After H.R. 1, otherwise known as President Donald Trump’s Big Beautiful Bill, was signed into law, it was estimated that millions of Americans would become insured by 2034 while health care costs dramatically increased due to cuts to Medicaid and Affordable Care Act marketplaces.
But following the California primaries, voters in Los Angeles County narrowly decided to support a ballot measure that aims to mitigate those impacts by increasing the sales tax to generate an estimated $1 billion annually over the next five years to support health care and other services.
Measure ER is a half-cent increase to the sales tax, increasing it from 9.75% to 10.25%, which will be in effect until Oct. 1, 2031 – unless extended by voter approval. The funds generated from the measure would go towards supporting public health programs, public hospitals and emergency rooms, community clinics, school-based health services, in-home support services for seniors and people with disabilities and other services.
In the June 2 election, the measure just managed to edge out a win, getting 50.64% of the vote.
Jim Mangia – president and CEO of St. John’s Community Health, a clinic with several locations in LA that provides a variety of physical and mental health services – expressed his relief over the measure being passed.
He and the clinic were part of the Yes on ER Coalition that included SEIU (Service Employees International Union) Local 721, Planned Parenthood Advocacy Project LA County, the Hospital Association of Southern California and the LA County Medical Association. The measure was also supported by LA County Supervisors Holly Mitchell and Hilda Solis.
The coalition began petitioning for this measure late last year before the county Board of Supervisors approved it to appear on the ballot on Feb. 10. Mangia recounted that when early votes were being counted, the measure was losing by a sizable margin, but as more and more votes were tallied, the gap shortened and eventually won.
“We worked really hard. It was a … difficult campaign because there were a lot of headwinds: $7 gas prices, the war in Iran, the cost of living [and] inflation,” Mangia said. “We were relieved because if [the measure] had not passed, we would have seen hospitals, emergency rooms, clinics and physician practices close. We would have had a serious health care crisis in Los Angeles County.”
That’s not to say that there haven’t already been consequences to Trump’s Big Beautiful Bill. Approximately 200,000 county residents have been disenrolled from full scope Medi-Cal coverage so far, including 40,000 children. Additionally, seven of the county’s public health clinics have closed following cuts to grants from the Centers for Disease Control and Prevention and the Health and Human Services.
These clinics provided services that many low-income and uninsured residents rely on, including vaccinations, sexually transmitted infection testing and treatment and tuberculosis testing and treatment. The county has six remaining public health clinics, including one in Pacoima.
But Measure ER, Mangia said, will create a coverage program for people who lose their Medi-Cal coverage due to budget cuts. He added that it will provide money to the Department of Public Health to backfill funding for programs impacted by federal grant cuts from the Trump administration’s push to eliminate DEI (diversity, equity and inclusion), including HIV programs and Black maternal health programs.
“It pretty much rounds out support for a safety net,” Mangia said. “Most of the funding will go to nonprofit community health centers to provide that care to the low-income families who may lose their Medi-Cal because of state and federal cuts.”
The Yes on ER Coalition held a press conference on June 10 outside St. John’s Community Health Center, celebrating the passage of the measure. Reflecting on it, Mangia noted that Measure ER brought together every sector of the health care delivery system in LA County, which spoke volumes as to how important it was.
“I think Angelenos will be all the healthier for it,” Mangia said. “Now we start the work of implementing it to make sure that the will of the voters is realized. … That’s what we’re focusing on now.”
Measure ER will go into effect on Oct. 1.