Santa Clara County is seeking voter approval for a temporary sales tax hike that will appear on the ballot in November’s special election.

County officials say Measure A is essential to offset the loss of hundreds of millions in federal funds that have been eliminated.

“This could mean reduced access to emergency care and longer wait times,” explained former County Public Health Officer Dr. Sara Cody. “Specialized regional services that only the county provides—such as our burn unit and rehabilitation center—are at risk.”

Measure A is expected to lessen, but not fully cover, an anticipated $1 billion shortfall caused by the federal budget passed on July 4. That budget included deep cuts to Medicaid, stripping Santa Clara County of over $2 billion in federal support.

Backers of the proposal, including Cody, argue that health care services are on the line. Opponents, however, say the plan is flawed.

Critics agree the federal cuts will severely affect the county, but contend that Measure A was hastily added to the ballot. They also accuse the county of mismanaging its hospitals and fear the five-year tax could become permanent. In addition, they insist the measure should be classified as a general tax, not an emergency tax. “Under the legal framework they used to place this on the ballot, none of the revenue is guaranteed for health care,” said Mark Hinkle of the Silicon Valley Taxpayers Association. “Essentially, they’re asking voters to hand over a blank check.”

County officials acknowledge the new tax won’t fully replace the lost revenue, but stress it would reduce the impact on local hospitals. Nonetheless, opponents are contesting both the measure and its ballot language—particularly the emphasis on medical care—in court.