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California Proposition 52, Continued Hospital Fee Revenue Dedicated to Medi-Cal Unless Voters Approve Changes (2016)
| California Proposition 52 | |
|---|---|
 | |
| Election date November 8, 2016 | |
| Topic Healthcare | |
Status Approved | |
| Type Amendment & Statute | Origin Citizens |
California Proposition 52, the Continued Hospital Fee Revenue Dedicated to Medi-Cal Unless Voters Approve Changes Initiative, was on the November 8, 2016, ballot in California as a combined initiated constitutional amendment and state statute. It was approved.
| A "yes" vote supported requiring voter approval to change the dedicated use of certain fees from hospitals used to draw matching federal money and fund Medi-Cal services. A "yes" vote also supported continuing the hospital fee program beyond January 1, 2018, and requiring a two-thirds majority vote of the California Legislature to end the program. |
| A "no" vote opposed this initiative, allowing the fee to end on January 1, 2018, and permitting the legislature to change, extend, or eliminate the hospital fee program with a majority vote. |
Proposition 52 permitted the legislature to amend the hospital fee program via a two-thirds vote, but only when the proposed changes "amend or add provisions that further the purposes of the Act."[1]
Election results
| Proposition 52 | ||||
|---|---|---|---|---|
| Result | Votes | Percentage | ||
| Yes | 9,427,714 | 70.07% | ||
| No | 4,026,710 | 29.93% | ||
- Election results from California Secretary of State
Overview
California's Medi-Cal hospital fee
The federal government's Medicaid program helps pay for healthcare services provided to low-income patients. In California, this program is called Medi-Cal. For a state to receive federal Medicaid funds, the state has to contribute a matching amount of its own money. In 2009, a new program was created such that California hospitals agreed to voluntarily pay a fee, known as the Hospital Quality Assurance Fee, to help California obtain the available federal MediCal funds. This program resulted in California hospitals receiving roughly $2 billion a year in additional federal money to Medi-Cal.[1] However, California had diverted some of the funds from the hospital fee program to the state's general fund.[2]
Initiative design
Proposition 52 added language to the California Constitution to require voter approval of changes to the hospital fee program to make it harder for the legislature to divert these funds from the original intended purpose of supporting hospital care to Medi-Cal patients and to help pay for healthcare for low-income children. The measure also repealed the statute ending the program on January 1, 2018, meaning that the hospital fee was to continue indefinitely unless repealed by a two-thirds vote in each chamber of the California Legislature.[1]
State of the ballot measure campaigns
Yes on Proposition 52 outraised opponents five-to-one. Supporters raised $60.28 million in contributions, while No on 52 raised $11.6 million. Over $11 million of supporters’ funds was donated by the California Health Foundation and Trust. The SEIU-UHW was funding the opposition. However, the union went from "opposed" to "neutral" on the proposition in early September 2016. Both the California Democratic Party and California Republican Party supported Proposition 52.
Text of measure
Ballot title
The initiative's ballot title was:
| “ |
State Fees on Hospitals. Federal Medi-Cal Matching Funds. Initiative Statutory and Constitutional Amendment.[3] |
” |
Ballot summary
The long-form ballot summary was as follows:[4]
| “ |
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The shorter ballot label summary was as follows:[4]
| “ |
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.[3] |
” |
The long-form, official ballot summary for Proposition 52 was changed from the initial summary provided to initiative proponents for the purpose of circulating the initiative for signature collection. The original summary provided for inclusion on signature petition sheets was:[5]
| “ |
Increases required vote to two-thirds for the Legislature to amend a certain existing law that imposes fees on hospitals (for purpose of obtaining federal Medi-Cal matching funds) and that directs those fees and federal matching funds to hospital-provided Medi-Cal health care services, to uncompensated care provided by hospitals to uninsured patients, and to children's health coverage. Eliminates law's ending date. Declares that law's fee proceeds shall not be considered revenues for purposes of applying state spending limit or determining required education funding.[3] |
” |
Fiscal impact
The fiscal impact statement for this initiative was:[5]
| “ |
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Note: The fiscal impact statement for a California ballot initiative authorized for circulation is jointly prepared by the state's legislative analyst and its director of finance.
