California poll of 2022 will be heavy on health care

When Californians go to the polls this year, they will be faced with controversial health care choices.

Voters will weigh whether to overturn a state law that bans flavored tobacco products and likely consider increasing the cap on medical malpractice benefits. They can also vote on proposals that effectively legalize psychedelic mushrooms and regulate dialysis clinics.

Two measures related to the pandemic could also qualify for the general election on November 8: one would tax the wealthiest residents of California to create an institute to detect epidemics and strengthen the state’s public health system. The other would limit the ability of government officials to shut down schools and businesses in the event of a public health emergency.

Although the elections are about 10 months away, money is already pouring in from deep-pocketed interests eager to defeat measures that would reduce their profits.

Big Tabac invested $ 21 million to overturn the ban on flavored products, and the healthcare industry gave up nearly $ 18 million to push back the proposal to increase California’s cap on medical malpractice awards, according to campaign fundraising records filed with the California Secretary of State. office from September 1, 2020 to December 8, 2021.

“The stakes could not be higher in monetary and human terms,” said Thad Kousser, who chairs the Department of Political Science at the University of California-San Diego. “Healthcare is a massive industry, as well as something that affects people in their most vulnerable times.”

Kousser, an expert on the California initiative process, noted that big spending doesn’t guarantee victory. He pointed to failed attempts by Mercury Insurance and its chairman in 2010 and 2012 to increase auto insurance premiums – voting measures voters rejected despite massive industry spending.

The flavored tobacco measure is the only one that officially qualified for the general election ballot, but supporters of the medical malpractice proposal have garnered enough signatures for it to qualify, according to the secretary’s office. State.

The healthcare industry is not waiting for the malpractice initiative to become official. The nearly $ 18 million the California Medical Association, California Hospital Association, and their allies donated to defeat her is almost a third of the amount they spent to successfully oppose a voting measure for 2014 medical malpractice, according to a KHN analysis of campaign fundraising records.

It is also more than the supporters of the initiative of 2014, who would have also increased the ceiling, raised for the whole of their campaign. This time around, the author of the medical malpractice voting measure said he plans to invest up to $ 40 million of his own money to counter opposition from the healthcare industry.

“I’m not backing down,” General Counsel Nick Rowley told KHN. “We have a grassroots effort. They have no idea what’s to come.

The measure would bring California’s $ 250,000 cap on medical malpractice benefits to about $ 1.2 million, adjusted annually for inflation. It would also change state law to allow a judge or jury to exceed the cap when a patient is left intoxicated, disfigured or permanently disabled, or a loved one has died – categories that critics say essentially include all patients and providers subject to a flood of prosecutions.

California lawmakers set the $ 250,000 cap in 1975 after doctors and hospitals complained that malpractice lawsuits were driving up costs and could push providers out of state.

More than four decades later, doctors and other providers are making a similar point.

“The biggest fear we have, if this is successful, is that we will have to stretch resources that are already thin,” said Leslie Abasta-Cummings, CEO of Livingston Community Health and Chairman of the Board of the Central Valley Health Network, which represents more than 100 health clinics. Patients, she warned, could “lose access to health care in some areas.”

Rowley, a Montana resident who practices law across the country, dismissed the argument, pointing to a growing number of states that no longer have a cap or have raised it. Doctors, he said, continue to practice in those states while victims of malpractice in California have limited legal options.

Healthcare providers are also preparing to defend a 2020 state law that bans the sale of flavored tobacco products popular with young people who smoke or vape.

When lawmakers approved the ban, they argued that the tobacco industry should not be allowed to market menthol e-cigarettes, candy and fruit to children. Tobacco companies argue that the law takes legal products off the market that adults should be allowed to use – and that it discriminates against black smokers who favor menthol cigarettes.

The California Coalition for Fairness – funded largely by tobacco giants RJ Reynolds Tobacco Co. and Philip Morris USA and its US subsidiary Smokeless Tobacco Co. – is trying to overturn the law through a referendum. The coalition quickly demonstrated political might, raising $ 21 million in the three months following the signing of the law by Governor Gavin Newsom in August 2020.

Healthcare groups have rallied together to defeat the measure of the ballot, but are far behind, with just $ 2.2 million in contributions – nearly 70% of which came from former New York City mayor Michael Bloomberg.

Several other health proposals could appear on the ballot:

Supporters of a measure to decriminalize the possession and cultivation of psychedelic mushrooms have until March 15 to collect the necessary signatures. Mushrooms containing psilocybin, known as “magic mushrooms”, are a Schedule I controlled substance under federal law.

A growing number of states and cities, including Oakland, Santa Cruz, and Arcata in California, have decriminalized mushrooms.

A union of healthcare workers is back with a third attempt to regulate dialysis clinics through the ballot process, calling for greater transparency in clinic ownership and stricter staffing requirements. If the past is any indication, the dialysis industry will again spend heavily to derail the initiative if the SEIU-United Healthcare Workers West union gets the signatures it needs by April 27. ads and spending $ 111 million in 2018 and $ 105 million in 2020.

Frustrated by school and business closures during the pandemic, supporters of a proposed initiative want to limit trade restrictions during public health and other emergencies to 30 days, unless they are extended every 30 days by state and local lawmakers. The proposal would require big box retailers to be treated like small businesses, noting that many small businesses were forced to close at the start of the pandemic while large retailers remained open. The proposal also describes schools as an essential service which should remain open “to the extent possible”. Supporters have until May 3 to collect signatures.

A proposal to strengthen California’s public health system, which its supporters say collapsed during the covid-19 pandemic, would raise the personal tax rate by an additional three-quarters of a percentage point on revenues greater than $ 5 million. The tax would last 10 years and generate up to $ 1.5 billion per year. Half of the proceeds would fund an institute to detect and prevent new outbreaks, 25% would pay for school safety upgrades, and 25% would help rebuild the local public health workforce and infrastructure. Contributors have until May 23 to collect signatures.

Angela Hart of California Healthline contributed to this story.

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