With nearly all the ballots counted, supporters of a Los Angeles County sales tax measure that helps close a funding gap in healthcare services after federal Medi-Cal cuts, celebrated a hard-fought victory Wednesday morning at a rally in Los Angeles.
Measure ER, the Essential Services Restoration Act on the June 2 direct primary, was ahead with 50.6% yes votes, and 49.4 no votes Tuesday night, continuing a winning trend since Monday. There were only 23,000 more ballots left to be counted on Wednesday night, June 10 and supporters said that would not be enough to overturn the results and that passage was assured.
“I am sure every vote being counted will be another vote of confidence for Measure ER,” declared Second District Supervisor Holly Mitchell, speaking at a victory celebration at St. John’s Community Health Clinic in Pico-Union.
Measure ER only needs 50% of the vote plus one for approval. It would raise the sales tax for all cities in the county and unincorporated communities by 0.50%.
The campaign was led by Jim Mangia, president and CEO of St. John’s, which operates medical, dental and mental health services to 144,000 patients a year at 25 clinic sites in L.A. County. He was joined by labor unions, including SEIU Local 721 that represents 100,000 public sector employees, and physician groups, including the Los Angeles County Medical Association.
“We saved the healthcare safety net in Los Angeles County,” said Mangia.
Supporters said Measure ER, which would raise about $1 billion a year, then sunset in 2031, would help plug the gap in medical services created by cuts from H.R. 1, the “Big Beautiful Bill” that became law in July in Congress, with support from President Donald Trump.
David Green, president of SEIU 721, called it the largest federal cuts to healthcare in Los Angeles County in U.S. history. The county is poised to lose $2.4 billion in healthcare funding over the next three years. Federal cuts affect 3.3 million low-income county residents who rely on federally funded Medi-Cal for health care services provided by the county, Mitchell explained in the last few months.
“We know Measure ER is not a magic wand, but it is a lifesaver to carry us through the storm we are in,” Mitchell said at the victory celebration.
“But we are doing everything we can to protect our healthcare system,” she said. “It is not lost on me that we have a president of the United States who guts healthcare services in order to find new ways to fund detention centers,” she said.
Mangia said supporters were already feeling the effects of H.R.1. The county has seen 300,000 residents lose their Medi-Cal benefits. This has caused a rise in emergency room visits at county hospitals, said Dr. Hector Flores, head of the L.A. County Medical Association.
The dire predictions of more people losing healthcare caused Mangia to act. He organized a coalition that included Mitchell and Solis. “We would not allow healthcare to be ripped away from the people who needed it the most,” he said.
For the first time, Mangia acknowledged getting people to vote for an increase in sales taxes was going to take a long, arduous battle. The Yes on ER group spent more than $9 billion on the campaign and barely squeaked out a victory.
“Measure ER was a grueling, expensive campaign. We won but it was close,” he said. “We won against seemingly insurmountable odds of $7 gas prices and an overall affordability crisis,” Mangia said.
The campaign took its message to Black churches, community clinic waiting rooms, even laundromats, he said in an interview.
“What we saw was the Black and Brown communities came out very strong in favor. And I think that put us over the top,” he said. “We stand here today victorious, continuing to build a healthy Los Angeles.”
Early signs point to lower-income communities voting in favor, maybe because they had the most to lose from a broken county healthcare system and are not concerned about a 0.50% rise in sales tax for five years that doesn’t affect groceries and medical equipment.
Voting analysis from June 3 show majority votes of 50% or more coming from heavily Latino communities, including: Cudahy, Huntington Park, Compton, Maywood, Bell Gardens, Lynwood, Paramount, South Gate, Bell, Gardena, San Fernando, Baldwin Park, Hawaiian Gardens, La Puente, South El Monte, El Monte and Montebello.
Both Mangia and Solis said after the first tally from the night of June 2, when the no votes were ahead by 6 percentage points, they were both quite concerned.
“I’ll be honest with you I was very worried. But I kept on telling my people we will win by a sliver,” said Solis.
Those in opposition said they were concerned that a general tax where the money goes to the county’s general fund might not do what it promised: Get the tax dollars to clinics and hospitals.
Mitchell pledged to be a watchdog and make sure the proper allocation is heeded.
“One hundred percent of the funds will be allocated directly to our healthcare system,” she said. “My resolve is to ensure we are accountable.”
Louise McCarthy, president and CEO of the Community Clinic Association of L.A. County, said the money will go to county health departments and community clinics, to prop up services slashed by Congress.
“One in five Angelenos rely on community clinics,” she said. “They go to 600 sites across the county. Measure ER will help keep these clinic doors open.”
She said investing in healthcare — something the majority of voters felt strongly about — also puts money into jobs and the local economy. “It is also investing in economic health,” she said.