Facing a mind-numbing field of ballot propositions and the din of campaign bellicose, Proposition 52 struggles to get voters’ attention. Proposition 52 is arcane, complex and has a high “who cares?” factor.
But we can make this simple. Voters should care. They should vote yes because it will improve and stabilize government funding for California hospitals that provide Medi-Cal services for the state’s poorest residents.
If you are not poor and if you do not receive Medi-Cal services, you still might be asking: Why should I care?
Simple. When government funding, or reimbursement for services, falls short of covering the cost of providing healthcare services for the poor, guess who pays? Yep, paying customers are charged more for hospital services and health insurance; and more of their tax dollars will be used to cover Medi-Cal costs.
Medi-Cal is the government’s insurance program for the poor. The state pays some of the costs and the federal government matches the payment.
In 2009, state legislators created a program requiring hospitals to pay fees to help offset some of the state’s costs. This money is matched by the federal government. Since its creation, the Legislature has extended the program beyond its expiration date four times.
But here’s where the existing program gets tricky. Money from the hospitals’ fees does not have to go to paying for healthcare services for the poor. Portions of the money can – and has – been diverted into the state’s general fund to pay for spending by other state departments.
While that’s kind of slimy, it also means that the federal government won’t match the diverted funds. Simply put, diverting hospital fee money to non-healthcare uses has left millions of federal reimbursement dollars sitting in Washington, rather than going to California to pay for medical care.
Proposition 52, which is supported by California public and private hospitals, as well as a wide range of other groups, will do three things: make the hospital fee permanent; require a two-thirds vote of the Legislature for the money to be spent on anything other than healthcare; and increase federal matching funds.
Service Employees International Union, United Health Care Workers West, is the major opponent. The union contends the initiative will give a blank check to already overpaid, fat-cat hospital administrators.
The union’s ongoing dispute over administrators’ pay and other grievances should be separated from voters’ consideration of Proposition 52. The measure is a sound strategy for stabilizing revenue for public and private hospitals, and it ensures that the money will be spent on healthcare, rather than being ripped off by other state agencies.