By Doug Porter
Back in the bad old days of the great recession, the California legislature diverted hundreds of millions in funding derived from a tax hospitals pay. The federal government kicks in matching funds for these taxes flowing back to the hospitals through MediCal, so it’s a sweet deal. Hospitals pay one dollar to get two back, more or less.
The recession is over, and the hospitals want their original deal back in place.
So they raised a boatload of money to put Proposition 52 before the voters. This is a “lockbox” measure, designed to give voters the opportunity to say that funds raised for or by a certain purpose must be spent in that general area as well.
This, proponents say, ensures California hospitals can continue to recover some of the money spent providing services to low-income patients. Unless the legislature renews this deal in 2017, a stable revenue stream and an estimated $4 billion in federal matching funds are at risk.
The main argument opponents have been able to summon up against Prop 52 stems from the complexity of the underlying legislation. Make no mistake about it, this deal amounts to an accounting scheme. But the net result is more funding in a critical area of healthcare.
Here’s the San Francisco Chronicle:
Supporters of Proposition 52, a California ballot measure that would lock in an existing hospital fee that helps fund the state’s Medicaid program for the poor, know their biggest opposition is the measure itself.
While the proposition lacks organized opponents, it’s just the sort of wonky, complicated and arcane type of measure that frustrates voters and makes them likely to skip that box on their elections form or to simply vote “no.”
“A lot of initiatives are not that simple, and this is included in that. That’s especially challenging given how large the ballot is,” said Kevin Riggs, spokesman for the Yes on 52 campaign, of the 17 statewide voter initiatives on the November ballot.
Via Ballotpedia: “Figure 1, which is from the state’s official voters guide, demonstrates the Medicaid matching process from fiscal year 2015-2016. If Proposition 52 was active in 2015-2016, the legislature would not have been able to divert the $900 million without voter approval.”
The ballot statements against Prop 52 complain of a lack of oversight and suggest this funding will be abused by hospital executives.
However, the original opponents of this measure, namely the Service Employees International Union – United Healthcare Workers West, have changed their stance to “neutral.”
SEIU-UHW Spokesperson Steve Trossman told the Chronicle: “After evaluating the many critical local, state and national races that are happening where we have a strong interest this November, we’ve decided to focus our political resources in other areas.”
This leaves the Libertarian Party of California as the sole opposition to Prop 52.
Here’s a snip from The Mercury News editorial endorsing the measure:
Yes on 52 Ad, from Youtube
Voters often reject measures they don’t fully understand. Resist that temptation with Prop. 52, which is critical to the state’s ability to collect federal dollars to help pay for health care for the poor. Vote yes…
…Medi-Cal covers one-third of California’s 39 million residents, including low-income families, seniors, children and the disabled. To fulfill this obligation, the state needs to draw down every federal matching dollar available and have a stable source of funding for Medi-Cal. Prop. 52 helps accomplish both of those goals.
The California Republican Party and the California Chamber of Commerce support Prop. 52. So do the Democratic Party and a wide range of labor organizations. Virtually every medical organization in the state, including the California Hospitals Association and the California Medical Association, are also on board. This is not controversial.
For More Information
Proposition 52
Ballot Language – MEDI-CAL HOSPITAL FEE PROGRAM. INITIATIVE CONSTITUTIONAL AMENDMENT AND STATUTE. Extends indefinitely an existing statute that imposes fees on hospitals to fund Medi-Cal health care services, care for uninsured patients, and children’s health coverage. Fiscal Impact: Uncertain fiscal effect, ranging from relatively little impact to annual state General Fund savings of around $1 billion and increased funding for public hospitals in the low hundreds of millions of dollars annually.
A YES vote would: Extend permanently an existing charge imposed on most private hospitals, scheduled to end on January 1, 2018. It would be harder for the Legislature to make changes to it. (Two-thirds voter approval needed)
A NO vote would: A NO vote on this measure means: An existing charge imposed on most private hospitals would end on January 1, 2018, unless additional action by the Legislature extended it.
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