Constitutional changes
The measure added a Section 3.5 to Article XVI of the California Constitution.
Note: Hover over the text and scroll to see the full text.
(a) No statute amending or adding to the provisions of the Medi-Cal Hospital Reimbursement Improvement Act of 2013 shall become effective unless approved by the electors in the same manner as statutes amending initiative statutes pursuant to section 10(c) of Article II, except that the Legislature may, by statute passed in each house by roll call vote entered into the journal, two-thirds of the membership concurring, amend or add provisions that further the purposes of the Act.
(b) For purposes of this section:
- (1) "Act" means the Medi-Cal Hospital Reimbursement Improvement Act of 2013 (enacted by ·Senate Bill 239 of the 2013-14 Regular Session of the Legislature, and any non-substantive amendments to the Act enacted by a later bill in the same Session of the Legislature).
- (2) "Non-substantive amendments" shall only mean minor, technical, grammatical, or clarifying amendments.
- (3) "Provisions that further the purposes of the Act" shall only mean:
- (i) amendments or additions necessary to obtain or maintain federal approval of the implementation of the Act, including the fee imposed and related quality assurance payments to hospitals made pursuant to the Act;
- (ii) amendments or additions to the methodology used for the development of the fee and quality assurance payments to hospitals made pursuant to the Act.
(c) Nothing in this section shall prohibit the Legislature from repealing the Act in its entirety by statute passed in each house by roll call vote entered into the journal, two-thirds of the membership concurring, except that the Legislature shall not be permitted to repeal the Act and replace it with a similar statute imposing a tax, fee, or assessment unless that similar statute is either: (i) a provision that furthers the purposes of the Act as defined herein; or (ii) is approved by the electors in the same manner as statutes amending initiative statutes pursuant to section 10(c) of Article II.
(d) The proceeds of the fee imposed by the Act and all interest earned on such proceeds shall not be considered revenues, General Fund revenues, General Fund proceeds of taxes, or allocated local proceeds of taxes, for purposes of Sections 8 and 8.5 of this Article or for the purposes of article XIIIB. The appropriation of the proceeds in the Trust Fund referred to in the Act for hospital services to Medi-Cal beneficiaries or other beneficiaries in any other similar federal program shall not be subject to the prohibitions or restrictions in Sections 3 or 5 of this Article.[3]
Full text
The full text of the initiative measure is available here.
Background
In fiscal year 2015-2016, private California hospitals paid $4.6 billion to the state in hospital fees. Of this amount, a total of $900 million was diverted to the General Fund and $3.7 billion went toward obtaining federal Medicaid funds. The federal government provided $4.4 billion as a matching amount. With the $3.7 billion from the private hospitals and $4.4 billion from the federal government, public and private California hospitals received a combined total of $8.1 billion. This was a $3.5 billion net benefit to hospitals.[4]
Figure 1, which was from the state's official voters guide, demonstrates the Medicaid matching process from fiscal year 2015-2016. If Proposition 52 were active in 2015-2016, the legislature would not have been able to divert the $900 million without voter approval.
