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LOS ANGELES — Backers of Measure ER, a half-cent Los Angeles County sales tax to fund health care services, are celebrating victory after the initiative staged a narrow come-from-behind win at the ballot box.
Following the June 2 election, early vote totals consistently showed the measure falling short of approval. But earlier this week, as the ballots continued to be tallied, the measure picked up steam and narrowly crossed the 50% support needed for passage.
As of June 9, the measure was passing by 23,405 votes, or roughly 50.6% to 49.4%.
According to the county Registrar-Recorder/County Clerk’s Office, there were only about 23,000 ballots remaining to be counted from the election.
Measure ER, which was introduced by Supervisors Holly Mitchell and Hilda Solis in January, is called the Essential Services Restoration Act and asked voters to enact the half-cent general sales tax increase for five years, through Oct. 1, 2031.
County officials said the measure would generate about $1 billion annually, with the goal of offsetting reductions in state and federal funding for various health care programs.
The county sales tax currently stands at 9.75%. The proposed hike would increase it to 10.25%.
“When you fight, we win,” Solis said during a gathering of supporters June 10. “We have to continue to fight for these residents and their families. If we don’t stick up for them, who the hell is?”
The Board of Supervisors voted 4-1 in February, with Supervisor Kathryn Barger dissenting, to place the proposal on the June ballot.
Barger argued at the time that the county’s sales tax was already among the highest in the nation and should not be forced on to residents who are “already stretched thin.”
In a June 10 statement, Barger said that while she opposed the measure, she will “respect the will of the voters.”
“Moving forward, my responsibility is to ensure the revenues generated are managed with accountability and measurable results,” Barger said. “Taxpayers deserve to know how these funds are being spent, whether promised outcomes are being achieved. I will be a strong advocate for rigorous oversight and fiscal responsibility every step of the way.”
Mitchell argued in February that health care services in the county will face dire losses if no action is taken to restore funding that she said was slashed under the federal budget bill passed earlier this year. She said the bill included “the largest federal funding cut to Medicaid in our nation’s history.”
“HR 1 pulled the rug out from under all of us,” she said. “That’s how we got here.”
At the June 10 rally, Mitchell hailed the measure’s passage.
“Today is not a celebration, but more so a declaration of our commitment to be accountable to the public,” she said.
The county sales tax already increased in April 2025 when voters approved Measure A, a half-cent sales hike that replaced Measure H, a quarter-cent sales tax. The funding from the tax supports homeless prevention initiatives.
Mitchell, who represents the Second District, encompassing South L.A. County cities and unincorporated areas, worked with a coalition of health care organizations and workers, called Restore Healthcare for Angelenos, on Measure ER.
In their motion, Mitchell and Solis said the tax measure would address the immediate need to provide financial support to the county’s health care system amid reductions in state and federal funding.
“Unfortunately, after exhausting every existing alternative, this temporary emergency measure is the only option that can be implemented quickly enough to prevent hospital closures and the loss of health care access for at least hundreds of thousands of residents,” the motion read.
The federal budget bill, known as the “One Big Beautiful Bill Act,” which was approved and signed by Congress and President Donald Trump, detailed billions of dollars of reductions in health care funding, according to the motion. Those reductions to Medi-Cal, coupled with eligibility changes, will impact county residents, who could face loss of coverage and reduced access to care.
“The county’s most impacted departments face projected losses totaling $2.4 billion over the next three years,” the supervisors’ motion reads. “Due to funding losses, county officials have already initiated hiring freezes and are contemplating service consolidations, potential layoffs of 5,000 staff, and facility closures in the coming years.”
State funding reductions in health care are exacerbating the issue. Due to budget constraints, California rolled back health care coverage for undocumented immigrants and reduced funding for other initiatives.
In January, the California Department of Health Care Services stopped enrolling new adult patients without legal status in its state-funded health care program, Medi-Cal. The state is expected to cut non-emergency dental care for immigrants here illegally who are already enrolled in the program.
State officials agreed to enact a $30 monthly premium starting in July 2027 for immigrants who remain on the program, including those with legal status.
Federal dollars do not support these initiatives, as using federal funding for those here illegally is against the law.
Money raised by Measure ER will be spent as follows:
- Up to 45% would support the county Department of Health Services.
- 5% would be allocated based on patient visits to nonprofit health agencies serving low-income and underserved populations.
- About 4% would benefit school-based health needs and programs as determined by the governing board of L.A. Care Health Plan.
- Another 10% would support the county Department of Public Health and its core public health functions.
- About 3% would be allocated to the county Department of Public Social Services to support Medicaid outreach and enrollment activities, and volunteer programs.
- Another 2.5% would go toward the Correctional Health Services.
- Some 22% would fund Department of Health Services to safeguard public hospitals and clinic services.
- About 5% would be allocated to support nonprofit hospitals in the county, and provide funding to entities that meet certain criteria.
- Another 2.5% would support in-home supportive services for seniors and people with disabilities.
- About 1% would support the cities of Pasadena and Long Beach, which have separate Public Health Departments from the county.
- And any remaining funds would be disbursed in a need-based manner focused on emergency department volume.
The measure also establishes a nine-member citizens’ oversight committee to ensure fiscal accountability for any revenue raised, which involves annual independent audits and making recommendations on how to allocate the funding.
Committee members will serve three-year terms and they would be eligible for reappointment by the Board of Supervisors.
The Howard Jarvis Taxpayers Association criticized the proposed sales-tax measure.
“The sales tax is already too high in Los Angeles County, so high that the most recent half-percent increase for homelessness services required special legislation from the state to allow it to exceed the cap on local sales taxes that is in state law,” the association said in a statement. “Raising the sales tax again is unreasonable and unfairly harsh on those who are least able to afford it.”
