We are doctors, not politicians. We have spent our careers caring for Santa Clara County residents on their hardest days and working to protect public health. We know what happens when care is close and accessible and when it is not.
This November, our community faces a critical choice. Federal budget cuts in HR1, passed by Congress and signed by President Trump, have taken billions from Medi-Cal and left a hole in our county health system that’s projected to grow to $1.3 billion annually by fiscal year 2029-30. Medi-Cal covers more than 450,000 county residents. When funding is cut, patients do not disappear. They turn to emergency rooms, the only places where they can still get care. That crowds hospitals and drives up costs for everyone.
Our public health system serves one in four residents and cares for more Medi-Cal and Medicare patients than any other provider in the county. It operates two of our three trauma centers, and nearly half of all ER visits end up at a county hospital. Without Measure A, a five-eighths-cent sales tax increase on the Nov. 4 ballot, beds will close, services will be cut, and some hospitals may not survive.
When hospitals close or when thousands lose insurance, patients still need care. They flood the nearest emergency room, creating overcrowding that means longer waits, delayed treatment for heart attacks, strokes and injuries, and worse outcomes for everyone, even those with private insurance. We saw ERs overwhelmed during COVID. Without Measure A, the next fire, earthquake or pandemic would be even harder to manage.
Measure A is a practical part of the solution. It raises about $330 million a year for five years. That will not fix every problem, but it will keep hospitals open while longer-term changes are made. Our county health system has an annual budget of $4.5 billion. A billion-dollar shortfall closed by cuts alone comes with unacceptable risks to public safety. Measure A provides the bridge we need to keep doors open and staff in place while the system stabilizes.
The measure is temporary and accountable. Every dollar stays in Santa Clara County. Washington cannot take a cent. Independent audits will show exactly how the funds are spent, and voters will be able to see the results.
Some may ask why the county acted quickly to put this measure on the ballot. The answer is simple: Hospitals cannot wait. The federal cuts created a crisis overnight. When an ER is full or a trauma center is short-staffed, lives are at risk. Local leaders acted fast because the need was urgent.
As physicians, we also understand the financial strain families face. Housing, food and gas costs are already high. But without Measure A, families will pay more in other ways. Longer ER waits mean delayed care. Closed services mean longer drives for treatment. When uninsured patients overwhelm the system, costs rise for everyone who is insured. The short-term local funding from Measure A is far less than what families will pay if hospitals close.
In our ERs, we do not ask who someone voted for. We ask how we can care for them. Measure A is about keeping that promise to every person in our county.
We see this crisis every day. We know what is at stake. Vote yes on Measure A. Keep our hospitals open. Protect care for seniors, children and families across Santa Clara County. Lives depend on it.
Dr. Sara Cody is the retired health officer and director of the Santa Clara County Public Health Department. Dr. Dennis Low is the retired chief of primary care and hospital medicine at Santa Clara Valley Medical Center.