A proposed countywide half-cent sales tax increase to fund healthcare services is struggling in early election returns Tuesday night, with voters so far rejecting the measure.
Measure ER, known as the Essential Services Restoration Act, asks voters to approve a half-cent increase in the county’s general sales tax for five years.
County officials estimate the measure would generate roughly $1 billion annually to help sustain healthcare services.
With ballots still being counted, Measure ER had the support of 46.3% of voters, below the 50% threshold required for passage.
If approved, the measure would raise the county sales tax rate from 9.75% to 10.25%.
The Los Angeles County Board of Supervisors voted 4-1 in February to place the measure on the ballot, with Supervisor Kathryn Barger casting the lone dissenting vote.
The proposal comes just over a year after voters approved Measure A, a half-cent sales tax increase that took effect in April 2025 and replaced the quarter-cent Measure H tax.
Revenue from Measure A supports homelessness, but has been controversial after recent audits found a lack of follow up on following money used in homeless spending.
In placing Measure ER before voters, county supervisors argued the measure was necessary to stabilize the county’s healthcare system as it faces significant reductions in state and federal funding.
According to the supervisors’ motion, recent federal budget changes are expected to reduce healthcare funding by billions of dollars.
County officials warned that cuts to Medi-Cal funding and eligibility changes could leave some residents without coverage and reduce access to care.
“The county’s most impacted departments face projected losses totaling $2.4 billion over the next three years,” the motion states.
“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 officials have also moved to curb healthcare spending.
In January, the California Department of Health Care Services stopped enrolling new adult immigrants without legal status into its state-funded Medi-Cal program.
California is also expected to eliminate certain non-emergency dental benefits for some existing enrollees and implement a $30 monthly premium beginning in July 2027 for immigrants who remain in the program, including those with legal status.
Federal law prohibits the use of federal healthcare dollars to cover individuals who are in the country illegally, leaving states responsible for funding those programs.
Opponents to the measure, including Barger, have argued that the healthcare crisis is not unique to Los Angeles County and should not be addressed through a local tax hike.