MANATEE — After hours of discussion, the Manatee County Commission Tuesday approved 4-3 an ordinance calling for a referendum on raising the sales tax by a half-cent to finance health care for the poor.

The vote was split, with Commission Chairman Larry Bustle and Commissioners John Chappie, Carol Whitmore and Michael Gallen voting in favor. Voting against were Commissioners Robin DiSabatino, Betsy Benac and Vanessa Baugh.

The sales tax rate would go up from 6.5 percent to 7 percent if voters approve, and would raise an estimated $23 million annually.

The referendum will be held June 18, officials said.

Speakers discussed the county health care plan financed by the half-cent sales tax increase calls for prevention and care organized through "patient-centered medical homes" as its key components.

The plan sets out how money generated by the tax increase would be used when current funds for indigent care are exhausted in 2015, officials have said.

There were speakers on both the pro- and con- sides of the argument.

Sara Cohen told the commission she thinks there are "so many questions" about the matter.

"It just seems to be at the wrong time," she said, urging the commission to put off a decision until more information was available for voters.

But Holmes Beach City Commissioner David Zaccagnino urged the board to approve an ordinance for a referendum on the issue.

“Let’s not kick this can down the road,” he said.

He noted that the accompanying property tax reduction would help to diversify the economy and encourage growth.

"We should take matters in our own hands and be more pro-active," he said.

The plan emphasizes primary and preventive services, early intervention, health education, case management and coordination of health and social services, according to the plan.

It would be administered by the county administrator's office or its designee, and monitored by an advisory committee, it states.

The sales tax hike is also part of a three-pronged effort to lower property tax rates by 13 to 26 percent by shifting costs to a broader base of payers, County Administrator Ed Hunzeker has said.

The plan's mission is to assure quality health care treatment and preventive services to medically needy residents "of all ages, who lack other health care coverage, and to develop and implement public health programs and policies that foster a healthy community," it said.

Sara Kennedy, Herald county reporter, will update this story through Tuesday afternoon here.