Trump targets funding for child care and hospitals, local dollars fill gaps ...Middle East

As the Trump administration moves to freeze billions in federal social services funding and advance deep cuts to health care and other programs, Bay Area counties are increasingly turning to local ballot measures to keep education, child care and medical services afloat.

On Tuesday morning, the administration froze $10 billion in social services funding across five Democratic-controlled states, affecting cash assistance for low-income families as well as scholarships and other child care programs. At the same time, the federal budget sharply reduces spending on health care and other services, leaving local governments to grapple with how to replace the lost money.

“This is a hurricane. It is a financial hurricane that is going to descend on local governments harder than any other level,” said Larry Gerston, political science professor at San Jose State University. “People don’t realize the gravity of what’s about to hit.”

While states file lawsuits to challenge the freezes and cuts — dozens of cases stem from California alone — and Congress fights over the details, counties from Alameda to Santa Clara are increasingly using voter-approved taxes to stabilize funding for services once heavily supported by federal dollars.

Funding childhood education

In Alameda County, the sales tax Measure C raises about $150 million per year for child care centers, early development screening and educational supports for children under five. That revenue will not fully replace the federal funding potentially at risk. But so far, about 78% of eligible child care facilities have received some assistance, most commonly through one-time emergency grants, with the program now expanding to scholarships for families.

“By age 5, most of a child’s brain is already built, so access to early care and education becomes a pipeline to opportunity — or to inequality,” said Kristin Spanos, CEO of Alameda County First 5, which administers the funds. “It’s the very base fabric of the health of our communities, and it’s great to have that local investment happening.”

In Dublin, one of California’s fastest-growing cities for families, The School of Imagination received a $75,000 emergency grant last fall. Administrators used the money to provide holiday bonuses to staff members like educator Lynelle Madsen, who said she had “never felt so appreciated.” Many of her students were born during the pandemic and had lost their “village,” she said, but local investment is helping rebuild what was lost.

“I couldn’t afford child care for the first two years of my son’s life,” said Maya Thompson, 27, a single mother in Dublin. “He’s only been in this program for about six months, and he’s already communicating more, signing more, talking more.”

An approach to health care

As federal grants are pulled back and budget cuts take effect, hospitals and health care providers are also turning to local voters, said Kristof Stremikis, a market analyst at the California Health Care Foundation.

“Everybody knows what’s going to happen, and everybody needs to be reacting to those changes right now,” he said.

The centerpiece of Trump’s legislative agenda so far, the One Big, Beautiful Bill, slashes $1 trillion from Medicaid, the nation’s health insurance program for millions of low-income kids and adults, seniors and people with disabilities, into the 2030s. More than one-third of Californians are enrolled in Medi-Cal, the state’s version of the program.

The federal government covered about 62% of Medi-Cal’s costs last fiscal year — roughly $108 billion — while California paid about $38 billion, or 22%, according to the foundation. The state stands to lose about $30 billion in federal Medi-Cal funding annually. Some of the cuts are already in effect, while others, including new work requirements for enrollees, will be implemented later.

Just as Alameda County turned to voters to fund early childhood education, officials in Santa Clara County relied on a ballot measure to temporarily raise sales taxes replace about one-third of the federal funding that had been cut. The county, which operates the state’s second-largest public hospital and health care system, estimated it would lose roughly $1 billion in federal revenue annually under the new federal budget. More than half of the Santa Clara Valley Healthcare system’s revenues come from Medi-Cal.

Voters approved Measure A in November, a 0.625% sales tax increase expected to generate about $330 million a year. In the same election, a hospital district in southern Alameda County passed a property tax increase to support local care.

It’s a trend Gerston, the San Jose State professor, expects will continue, with Bay Area voters seeing more ballot measures in 2026 from local governments seeking increases in tax revenue to fill in the gap left by federal dollars, including child care subsidies.

Charlene Sigman, founder of The School of Imagination, said there’s still much need in the child care community.

“A lot of the smaller programs, like daycares, are closing down, and so parents don’t have as many choices,” she said.

The options for parents like Thompson, the Dublin mom, are limited. She initially waited for a scholarship to another child care facility largely funded by state and federal grants. But scholarship funding for the child care facility dried up, she said. Instead, she’s looking to First 5 in hopes of receiving a scholarship for her son to continue attending The School of Imagination.

“I’m just grateful that Measure C is going to help a lot of children in our future generation,” Thompson said. “Every child deserves child care.”

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