Contra Costa County · 2026 Healthcare Sales Tax · Precinct Strategy
1,169 precincts
720K
Registered Voters
255K
On Medi-Cal Today
58.5%
Measure X 2020 (same type)
50%+1
Victory Threshold
MetricWon (>50% MX)Lost (<50% MX)Gap
Medi-Cal enrollment15.9%10.5%+51% more need
SNAP households7.9%4.1%+93% more need
Below 200% poverty18.5%12.2%+52% more need
Seniors living alone22.3%16.1%+38% more need
Median household income$129K$175K−26%
Service & blue-collar workers37.7%19.5%+93% more
Healthcare workers9.8%8.9%+10% more
Key Insight

Precincts that voted YES on Measure X have 93% more SNAP households and 51% higher Medi-Cal enrollment than NO precincts.

Need and support move together — the healthcare measure argument is strongest exactly where the votes are.

The electorate has shifted — the new measure starts in a stronger position

71.3%
Prop 50 YES (Nov 2025)
58.5%
Measure X YES (2020)
+12.6pp
Avg P50 Outperformance vs MX
103
MX-NO Precincts That Flipped YES
The headline

Prop 50 outperformed Measure X by an average of 12.6 points at the precinct level. 103 precincts that voted NO on Measure X in 2020 flipped to YES on Prop 50 — that’s 156,000 registered voters in precincts that have moved toward reform since the last healthcare vote.

103
MX-NO Precincts Flipped YES on P50
156K registered voters in precincts that have moved toward reform since 2020.
+19.9pp
Biggest Swing: Hard No Tier
MX 41.3% → P50 61.2%. The hardest precincts moved the most — nearly 20 points.
155
Triple-Lock Precincts
MX YES + P50 YES + low turnout. That’s 207K voters who agree on every data point but didn’t show up.
18–23pp
Turnout Drop from 2024
San Ramon: 11.5K missing. Antioch: 12.2K missing. These voters need a reason to show up.
TierMeasure X 2020Prop 50 2025Shift
Base (West County)69.0%78.4%+9.4pp
Swing (Central)54.9%70.6%+15.7pp
Flip (Near-Miss)47.8%67.5%+19.7pp
Hard No41.3%61.2%+19.9pp
TierHealthcareServiceBlue CollarMgmt / Professional
Base9.8%18.4%19.3%42.7%
Swing9.1%14.5%14.0%52.7%
Flip9.3%11.3%10.0%60.1%
Hard No8.5%9.0%9.5%62.6%
Workforce insight

Base precincts have 2x the service and blue-collar workforce of Hard No areas. These are the workers who rely on county health services — and they live in the precincts where both MX and P50 already have majority support. The message writes itself.

The takeaway

The shift was greatest where MX was weakest. Flip precincts moved +19.7pp, Hard No moved +19.9pp. The electorate is more reform-friendly than it was in 2020 — and the precincts that blocked MX are exactly where the most ground has been gained.

Community2024 TurnoutP50 TurnoutDropMissing Voters
Color by: Highlight:
Measure X 2020 vote %
Medi-Cal enrollment %
🔒

Full Strategy & Targeting

Available with a VoterForce partnership.

Four-tier precinct targeting
Community messaging frameworks
Mail & digital geofencing exports
Live data updates through cycle
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Tier 1
West County Base
269K REG · >60% MX
Cities: Richmond, San Pablo, Pittsburg, Antioch, Hercules, El Cerrito
MX 2020: 69.0% YES
P50 2025: 78.4% YES (+9.4pp shift)
Message
“This IS our healthcare — don’t let them take it”
VBM · Multilingual mail · Health workers, faith leaders, union stewards
Tier 2
Central County
150K REG · 50–60% MX
Cities: Concord, Walnut Creek, Martinez, Pleasant Hill
MX 2020: 54.9% YES
P50 2025: 70.6% YES (+15.7pp shift)
Message
“Protect the care you’ve earned”
Senior town halls · Direct mail 65+
Tier 3
Near-Miss
95K REG · 45–50% MX
Cities: San Ramon, Brentwood, Orinda, Lafayette, Danville
MX 2020: 47.8% YES
P50 2025: 67.5% YES (+19.7pp shift)
Message
“County solutions — not federal chaos”
Targeted digital · Business community
Tier 4
Hard No
66K REG · <45% MX
Cities: Blackhawk, Alamo, Tassajara
MX 2020: 41.3% YES
P50 2025: 61.2% YES (+19.9pp shift)
Message
Earned media only
No paid resources allocated
West County
Direct Impact
“This IS our healthcare —
don’t let them take it”
Health workers, faith leaders, union stewards. Multilingual.
Central County Seniors
Personal Stakes
“Protect the care
you’ve earned”
Senior town halls. Direct mail to 65+.
San Ramon Valley & Lamorinda
Local Control
“County solutions —
not federal chaos”
Targeted digital. Business community.
What This Analysis Provides
1,169 precincts mapped by Measure X 2020, Prop 50 2025, Medi-Cal, SNAP, poverty & 2024 turnout
103 MX-NO precincts flipped YES on P50 (156K voters) · 207K in triple-lock mobilization universe
Community data table ready for field targeting, mail universes & digital geofencing