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California Election Results:
The November 4th special election turned out to be an interesting night, with several victories for the Democratic party. Including a major win for Governor Gavin Newsom, with the passage of Proposition 50 succeeding with an overwhelming majority.
Proposition 50
California voters approved Proposition 50, Governor Gavin Newsom’s initiative authorizing mid-decade redistricting for congressional districts. The measure allows the state legislature, rather than the independent Citizens Redistricting Commission, to draw new congressional boundaries prior to the 2030 census. CalMatters reported over 7.2 million ballots were submitted prior to Election Day, with overall voting proceeding smoothly despite long lines at some polling sites. Prop. 50 was among the most expensive ballot campaigns in recent years, with supporters raising approximately $120 million and opponents about $44 million.
The passage of Prop. 50 triggers a new redistricting process that will be led by the California Legislature. The new California Congressional maps are expected in early 2026.
Measure A: Santa Clara County
A local measure, Measure A in Santa Clara County, establishes a five-eighths cent general sales tax, which will go into effect on April 1, 2026, and is set to expire in five years, in April of 2031. ACHD was closely monitoring this tax as it marks the first local tax in direct response to the significant changes in the financial landscape for public health care providers. The measure was placed on the ballot specifically to counter the effects of the One Big Beautiful Bill Act. The measure is anticipated to generate $330 million a year for the county.
As of 10:50 p.m. Tuesday, 56.7% of voters cast ballots in favor of Measure A, or 200,430 votes, with 43.2% voting against it, or 152,850 votes. The general tax needs a simple majority of more than 50% to pass and it appears most news outlets are reporting the measures success.
This is an important marker in the shifting financial climate and the potential solutions. ACHD will continue to monitor the tax's implementation and other local efforts across California to enact similar financial models.
National Election Highlights:
Several other key races captured national attention on Election Day:
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Colorado: Voters approved a tax increase on high-income earners to permanently fund the Healthy School Meals for All program, which provides free public-school lunches statewide.
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New York: Zohran Mamdani (D) was elected Mayor of New York City.
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New Jersey: Rep. Mikie Sherrill (D) won a highly contested gubernatorial race.
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Virginia: Abigail Spanberger (D) flipped the governor’s office, becoming the first woman elected Governor of Virginia.
Rural Health Transformation Fund:
California submitted their application for Rural Transformation Fund to CMS on Tuesday, November 4, 2025. As a reminder, California’s application can be approved in whole or in part. An executive summary of the application, shared with ACHD, highlights innovative care models and tools and technology, with specific programmatic priorities and concepts flowing from those two categories. ACHD has been closely monitoring and participating in this process. As a reminder, state applications must be approved by CMS on or before December 31, 2025. ACHD anticipates significant continued advocacy around any funds that are granted to California to ensure, to the extent possible, that funds are flowing to rural communities and providers.
Upcoming Legislative Year:
ACHD has continued to increase our presence and distinction in the Capitol. We are excited for the 2026 legislative year, though we know it will continue to present challenges. Should your district have any pressing legislative concerns, please reach out, so we can incorporate this into our planning for the coming year. Look to December and January Advocates for exciting updates related to ACHD’s advocacy presence over the last year.
For now, we encourage healthcare districts to continue to meet with your elected officials while they are back in the district for interim. The Legislature will reconvene on January 5, 2026, for the last year of the two-year session. A tentative 2026 Legislative Calendar can be accessed here.
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