Support
Yes on Proposition 52 - Keep a Good Idea Working led the campaign in support of Proposition 52.[6] The initiative was developed by the California Hospital Association.[7]
Supporters
Officials
- U.S. Rep. Anna Eshoo (D-18)[8]
- U.S. Rep. John Garamendi (D-3)
- U.S. Rep. Alan Lowenthal (D-47)
- U.S. Rep. Grace Napolitano (D-32)
- U.S. Rep. Brad Sherman (D-30)
- Sen. Kevin de Leon (D-24)
- Sen. Jean Fuller (R-16)
- Sen. Joel Anderson (R-38)
- Sen. Patricia Bates (R-36)
- Sen. Tom Berryhill (R-8)
- Sen. Anthony Cannella (R-12)
- Sen. Ted Gaines (R-1)
- Sen. Cathleen Galgiani (D-5)
- Sen. Isadore Hall (D-35)
- Sen. Ben Hueso (D-40)
- Sen. Bob Huff (R-29)
- Sen. John Moorlach (R-37)
- Sen. Mike Morrell (R-23)
- Sen. Jim Nielsen (R-4)
- Sen. Richard Pan (D-6)
- Sen. Richard D. Roth (D-31)
- Sen. Sharon Runner (R-21)
- Sen. Jeff Stone
- Sen. Andy Vidak (R-14)
- Sen. Bob Wieckowski (D-10)
- Asm. Chad Mayers (R-42)
- Asm. Katcho Achadjian (R-35)
- Asm. Luis Alejo (D-30)
- Asm. Travis Allen (R-72)
- Asm. Joaquin Arambula (D-31)
- Asm. Toni Atkins (D-78)
- Asm. Catharine Baker (R-16)
- Asm. Frank Bigelow (R-5)
- Asm. Richard Bloom (D-50)
- Asm. Susan Bonilla (D-14)
- Asm. Rob Bonta (D-18)
- Asm. Autumn Burke (D-62)
- Asm. Cheryl Brown (D-47)
- Asm. Ian Calderon (D-57)
- Asm. Ling-Ling Chang (R-55)
- Asm. Rocky Chavez (R-76)
- Asm. Ken Cooley (D-8)
- Asm. Jim Cooper (D-9)
- Asm. Matt Dababneh (D-45)
- Asm. Brian Dahle (R-1)
- Asm. Tom Daly (D-69)
- Asm. Bill Dodd (D-4)
- Asm. Susan Talamantes Eggman (D-13)
- Asm. Jim Frazier (D-11)
- Asm. Beth Gaines (R-6)
- Asm. James Gallagher (California) (R-3)
- Asm. Eduardo Garcia (D-56)
- Asm. Mike Gatto (D-43)
- Asm. Mike Gipson (D-64)
- Asm. Adam Gray (D-21)
- Asm. Shannon Grove (R-34)
- Asm. David Hadley (R-66)
- Asm. Chris Holden (D-41)
- Asm. Jacqui Irwin (D-44)
- Asm. Brian Jones (R-71)
- Asm. Reginald Jones-Sawyer (D-59)
- Asm. Young Kim (R-65)
- Asm. Tom Lackey (R-36)
- Asm. Marc Levine (D-10)
- Asm. Eric Linder (R-60)
- Asm. Patty Lopez (D-39)
- Asm. Evan Low (D-28)
- Asm. Brian Maienschein (R-77)
- Asm. Devon Mathis (R-26)
- Asm. Kevin McCarty (D-7)
- Asm. Jose Medina (D-61)
- Asm. Melissa Melendez (R-67)
- Asm. Patrick O'Donnell (D-70)
- Asm. Kristin Olsen (R-12)
- Asm. Jim Patterson (R-23)
- Asm. Bill Quirk (D-20)
- Asm. Freddie Rodriguez (D-52)
- Asm. Miguel Santiago (D-53)
- Asm. Marc Steinorth (R-40)
- Asm. Don Wagner (R-68)
- Asm. Marie Waldron (R-75)
- Asm. Scott Wilk (R-38)
- Asm. Jim Wood (D-2)
- Mayor Kevin L. Faulconer (R), San Diego
- Mayor Kevin Johnson (D), Sacramento
- Mayor Libby Schaaf (D), Oakland
- Solano County Supervisors[9]
Parties
- California Democratic Party [10]
- California Republican Party[11]
- Green Party of California[12]
- California Peace and Freedom Party[13]
- California Young Democrats
- Harvey Milk LGBT Democratic Club[14]
- Action Democrats of the San Fernando Valley
- Alameda County Democratic Party
- Burbank Democratic Club
- Democratic Alliance for Action
- Democratic Headquarters of the Desert
- Democratic Party of Contra Costa County
- Democratic Party of Orange County
- Democratic Party of the San Fernando Valley
- Democrats for Israel (Los Angeles)
- Fresno County Democratic Party
- Helen L. Doherty Democratic Club
- Laguna Woods Democratic Club
- Los Angeles County Democratic Party
- New Frontier Democratic Club
- NorthEast Democrats Club
- Progressive Democrats of the Santa Monica Mountains
- Riverside County Democratic Party
- Sacramento County Democratic Party
- San Bernardino County Democratic Party
- San Diego County Democratic Party
- San Mateo County Democratic Party
- Santa Clara County Democratic Party
- Santa Monica Democratic Club[15]
- Stonewall Democratic Club
- Torrance Democratic Club
- West End Democratic Club
- Yuba County Democratic Party
Organizations
Civic organizations
Hospitals and health systems
Healthcare and medical associations
Business associations
Unions
|
Arguments
Supporters made the following arguments in support of Proposition 52:[4]
- The proposition would "keep a good idea" working by extending the Medi-Cal hospital fee program.
