California voters defeated Proposition 8, a controversial ballot proposal to cap revenue at the state's dialysis centers, at the polls on Tuesday.
The contentious issue has been a record setter, with the San Francisco Chronicle reporting the opposition led by dialysis giants DaVita and Fresenius raised more than $111 million to fight the measure.
Under the proposition, the state's 588 dialysis clinics would have had to limit revenue to 15% more than their costs of doing business including the cost of paying for staff and facilities and refund any excess funds to insurance companies to help them pay for dialysis treatments.
The ballot measure would also have prohibited clinics from refusing to treat patients based on payment source.
The proposal was drafted by healthcare union SEIU-United Healthcare Workers West, which has raised $20 million to support its passage by voters after Gov. Jerry Brown vetoed an attempt to get revenue limits passed through legislation in September. It was supported by insurers and employers but opposed by dialysis providers and the National Kidney Foundation.
Proponents said it would have require dialysis centers to reinvest in patient care and increase access. But opponents say it would have harm patient access to dialysis and have accused the union of backing the measure to punish companies that resisted their efforts to unionize dialysis center workers.
According to an official voter guide, the estimated fiscal impact on state and local governments would have ranged from net positive impact in the low tens of millions of dollars to a net negative impact in the tens of millions of dollars. But groups like DaVita could have lost up to $400 million if the measure had passed, CNBC reported.