Alameda County is rushing to ask voters to renew in June a health care sales tax that supports the safety net of public hospitals and clinics.
Just four months before the June 3 primary election but five years from the current tax's 2019 expiration, officials are scrambling to get the Measure A half-cent sales tax extended until at least 2034.
"Now we have a track record of what we've done, the services that have been provided, how it's benefited the residents of Alameda County," said Supervisor Nate Miley, who is eager to get the new Measure A campaign moving. "Without that funding, our ability to deliver indigent care in the county would be devastated."
Approved by 71 percent of county voters in 2004, the 15-year revenue stream has helped fortify a public safety net that had been in dire straits before its passage.
Of Measure A's annual revenue of about $100 million, 75 percent automatically goes to the Alameda Health System, a public health authority that runs Highland Hospital in Oakland; Fairmont Hospital, San Leandro Hospital and John George Psychiatric Hospital, all in San Leandro; and satellite clinics. The district, formerly known as the Alameda County Medical Center, is also expanding to take over Alameda Hospital.
The remaining quarter is allocated by the Alameda County Board of Supervisors to fund an array of primary care, public health and mental health services designed to help "indigent, low-income and uninsured adults, children and families, seniors and other residents of Alameda County." About $3 million supports local hospitals outside of the Alameda Health System, such as the nonprofit Children's Hospital Oakland and St. Rose Hospital in Hayward.
A larger sum, about $5.5 million, funds a network of community-based medical clinics that stretches from Berkeley to the Tri-Valley region and Fremont. Other revenue has paid for health care at public schools and at Santa Rita Jail.
Although the launch of President Barack Obama's federal health care law is relieving some East Bay medical providers by increasing the number of insured, including those who qualify for free or low-cost Medi-Cal and Medicare, it is also causing the state to take away millions of dollars it had previously awarded the county to help cover the uninsured.
Part of the discrepancy is that Alameda County has pledged to keep caring for a population excluded from the federal health insurance exchange: undocumented immigrants.
Two chief reasons are driving officials to push for a June renewal measure. One is that if it fails, there is still plenty of time to try again -- most likely in 2016.
"They want a couple of chances to pass it, if it doesn't pass the first time," said Kay Eisenhower, former chairwoman of the oversight committee that reviews how Measure A money is spent.
The other reason is that the November general election is getting crowded and could include a competing sales tax measure to fund transportation projects in Alameda County. The retail tax is already 9 cents for every dollar of taxable goods in most Alameda County cities.
The November 2014 election will be the second try for the Alameda County Transportation Commission, which sought to double a half-cent sales tax for transportation to a full cent during the 2012 presidential election. The measure lost by a fraction of a percentage.
Both tax measures would require two-thirds approval.
A task force that met at the Castro Valley Library last week voted to recommend that the health measure -- which would extend but not raise the half-cent tax -- go to voters in June. The Alameda County Board of Supervisors is expected to vote next week to approve a June ballot measure.
A telephone poll taken last year showed 70 percent of likely Alameda County voters expressed support for renewing Measure A, and another 6 percent were leaning toward support, though many voters said they did not know much about the tax and could be persuaded to vote for or against it.
"Support for Measure A renewal exists, but passage will require a vigorous and well-funded campaign," said a report by Oakland-based polling firm EMC Research. "Public debate and controversy about Measure A will negatively affect public support."
Some who were worried that June was too soon say they have changed their minds.
"We're planning on running a full campaign," said union health policy consultant Bradley Cleveland, who was also involved in the 2004 campaign. "I assume it's going to be easier than 10 years ago, when we first ran the measure. Now there's really 10 years of history showing the kind of services this measure has supported and its importance."