- The proposition would keep legislators from diverting federal matching funds from their original purposes superfluously by requiring that voter approval be obtained first.
- The proposition would generate $3 billion dollars in federal matching funds without costing the taxpayers any money.
Official arguments
C. Duane Dauner, president of the California Hospital Association, Theresa Ullrich, president of the California Association of Nurse Practitioners, and Deborah Howard, executive director of California Senior Advocates League, wrote the official argument in support of Proposition 52 found in the state voters guide. Their argument was as follows:[4]
YOUR YES VOTE ON PROPOSITION 52 WILL KEEP A GOOD IDEA WORKING --ONE THAT'S DOING A LOT OF GOOD FOR A LOT OF GOOD PEOPLE WHO NEED THE HELP. WHAT DOES PROPOSITION 52 DO? It does two things. First, it extends the current Medi-Cal hospital fee program that generates more than $3 billion a year in federal matching funds that would not be available otherwise. This money helps provide Medi-Cal health care services to over 13 million Californians, including:
Second, Proposition 52 strictly prohibits the Legislature from using these funds for any other purpose without a vote of the people. That's it. WHO IS BEHIND THIS INITIATIVE AND WHY IS IT ON THE BALLOT?
WHO IS SUPPORTING PROPOSITION 52? This Initiative has generated the unprecedented support of virtually all major health care, business, labor, and community organizations throughout the state. It is unlikely that a consensus coalition like this has ever been achieved before. For example, the California Teachers Association, California Building Trades Council, California Professional Firefighters and the Teamsters Union and over 30 local unions have joined with the California Chamber of Commerce, The Business Roundtable, as well as advocacy organizations for children, seniors and the disabled. Additionally, it has been endorsed by both the state Democratic and Republican parties. In today's very contentious political environment, this alone is an amazing development. HOW DOES PROPOSITION 52 IMPACT CALIFORNIA TAXPAYERS? This measure GENERATES OVER $3 BILLION IN AVAILABLE FEDERAL FUNDS WITH NO STATE COST TO CALIFORNIA TAXPAYERS. By extending the current state Medi-Cal hospital fee the state will continue to receive more than $3 billion a year in available federal matching funds for Medi-Cal. Without it, the shortfall will cause some community safety net hospitals to close. Please VOTE YES ON PROPOSITION 52 TO KEEP A GOOD IDEA WORKING--THAT'S DOING A LOT OF GOOD FOR A LOT OF GOOD PEOPLE. |
Campaign advertisements
The following video advertisements were produced by Yes on 52:[17]
- Note: Yes on 52 removed campaign advertisements from Youtube following the election.
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Opposition
No on 52 led the campaign in opposition to Proposition 52.[18] The Service Employees International Union-United Healthcare Workers was funding the opposition. However, the union went from "opposed" to "neutral" on the proposition in early September 2016. Spokesperson Steve Trossman said, "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."[19] Union leaders had argued that the measure would divert funds from patients and favor corporations and hospital executives.
