Raising the stakes on a proposed property tax increase, the University of Texas has declared that its approval next month by Travis County voters is essential for establishing a medical school in Austin.

For us, this is a yes or no proposition, said Steven Leslie, UTs executive vice president and provost, in a memo to faculty and staff members that was obtained by the American-Statesman. Without a complete and reliable source of new funding, we will not be able to start a medical school.

Taxpayers in other Texas communities have helped finance medical schools and teaching hospitals through various means, but the proposal by Central Health, Travis Countys hospital district, differs in two important ways.

One, voters must first approve a 63 percent increase in their property taxes for health care, going from 7.89 cents to 12.9 cents per $100 of assessed value. No other medical school in Texas has hinged on raising local property taxes.

Two, a specific amount of the estimated $54 million a year in new tax revenue $35 million would be permanently earmarked for services provided to needy patients by the medical schools faculty and residents, who are physicians in training.

The tax is the final piece of a plan that has been under discussion for several years but that has not coalesced until recent months.

Building and operating the medical school for the first 12 years would cost $4.1 billion, according to UT-Austins cost estimates. The UT System Board of Regents has committed at least $25 million a year in endowment proceeds, plus $5 million a year for eight years to buy equipment. The nonprofit Seton Healthcare Family, which already spends $45 million to sponsor an academic education program, has tentatively committed $250 million to build a new teaching hospital to replace University Medical Center Brackenridge, which Central Health owns and Seton operates.

If Proposition 1 passes, the average Travis County homeowner would pay an extra $107.40 in 2014, for an average health care tax bill of $276.79. That prospect has aroused opposition from those who say UT should pay the full cost of its medical school.

Saying you have to pay a property tax for us to build a medical school is unprecedented in Texas history, said Don Zimmerman, campaign treasurer of the Travis County Taxpayers Union political action committee, which formed to fight the ballot proposition.

But proponents and others say it reflects changing financial and political realities.

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Health tax increase a ‘yes or no’ vote on medical school, UT says