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Posted inLocal News

Santa Clara County sales tax hike to save hospitals appears headed for voter approval

by Brandon Pho, San Jose Spotlight November 4, 2025November 4, 2025

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Supporters of Measure A at an election night watch party react to early results showing the sales tax increase ahead on Nov. 4, 2025. (Brandon Pho/San Jose Spotlight)

Early results show Santa Clara County’s sales tax increase measure leaning toward voter approval on election night.

As of 8:45 p.m. Tuesday, just more than 57% of voters cast ballots in favor of Measure A, or 184,177 votes, with nearly 43% voting against it, or 138,676 votes. The general tax needs a simple majority of more than 50% to pass. County leaders say the five-eighth cent sales tax increase would bring in $330 million in extra revenue annually to stave off the threat of crushing hospital closures, but wouldn’t avoid cuts entirely. County hospitals are losing their largest source of federal funding after the passage of unprecedented cuts to Medicaid under President Donald Trump’s “One Big Beautiful Bill,” or H.R. 1.

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Sharply-dressed county executives, local activists and supporters of Measure A gathered over spirits at the swanky Copita Tequileria y Comida restaurant in Willow Glen. Many expressed anxiety as the results continuously refreshed on the screen.

County Executive James Williams said the early results send a message to the rest of the country.

“We have reaffirmed tonight our commitment to a public health care delivery system with the standard of excellence and standard of service that is the shining beacon for the entire United States,” Williams told the crowd.

District 2 Supervisor Betty Duong said she felt optimistic and confident county voters will make the best choice for their future.

“We always come through for each other — that’s the legacy of Santa Clara County,” Duong told San José Spotlight. “I think tonight we’re going to see it shine. I am cautiously optimistic. It’s not final until it’s final.”

Measure A has become a socioeconomic referendum in Silicon Valley. The county’s public hospital system is the second largest in California — a critical safety net service for the region’s publicly-insured patients, as well as those without insurance.

County doctors and patient advocates have warned that cuts to the public hospitals will impact everyone regardless of where they get care, as people who lose coverage will turn to emergency departments, delaying critical care and ambulance transports across the Bay Area. The county hospitals already routinely reach capacity, dragging out wait times for care and appointments.

Santa Clara County Executive James Williams and District 2 Supervisor Betty Duong at a watch party for supporters of Measure A on Nov. 4, 2025. (Brandon Pho/San Jose Spotlight)

But the tax has faced hefty opposition from the Silicon Valley Taxpayers Association, the Libertarian Party of Santa Clara County and the Santa Clara County Republican Party. A handful of current and former leaders from the wealthy West Valley and North County also formed a campaign against the measure, arguing county hospitals should instead be forced to downsize.

Some supporters came around late. County law enforcement and prosecutor unions — along with San Jose Mayor Matt Mahan — initially signaled doubt about the measure in early public statements. Mahan voiced skepticism about the county’s ability to run four hospitals and 15 health clinics. The public safety unions, facing their own county department budget woes, questioned whether they too would get some of Measure A’s estimated $330 million in new revenue every year, if approved.

Those qualms apparently subsided after the unions — along with Mahan and District Attorney Jeff Rosen — announced their support for Measure A in October. A poll from the public safety unions argues Measure A can win over more Republicans if proponents emphasize the tax will also help law enforcement and the courts.

“I expect if the measure passes, some of the revenue generated from it will go toward public safety just as some of the revenue will go toward hospitals,” Rosen, who attended the watch party in Willow Glen, told San José Spotlight. “If this passes, I would think part of the reason it passed is people wanted to support health care and part of the reason is that people wanted to support public safety.”

Congresswoman Zoe Lofgren spoke in support of Measure A during the election night watch party. (Brandon Pho/San Jose Spotlight)

Congresswoman Zoe Lofgren attended the watch party in support of Measure A. She said the results don’t surprise her.

“We’ve really stepped up to the bat and people are for that. This is not the first time people have voted to tax themselves so others could have health care,” Lofgren told San José Spotlight.

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Measure A was nearly held up in court after opponents sued to stop it from appearing on the ballot, arguing federal spending cuts did not constitute an emergency to place a tax measure on a non-election year ballot under state law. A superior court judge disagreed, allowing the measure to move forward, but ordered the county to remove Trump’s name from the ballot language at opponents’ request.

Opponents have more recently criticized the county for blurring the lines between public health advisories and campaign messaging. The county has been sending out taxpayer-funded mailers warning of hospital closures absent sufficient federal funding — without mentioning Measure A. County leaders say they’re responding to a never-before-seen threat to the existence of the region’s health system.

“The people have spoken, and I hope the county will spend the money judiciously,” Rishi Kumar, chair of the No on Measure A committee, told San José Spotlight.

This story will be updated.

Contact Brandon Pho at [email protected] or @brandonphooo on X.

This story originally appeared in San José Spotlight.

Tagged: ballot measures, closures, Election 2026, Health care access, hospitals, Measure A, One Big Beautiful Bill, public health, sales tax, San Jose Spotlight, Santa Clara County, Silicon Valley

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