With less than a week left until a special election in Santa Clara County, West Valley cities are negotiating how to handle the effects of federal budget cuts from HR1, aka President Donald Trump’s “Big Beautiful Bill.”
After Trump signed HR1 on July 4, it was reported that Santa Clara County would lose more than $1 billion in federal funding in the next five years. A majority of the county’s budget goes toward providing health services. In Santa Clara County, 465,000 residents rely on Medicaid and 133,000 get food assistance through the Supplemental Nutrition Assistance Program, or SNAP. Almost $1 trillion was cut from Medicaid, which is the primary source for the county’s hospital system.
Facing budget deficits that would affect the county’s general fund and Santa Clara Valley Healthcare, which provides a healthcare safety net that includes four public hospitals and and 15 clinics, county supervisors unanimously voted in August to put Measure A on the ballot in November. It would raise the sales tax throughout the county by five-eights of a cent. This would bring up the sales tax in Los Gatos to 9.875%, but in other cities, like San Jose and Milpitas, the tax on consumer purchases would increase to 10%. Campbell would have the highest sales tax rate as a result at 10.5%.
“I don’t think anybody likes more taxes, but to be frank, there were very few if any other options for the county to address this big hole that we have,” Supervisor Margaret Abe-Koga told members of the Los Altos Community Coalition.
Los Gatos Vice Mayor Rob Moore and Councilmember Maria Ristow worked with Together We Will/Indivisible Los Gatos and the Los Gatos Anti-Racism Coalition to canvass neighborhoods in support of Measure A on Oct. 12. The ballot measure is temporary, but it is expected to raise about $330 million annually over the next five years.
Moore said that while he was canvassing, many people seemed opposed to Measure A because they saw it as a tax increase. However, Moore said he persuaded prospective voters in the town that Measure A was needed because public hospitals support the private healthcare services that many of the town residents already have.
About 68% of Los Gatos residents in 2022 and 2023 used employer-provided healthcare coverage, according to Data USA. According to a presentation during a Monte Sereno City Council meeting on Sept. 16, over 3,700 residents in Monte Sereno and Los Gatos rely on Medi-Cal. Around 5,500 residents across Monte Sereno, Los Gatos and Saratoga receive care from Santa Clara Valley Healthcare.
If a county hospital were to close, Moore said it would reduce the capacity of the overall healthcare system in the region, and people would be would have to wait longer for decreased care.
“Those are things that would impact people in Los Gatos, regardless of whether or not they have private or public health care insurance,” Moore said.
Additionally, Santa Clara County operates two out of the three trauma facilities in the county. In the event of a severe medical emergency, like a collision, shooting or a bad fall, patients would be taken to either be Valley Medical Center or Regional Medical Center at the county level. In fact, a presentation by the county to Monte Sereno councilmembers stated that 95% of trauma cases are taken to a county-operated hospital.
“My feeling is that if Measure A dos not pass, the level of care is inevitably going to get worse because the county just doesn’t have the money to do everything it currently does,” Moore said.
County officials further warned that the federal funding cuts due to HR1 could impact other services like public safety. According to Santa Clara County’s updated fiscal forecast for the 2026-27 fiscal year, counties must provide services, including local public and behavioral health systems, social services and safety net programs, child protective services and foster care, criminal justice, local jails, property tax assessment and collection and elections.
During an Oct. 15 Saratoga City Council meeting, councilmembers discussed what services to prioritize after the county sheriff’s office announced that it was increasing costs for its contract cities to address chronic staffing shortages, rising salaries and benefits for deputies and annual budget deficits from excessive overtime pay.
The Sheriff’s Office has two Psychiatric Emergency Response Teams, or PERTs, which pair a mental health clinician funded by the county’s Behavioral Health Services with a plainclothes deputy contracted by the city to respond to mental health-related calls. However, the Behavioral Health Services Department is facing a $154 million deficit and announced it would end funding for PERT clinicians.
Saratoga had 226 PERT calls over the last two years. If Saratoga wants to keep PERT services, they would have to enter a shared-cost agreement with Cupertino and Los Altos Hills for more than $269,000 per clinician or $1.35 million for the five-year funding commitment the department is asking for. The alternative would be shifting to Mobile Crisis Response Teams, which is used in Cupertino, and 9-8-8 clinicians.
“There’s not a lot of money to be made in helping people that have severe mental health issues, especially folks that are homeless or very poor, but who we see out on the streets have challenges that need to be addressed, so the county is the entity that is responsible for taking care of those people,” Moore said.