Voters across the county are receiving a glossy mailer warning that "every hospital in our country will be impacted by federal budget cuts" and that John Muir Health "will face $80 million and $130 million in losses." The clear implication is that without Measure B, John Muir's doors could close. The mailer was paid for by the Yes on Measure B committee, whose top funders are the California Nurses Association PAC, IFPTE Local 21, and the Central Labor Council of Contra Costa County, AFL-CIO.

The appeal to John Muir is emotionally potent. Tens of thousands of Contra Costa families receive care there. But the mailer omits every piece of financial context that would allow voters to evaluate whether John Muir actually needs a countywide sales tax bailout.

It doesn't. John Muir Health's most recent IRS Form 990, covering fiscal year 2024, reports total assets of $3.6 billion dwarfing its $1.4 billion in liabilities. Annual revenue of $2 billion exceeded expenses by $57 million. Executive compensation totaling $11 million with CEO Michael S. Thomas receiving $2.1 million. This is not a health system on the brink of financial collapse. It is one of the wealthiest nonprofit hospital operators in Northern California.

Don’t believe the proponent mailers. Vote No on Measure B on June 2.

New York Times Investigation Validates CoCoTax Findings on Autism Therapy Spending

Allegations of waste, fraud, and abuse in the Medicaid program (the federal name for Medi-Cal) have been making news this year, but many neighbors may discount these charges because they usually come from the Trump Administration and its allies. But, on May 23, The New York Times published an investigation documenting how autism therapy clinics across the country have turned Applied Behavioral Analysis into a multibillion-dollar industry fueled by Medicaid dollars and private equity investment. The Times found clinics routinely overprescribing hours, billing Medicaid roughly $70 to $83 per hour for therapy largely delivered by workers earning around $20, and operating with minimal regulatory oversight.

This dovetails with our own analysis of Contra Costa Medi-Cal claims data, which shows a rapid rise in autism-related charges. One provider, BHPN, LLC of Walnut Creek, billed Medi-Cal $118.3 million in 2024, making it the county's second-largest Medicaid biller after Contra Costa County itself. Almost all of that billing was for autism and behavioral health codes. BHPN accounts for more than 75% of all ABA therapy spending in the county across twelve total ABA providers. Total ABA and autism therapy spending in Contra Costa County soared to $112.6 million in 2024. This is exactly the kind of runaway Medi-Cal spending that drives budget pressure at the county and state level, yet it receives almost no public scrutiny. The national investigation the Times has now undertaken suggests California's turn may be coming.

Upcoming Events

CoCoTax Lunch, June 26: Former State Senator Steve Glazer Discusses BART Accountability
Friday, June 26, 2026 | 11:45am – 1:15pm PDT

CoCoTax Lunch, July 24: County Budget Overview with County Administrator Monica Nino
Friday, July 24, 2026 | 11:45am – 1:15pm PDT

Although we won’t have a lunch in August, we will have a members Zoom call on or about August 12th to discuss CoCoTax recommendations for the November ballot.

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