Contra Costa Voters Reject Measure B — a ~$150M/Year Medicaid-Backfill Sales Tax Fails ~42%-58%, the First California County Safety-Net Tax to Lose in 2026

Contra Costa County's Measure B — a 0.625-cent general sales tax projected to raise ~$150 million a year for five years, placed on the June 2 ballot explicitly to 'address deep cuts in federal funding' — failed decisively. The June 5 count shows ~42.1% yes to ~57.9% no, down by more than 36,500 votes (it needed a simple majority).

County staff had projected more than $300 million in health-system losses over five years, and the 'Safe & Healthy Contra Costa' campaign warned ~93,000 residents could lose coverage by 2029 and that H.R. 1 could cut ~$1.5 billion in federal contributions to Contra Costa Health over five years.

Contra Costa Health runs the county hospital, its clinics, and Contra Costa Health Plan (~270,000 members) — so the 'no' vote means there is no local backstop for H.R. 1 Medicaid losses or the signed budget's July 1, 2027 UIS/PPS planning exposure in a major Bay Area county.

For independent Contra Costa FQHCs (LifeLong Medical Care, La Clínica de la Raza, Brighter Beginnings), the failure removes a potential referral-and-stability cushion and signals harder county-side competition for shrinking dollars. The bigger pattern: California's 'tax ourselves to backfill federal Medicaid cuts' model is now 2 wins (Santa Clara Measure A, ~$330M/yr, Nov 2025; LA's Measure ER passed June 10, ~$1B/yr) and 1 loss (Contra Costa B failed) — voters will fund a county-anchored health system but rejected Contra Costa's general-fund version.