Opponents
Officials
Organizations
- Californians for Hospital Accountability and Quality Care
- Libertarian Party of California[21]
Individuals
- Kevin Drum, political blogger for Mother Jones[22]
Arguments
Opponents made the following arguments in opposition to Proposition 52:[4]
- The proposition would divert resources from patients and communities to special interests.
- The proposition would not require any sort of accountability for hospital CEOs and lobbyists regarding how money is spent.
- The proposition would not guarantee that funds are spent on healthcare.
- The proposition would only favor corporations and hospital CEOs.
Official arguments
Virginia Anders-Ellmore, a nurse practioner, Michelle Ross, a healthcare worker, and Jovita Salcedo, a Medi-Cal beneficiary, wrote the official argument against Proposition 52 found in the voters guide. Their argument was as follows:[4]
"Our health care dollars should be treating patients, not funding lavish perks for millionaire CEOs. Prop. 52 takes resources from patients and communities and siphons it into the pockets of rich special interests, with no oversight, no accountability, and no guarantee it is even spent on health care. That's wrong and makes nurses' and doctors' jobs harder." --- Virginia Anders-Ellmore, Nurse Practitioner
The wealthy hospital CEOs and their lobbyists are spending millions - including our tax dollars - to trick you into believing Prop. 52 helps Medi-Cal patients. It doesn't. It hurts the people who need it most and only helps hospital lobbyists and their overpaid CEOs. This is what it really does:
Here is what advocates for low-income patients say: "This initiative takes money from needy Californians and gives it to rich millionaires instead, with no oversight and no requirement it be spent on health care for poor people, or even health care at all. Our healthcare system is already broken - and this no-strings attached money grab by rich CEOs will only make it worse." --- Michelle Ross, Healthcare Worker "I'm already struggling to make ends meet and can't afford to take my children to the doctor, Now they want to take what little I have and give it to the special interests and corporations who run for-profit hospitals, no questions asked." --- Jovita Salcedo, Medi-Cal Patient The corporate-funded California Hospital Association wrote Prop 52 in order to permanently guarantee more than $3,000,000,000 of our federal and state health care dollars go to them no matter what, with no oversight and no guarantee it be spent on health care. It rigs the system in favor of corporations and millionaires and hurts low-income women, children, and seniors. It eliminates oversight of how this $3,000,000,000 in our tax money is spent and asks us to trust the CEOs and lobbyists instead. We need more oversight of CEOs, not less. VOTE NO ON PROP 52 |
Campaign finance
Note: Ballotpedia's campaign finance information for Proposition 52 differs significantly from the data shown by the California Secretary of State's Power Search Campaign Finance Function. This is because the Power Search function did not count the contributions provided to the support campaign in the 2013-2014 election cycle in order to eliminate any contributions that could have been for purposes other than supporting Proposition 52. Ballotpedia, however, maintains that these contributions should be counted since Proposition 52 was originally planned for the 2014 ballot, and the committee in question has been focused on the initiative since it was created. This assertion was confirmed by other sources, including the state's Cal-Access campaign finance database and PolitiFact.[23]
One committee was registered in support of the measure: Yes on Proposition 52 — A Coalition of California Association of Hospitals and Health Systems and Non-Profit Health Care Organizations. The committee reported $60.2 million in contributions. One committee was registered in opposition to the measure: Californians for Hospital Accountability and Quality Care - No on 52. It reported $11.5 million in contributions.[24]
| Cash Contributions | In-Kind Contributions | Total Contributions | Cash Expenditures | Total Expenditures | |
|---|---|---|---|---|---|
| Support | $59,939,023.70 | $343,883.24 | $60,282,906.94 | $66,176,971.41 | $66,520,854.65 |
| Oppose | $11,374,980.00 | $188,151.05 | $11,563,131.05 | $3,526,635.28 | $3,714,786.33 |
