Healthcare workers lay down on the lawn outside St. Rose Hospital in Hayward Thursday, staging a die-in to dramatize what they say is a looming threat to the facility's survival: federal healthcare funding cuts that have left Alameda Health System facing a $100 million funding gap. The demonstration came weeks before California voters decide the fate of Proposition 40, a one-time wealth tax on billionaires that labor groups are pitching as a lifeline for hospitals like St. Rose.
According to The Mercury News, the die-in drew participation from California Assemblymember Liz Ortega, SEIU United Healthcare Workers West, and Eden Area Indivisible, all urging voters to back the measure on the November ballot. Protesters say they are opposing cuts tied to H.R. 1, the federal law also known as the One Big Beautiful Bill, which the outlet reports has stripped about $100 billion from California's healthcare system and left a $100 million funding gap at Alameda Health System.
Ortega, who helped lead the 2024 push with Aisha Wahab to get Alameda Health System to acquire St. Rose, told the outlet that the stakes of inaction are severe, warning that children may lose access to care and mothers may die giving birth. The assemblymember authored Assembly Bill 2271, which helped raise awareness and rally support for the acquisition, according to the Official Website of Assemblymember Liz Ortega, which notes St. Rose was facing imminent closure before the state-backed transfer.
A Hospital Already Stretched Thin
The rescue of St. Rose did not end its financial troubles. Alameda Health System began its 2024-2025 fiscal year facing a $100 million operating budget gap, roughly 7% of its $1.4 billion budget, according to Alameda Health System Board of Trustees meeting records.
St. Rose's labor and delivery department closed in 2025, Tri-City Voice reported at the time. Alameda Health System indicated it would evaluate restoring maternity services within 12 to 18 months, per that same reporting. The acquisition had already been credited with saving Hayward's only emergency room from closure, per The Mercury News.
St. Rose has also been the focus of plans to expand care. Stanford University also agreed in April 2026 to partner with the health system to expand specialty medical care at St. Rose, a deal expected to help the hospital develop an inpatient psychiatric unit and improve its long-term stability, according to The Mercury News.
Workers Describe Mounting Strain
The human toll of the funding squeeze shows up in daily hospital operations, workers say. Nastasha Evans, a patient access registration lead at Alameda Hospital, told The Mercury News she had worked 14 consecutive days by Thursday. She said the hospital once saw a couple dozen or fewer uninsured patients per week before the cuts began stripping Medi-Cal coverage, but now sees upwards of 18 uninsured patients daily — a shift Evans fears will worsen drastically if the state fails to pass the wealth tax.
Justin Kmetz, a radiology technologist who has worked at St. Rose for 24 years, told the outlet he fears the hospital could close altogether because of the ongoing cuts. Ortega noted that California has more than 200 billionaires, framing Proposition 40 as a way to ask the wealthiest residents to help offset the federal reductions squeezing hospitals statewide.
What Proposition 40 Would Actually Do
Proposition 40 would levy a one-time 5% wealth tax on California residents with a net worth exceeding $1 billion as of January 1, 2026, directing 90% of the revenue toward public healthcare programs, according to the California Secretary of State's Official Voter Information Guide. Real estate and traditional retirement accounts are exempted from the tax base. Healthcare unions, including SEIU-UHW, support the measure, which could direct tens of billions of dollars to public healthcare programs.
Public opinion appears closely split. A Public Policy Institute of California survey from September showed 52% of likely voters favoring the measure and 46% opposing it, a narrow margin for a measure that needs only a simple majority to pass.
A $300 Million Opposition Campaign
Money has flooded against the measure. Opposition campaigns have raised more than $300 million — roughly ten times what supporters have collected — with figures including Governor Gavin Newsom joining billionaires to fight the measure, according to the Associated Press. Google co-founder Sergey Brin alone contributed nearly $100 million to opposition efforts, the wire service reported.
Beyond the money, opponents have built a procedural backstop. Rival Propositions 41 and 42 contain competing provisions designed to nullify Proposition 40 if all three measures pass, with legal precedence going to whichever receives the most votes, according to Ballotpedia. Proposition 40 includes reciprocal language seeking to void Props 41 and 42 in turn, setting up a tangle that could decide the measure's fate even if it wins outright.
St. Rose's predicament is not unique. Federal healthcare funding reductions under H.R. 1 have raised concerns about risks to safety-net hospitals. Locally, Alameda County has also provided support to Alameda Health System, illustrating how local funding helps sustain the system's safety-net operations.
The die-in at St. Rose follows other Bay Area mobilizing around Proposition 40, including a Sanders rally backing Prop 40. With Election Day approaching, workers at St. Rose used Thursday's demonstration to draw attention to their concerns about the hospital's future.
