Los Angeles County cannot afford to lose our health care safety net. Yet, that is exactly where we are headed, due to the Trump administration cutting billions in health care funding from California’s budget.
Angelenos are already being squeezed from every direction – from housing, to groceries, to gas. Even residents considered high earners increasingly struggle to maintain financial stability in one of the most expensive regions in the country.
In this environment, health care has become one of the most urgent affordability issues facing Los Angeles County. Medical debt remains the leading cause of personal bankruptcy in the United States. When people lose access to care, the financial consequences ripple far beyond hospital walls.
From now until June 2nd, voters face a consequential decision: whether to approve Measure ER, a temporary half-cent sales tax intended to stabilize Los Angeles County’s rapidly deteriorating health care system before deeper economic and human damage sets in.
The stakes extend well beyond public health. Health care is one of the foundational engines of the Los Angeles economy. Health care and social assistance is the largest and fastest growing sector in Los Angeles County, employing roughly 13.2 percent of the county’s workforce and generating more payroll than any other industry in the region. Notably, every lost Medi-Cal dollar translates to $1.85 in lost economic output. If the county’s safety-net system continues to unravel, the economic fallout will be substantial.
We are already seeing warning signs. Seven of Los Angeles County’s 13 public health clinics closed this year due to funding shortfalls, while additional clinics, hospitals, and Planned Parenthood centers remain under threat of closure. Every closure means fewer jobs, less access to preventive care, and greater pressure on emergency rooms that are already stretched thin.
Those consequences compound quickly.
More than 200,000 Angelenos have already lost health care coverage, with up to a million potentially at risk. When people cannot afford routine doctor visits or prescriptions, chronic illnesses worsen. Injuries go untreated. Preventive screenings disappear. Eventually, people become too sick to work consistently. When incomes disappear, rent payments become impossible. Housing instability rises. Homelessness increases. Productivity falls. The economic burden spreads to employers, taxpayers, hospitals, and families alike.
In other words, a weakened health care system does not stay confined to the medical sector. It destabilizes the broader regional economy.
Measure ER is designed as a temporary intervention to prevent that downward spiral. The measure would impose a half-cent sales tax expected to generate approximately $1 billion annually for Los Angeles County’s health care infrastructure. In practical terms, that amounts to 50 cents for every $100 spent on taxable purchases.
The funds would be directed toward community clinics, hospitals, Planned Parenthood centers, and other frontline providers. Supporters of the measure also point to oversight provisions, including an advisory structure intended to ensure the funding is distributed as promised. Importantly, the measure is structured as a temporary stopgap, with an automatic sunset date in 2031, and excludes groceries, prescriptions, and medical equipment.
Critics understandably argue that Californians are already heavily taxed. Many residents feel financially exhausted, and skepticism toward new taxes is real and warranted.
But the reality is that allowing our health care system to collapse would cost far more.
Without a functioning safety net, patients often delay treatment until conditions become emergencies. That leads to overcrowded emergency rooms, longer wait times, and higher costs across the system. Hospitals absorbing uncompensated care costs eventually pass those expenses to insurers, who then pass them on to consumers through rising premiums. Taxpayers ultimately shoulder additional burdens through emergency government interventions and public health crises that spiral out of control.
The costs do not disappear if Measure ER fails. They simply reemerge later in more expensive, less efficient, and more damaging forms.
When people cannot access basic medical care, preventable and treatable illnesses become life-threatening. Families lose loved ones. Communities lose workers, caregivers, and neighbors. Behind every budget debate is real human consequence.
Los Angeles County’s health care system is core infrastructure — as essential to economic stability as transportation, housing, or education. If our health infrastructure fails, the effects will reach every socioeconomic level in Los Angeles County.
This election, voters are being asked whether they are willing to make a temporary investment to prevent a far more severe economic and humanitarian crisis down the road. Whatever one’s position on taxation is generally, the reality is that allowing the county’s health care safety net to continue deteriorating carries costs that Los Angeles may not be able to absorb. I urge LA County voters to take these risks and opportunities seriously by voting yes on Measure ER.
David Green,
President & Executive Director, SEIU Local 721