I recently received an item in the mail urging me to vote for L.A. County Measure ER, the so-called Essential Services Restoration Act. The measure would impose half-cent sales tax increase on purchases made in Los Angeles County to offset cuts to the L.A. County Department of Healthcare Services resulting from enactment of the One Big Beautiful Bill Act. Measure ER was placed on the June ballot by the Los Angeles County Board of Supervisors. Only a simple majority of voters is needed to pass the measure.
Supporters claim that Measure ER will prevent the L.A. County health care system from collapsing, will prevent layoffs of health care professionals and the closure of clinics and possibly the four L.A. County public hospitals. They tout that the measure is temporary and has a definitive expiration date in 2031. Ostensibly there are strict accountability provisions, including annual public audits and independent citizens’ oversight.
As the parent of a child with cystic fibrosis, I fully understand the financial medical plight of the chronically ill and others who must rely on Medicaid (known as Medi-Cal in California) and I am personally disgusted by the provisions of OBBBA that reduced federal Medicaid funding. While it is true that H.R. 1 clearly reduced local health care funding in a manner primarily affecting low-income people who rely on Medi-Cal for health care coverage, it is important to look at Measure ER with a “trust but verify” mindset.
According to the Los Angeles County Chief Executive Office, “Revenues generated by the sales tax would be placed in the county’s general fund and used for purposes consistent with general fund expenditures. The Board of Supervisors ultimately decides how general fund dollars are allocated. An advisory citizens’ oversight committee would be established to review the receipt and expenditure of the revenue from the tax, including the county’s annual independent audit, and make recommendations to the board on how to allocate the revenue generated by this sales tax. The review would be completed in conjunction with the county’s budget process.”
Note that the first three sentences do not require that the county actually spend the tax revenues on medical care funding. Instead, it contains rather nebulous language about using those revenues for purposes consistent with general fund expenditures, which are controlled by the Board of Supervisors.
What if the federal spending cuts enacted by OBBBA are restored after President Donald Trump leaves office in 2028? What would the county supervisors do with the additional sales tax revenue if the stated need for raising the revenue no longer exists?
Furthermore, the incremental sales tax proceeds are not placed in a special fund, but rather are commingled with other funds in the county’s general fund. This inherently translates into less transparency and accountability. If the proceeds were placed in a separate fund, it would be much more difficult to divert the spending to other purposes.
As to the advisory citizens oversight committee that would be established, I have firsthand experience as the chair of the Santa Clarita Community College District Citizens’ Bond Oversight Committee. Much of what citizens oversight committees do is to accept the auditor’s reports, which requires an understanding of generally accepted government accounting principles and government auditing standards. Unless the citizens’ oversight committee has at least one member who understands those principles and standards, the committee probably lacks the expertise to perform a meaningful review.
Furthermore, government auditing standards generally focus on ensuring that, once an expenditure is approved, it is properly accounted for. The standards do little, if anything, to evaluate whether the expenditure was prudent or wasteful.
The oversight committee envisioned by Measure ER is a little different from the typical school bond oversight committee because it consists of people who have a vested interest in ensuring that the money is spent on health care. Even so, the county supervisors apparently are not required to accept the citizens review board recommendations. While the county executive’s explanation of how the money will initially be spent seems appropriate, I don’t believe that county supervisors have the best track record of effectively spending taxpayer dollars.
I would consider supporting Measure ER with the following changes:
• Restrict spending solely to replacing federal government shortfalls in Medicaid funding.
• Require that tax revenues be placed in a special restricted fund created for meeting the measure’s stated objectives.
• Mandate a rescission of the tax increase if federal funding is reinstated before the sales tax expiration date of Oct. 1, 2031.
Without those changes I cannot support Measure ER.
Jim de Bree is a Valencia resident.
