Experts are concerned that a hospital finance measure on the ballot in California this year is too convoluted for voters to follow, according to Kaiser Health News.
Proposition 52 would make permanent the Golden State’s Hospital Quality Assurance Fee, an amount the state government claims from private hospitals to bolster funds for the state Medicaid program.
The fee has been in place since 2009 and hospital leaders claim it gives an underfunded program a much-needed shot in the arm, giving hospitals an additional $3.5 billion in fiscal 2015-2016, according to the article. Without the fee, hospitals participating in Medi-Cal, the state program, would be short about $8 billion of what they need to provide services to enrollees. The fee offsets about 40 percent of this deficit, KHN reports.
If it passes, Prop 52 would require a two-thirds majority in the state legislature to make any changes to the fee. The only changes lawmakers could make to it, however, are those that comply with federal law and modify fee disbursement. They could not change the proportion of funding hospitals get back.
However, the measure is written in a way that targets industry leaders, not voters, and voters who aren’t familiar with the issue may simply not vote on the initiative, Wesley Hussey, an associate professor of government at Sacramento State University, told the publication.
The measure has bipartisan support as well as boosters among labor unions and business groups. However, the Service Employees International Union-United Healthcare Workers West (SEIU-UHW) is one of its highest-profile detractors, arguing that legislators are better positioned to allocate funds, and a decision voted on directly by Californians would be harder to amend or undo in the future. Prop 52 “says to everybody… these tax dollars are not the property of the people of California, but they belong only to the private hospital industry,” David Kieffer, SEIU-UHW‘s director of governmental relations, told KHN.
This is far from the first time SEIU-UHW and hospital leaders have clashed; in 2014 they squared off over an initiative to cap hospital CEO compensation. A similar SEIU-UHW-backed measure was pulled earlier this year, FierceHealthFinance previously reported.
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