming budget deficits, county supervisors voted unanimously in August to place Measure A on the ballot for the upcoming special election in November. This measure proposes a temporary sales tax increase of five-eighths of a cent across the county. If approved, the sales tax in Los Gatos would rise to 9.875%, while cities like San Jose and Milpitas would see their rates climb to 10%. Campbell would face the highest rate at 10.5%.
Supervisor Margaret Abe-Koga addressed the necessity of this measure, stating, “I don’t think anybody likes more taxes, but to be frank, there were very few if any other options for the county to address this big hole that we have.”
Community leaders, including Los Gatos Vice Mayor Rob Moore and Councilmember Maria Ristow, have actively campaigned for Measure A alongside local advocacy groups. Their canvassing efforts have revealed a mixed response from residents, many of whom view the measure as an unwelcome tax increase. Moore emphasized the importance of public hospitals, stating that they support the private healthcare services utilized by many residents.
In 2022 and 2023, approximately 68% of Los Gatos residents accessed healthcare through employer-provided coverage. A report presented during a Monte Sereno City Council meeting on September 16, 2023, noted that over 3,700 residents in Monte Sereno and Los Gatos rely on Medi-Cal, while around 5,500 individuals from these areas and Saratoga receive care from Santa Clara Valley Healthcare.
Moore highlighted the potential ramifications of a county hospital closure, warning that it would strain the regional healthcare system and lead to longer wait times for care. “Those are things that would impact people in Los Gatos, regardless of whether or not they have private or public health care insurance,” he stated.
Santa Clara County operates two of the three trauma facilities in the region, which are crucial for emergency medical situations, such as accidents or severe injuries. According to a presentation by county officials, an overwhelming 95% of trauma cases are directed to county-operated hospitals. Moore expressed concern, saying, “If Measure A does not pass, the level of care is inevitably going to get worse because the county just doesn’t have the money to do everything it currently does.”
The implications of the federal cuts extend beyond healthcare. County officials have warned that reductions due to HR1 could jeopardize various services, including public safety and social services. The updated fiscal forecast for the 2026-27 fiscal year indicates that counties must continue providing essential services, such as behavioral health systems, child protective services, and local law enforcement.
At a October 15, 2023, Saratoga City Council meeting, council members discussed prioritizing services after the county sheriff’s office announced increased costs for contract cities due to staffing shortages and budget deficits. The Sheriff’s Office currently operates two Psychiatric Emergency Response Teams (PERTs) that combine mental health clinicians with deputies to respond to mental health-related incidents. However, the Behavioral Health Services Department is facing a $154 million deficit, threatening the continuation of funding for PERT clinicians.
Saratoga has seen 226 PERT calls over the past two years. To maintain these critical services, the city may need to enter into a shared-cost agreement with nearby cities, potentially costing more than $269,000 per clinician or around $1.35 million for a five-year commitment. An alternative would involve transitioning to Mobile Crisis Response Teams, which have been successfully implemented in Cupertino.
Moore underscored the importance of addressing mental health issues, stating, “There’s not a lot of money to be made in helping people that have severe mental health issues, especially folks that are homeless or very poor.” He emphasized the county’s responsibility to care for these vulnerable populations.
As the special election approaches, the future of Measure A and its potential impact on healthcare and essential services in Santa Clara County hangs in the balance, highlighting the critical need for funding in an increasingly challenging fiscal landscape.
