Voters in Contra Costa County are being asked to pay more than a half-cent extra in sales tax to help support local healthcare programs that officials say are at risk of becoming overburdened due to federal cutbacks.
Measure B, which the county’s board of supervisors placed on the June 2 primary ballot, would raise the county’s general sales tax by 0.625 of a cent. If approved, the sales tax in Richmond would increase from 9.75% to 10.375%, or slightly more than 10 cents on every dollar of eligible taxable purchases.
The increase would give residents of El Cerrito and Pinole the highest sales tax in the county — 10.875%.
Under state law, the tax cannot be applied to food, housing or medical purchases.
Measure B, which needs a 50% majority vote to pass, would be in effect for five years and would raise a projected $150 million per year. The money would officially go into the county’s general fund, but supporters say most of it would be spent on healthcare programs.
In April, a Contra Costa Superior Court judge ruled that the ballot description for the measure needed to be rewritten. Judge Leonard Marquez agreed with Measure B opponents, who felt the original ballot language was “biased” in favor of a “yes” vote.
Why supporters say Measure B is crucial for healthcare programs
For supporters of Measure B, the goal is to ensure that Contra Costa County residents retain their health insurance.
On their website, Safe & Healthy Contra Costa, Measure B supporters say 93,000 people in Contra Costa County could lose healthcare coverage by 2029 under federal budget cuts being imposed by the Trump administration. They say those cuts could reduce federal contributions to Contra Costa health services by $1.5 billion over the next five years.
Contra Costa County Supervisor John Gioia, whose district includes Richmond, points out that 270,000 people in Contra Costa County are currently served by the Contra Costa Health Plan, which is the Medi-Cal managed-care provider for the county.
Gioia said an estimated 70% of Richmond households have at least one member who is enrolled in Medi-Cal.
He said the federal cuts as well as changes in Medi-Cal eligibility requirements could result in a loss of health coverage for more than 90,000 Contra Costa County residents.
He said Measure B money would be allocated toward health services as well as programs that can help people retain their Medi-Cal eligibility under the new rules.
“It’s a lot cheaper to keep people enrolled than it is to provide emergency services to them,” Gioia told Richmondside.
He noted that people who lose coverage tend to delay preventive health services and end up in emergency rooms with more serious health problems.
He said the amount Richmond residents would pay in extra sales tax would be much lower than the increase in their healthcare costs.
“The cost to Richmond residents will be greater if Measure B doesn’t pass,” Gioia said.
Why opponents are urging a ‘no’ vote on Measure B
On the website Stop Measure B, opponents of the tax initiative say the higher sales tax would “make everyday purchases more expensive across Contra Costa County.”
They note that the extra sales tax would take effect in October 2026 while the initial federal budget cuts aren’t slated to go into effect until January 2027.
“Measure B starts collecting in October 2026 — locking in five years of higher taxes before most impacts are even known,” the organization states.
In their ballot argument, Measure B opponents state that “Contra Costa County has a spending problem, not a revenue problem.”
They note that Contra Costa County employee salaries and benefits have risen 47% since 2020.
“Measure B could facilitate or directly bankroll more such increases,” they say. “Measure B is an affordability tax. Added atop rising prices, Measure B is itself inflationary. It’s also regressive, disproportionately burdening our poorest, most vulnerable residents.”
They suggest that the county use money from Measure X, the half-cent sales tax approved by Contra Costa voters in November 2020 that generates $120 million a year, to bridge any budget gaps in healthcare services.
Marc Joffe, the president of the Contra Costa Taxpayers Association, points out voters could also be asked to approve a half-cent sales tax for Contra Costa transit services as well as a proposed California Billionaire Tax on the November ballot.
Joffe adds that the county general fund and health system have “a large cash balance.”
“Thus, it would have been easy (and more prudent) for the supervisors to have deferred the tax increase to 2028, once more was known,” he told Richmondside. “Any losses in the meantime could be absorbed by drawing down reserve balances.”
However, Gioia said waiting to see what happens isn’t a viable option for people who might lose their health insurance coverage or who might decide they can’t afford it given the loss of Affordable Care Act credits under the Trump administration.
“We don’t want to gamble on our healthcare future by waiting,” he said.
Measure B has garnered support from labor, business groups
Measure B has received support from a variety of organizations.
Among the endorsements are the California Nurses Association, the Service Employees International Union and the Teamsters.
The initiative has also been endorsed by the Hospital Council of Northern & Central California, which represents nearly 200 hospitals from the Central Valley to the Oregon border. Those institutions include Contra Costa County’s nine hospitals.
“When people lose their health insurance, they lose access to primary and preventive healthcare services,” said Rebecca Rozen, the Hospital Council’s regional vice president representing the East Bay, in a statement. “Emergency department visits, already at record levels, will continue to rise. This undermines our shared goal of ensuring patients receive the right care, at the right time, and in the right setting. Any delay in care can have serious and lasting impacts on community health.”
The Hospital Council notes that emergency rooms in eight Contra Costa emergency rooms treated nearly 475,000 patients, a 43% increase from 2020.
“In the East Bay, our biggest concern is that patients will have a harder time accessing the care they rely on — and strengthening hospitals in Contra Costa County is a critical step toward strengthening care for all who call the Bay Area home,” Rozen added.
The Contra Costa Labor Council is also supporting the measure.
“These cuts would hit working families first and hardest,” said Stacie Hinton, president of the Contra Costa Labor Council and AFSCME 2700, in a press release. “Our members rely on accessible, affordable healthcare to stay on the job and support their families. If the system destabilizes, it won’t just impact individuals — it will ripple across every industry in Contra Costa County.”
Measure B has also received an endorsement from East Bay Leadership Council, an employer-led policy advocacy organization that promotes economic vitality in Contra Costa and Alameda counties.
“A strong economy depends on a healthy community,” said Mark Orcutt, president and chief executive of the East Bay Leadership Council. “If people can’t get care, they miss work, businesses lose productivity and costs escalate fast. That’s a hit our local economy can’t afford.”