| Total | $71,314,003.70 | $532,034.29 | $71,846,037.99 | $69,703,606.69 | $70,235,640.98 |
Support
The following table includes contribution and expenditure totals for the committee in support of the ballot measure.[24]
| Committees in support of Proposition 52 | |||||
|---|---|---|---|---|---|
| Committee | Cash Contributions | In-Kind Contributions | Total Contributions | Cash Expenditures | Total Expenditures |
| Yes on Proposition 52 — A Coalition of California Association of Hospitals and Health Systems and Non-Profit Health Care Organizations | $59,939,023.70 | $343,883.24 | $60,282,906.94 | $66,176,971.41 | $66,520,854.65 |
| Total | $59,939,023.70 | $343,883.24 | $60,282,906.94 | $66,176,971.41 | $66,520,854.65 |
Donors
The following table shows the top donors to the committee registered in support of the ballot measure.[24]
| Donor | Cash Contributions | In-Kind Contributions | Total Contributions |
|---|---|---|---|
| California Health Foundation and Trust | $11,501,975.00 | $0.00 | $11,501,975.00 |
| Dignity Health | $8,478,390.00 | $0.00 | $8,478,390.00 |
| Sutter Health | $4,160,670.00 | $0.00 | $4,160,670.00 |
| Childrens Hospital Los Angeles | $3,418,305.00 | $0.00 | $3,418,305.00 |
| Adventist Health | $3,020,143.00 | $0.00 | $3,020,143.00 |
Opposition
The following table includes contribution and expenditure totals for the committee in opposition to the ballot measure.[24]
| Committees in opposition to Proposition 52 | |||||
|---|---|---|---|---|---|
| Committee | Cash Contributions | In-Kind Contributions | Total Contributions | Cash Expenditures | Total Expenditures |
| Californians for Hospital Accountability and Quality Care - No on 52 | $11,374,980.00 | $188,151.05 | $11,563,131.05 | $3,526,635.28 | $3,714,786.33 |
| Total | $11,374,980.00 | $188,151.05 | $11,563,131.05 | $3,526,635.28 | $3,714,786.33 |
Donors
The following table shows the top donors to the committee registered in opposition to the ballot measure.[24]
| Donor | Cash Contributions | In-Kind Contributions | Total Contributions |
|---|---|---|---|
| SEIU United Healthcare Workers West Political Issues Committee | $8,374,980.00 | $0.00 | $8,374,980.00 |
Methodology
To read Ballotpedia's methodology for covering ballot measure campaign finance information, click here.
Media editorials
Support
- The Bakersfield Californian: "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."[25]
- East Bay Express: "Medi-Cal is a critical program for low-income Californians. And, after its recent expansion under the Affordable Care Act, we don’t want state lawmakers diverting funding to other programs. This is a no-brainer."[26]
- East Bay Times: "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 attract every federal matching dollar available and have a stable source of funding for Medi-Cal. Prop. 52 helps accomplish both goals."[27]
- Los Angeles Times: "Generally speaking, it's better for voters not to tie lawmakers' hands on the budget. But the tradeoff presented by Proposition 52 is, on balance, a fair one. It would preserve an important revenue source for a vital safety program that's already woefully underfunded. It deserves a yes vote."[28]
- The Mercury News: "Mandating that fees go to a specific purpose limits the Legislature’s discretion during budget crises. But the linkage here is direct and appropriate. The state is providing more and more Californians with Medi-Cal coverage. It can’t keep doing that without paying hospitals and doctors adequately, and failing to claim federal dollars available for that compensation was, and would be, irresponsible. Vote yes on Proposition 52."[29]
- The Record: “Vote yes. This will help hospitals recover some of the money they now spend for services to low-income patients. We feel concerns the money will be 'diverted' to hospital bureaucracy are overstated.”[30]
- The Sacramento Bee: “Proposition 52 is a rare initiative for which there should be little debate or dissent. The measure would extend an existing fee on hospitals to provide health care to poor people, guarantee that the federal government will match the state’s share, and inhibit the Legislature from diverting the money to other programs.”[31]
- San Diego City Beat: “ Making this fee permanent allows the system to continue and expand its care for the 13 million low-income Californians who rely on Medi-Cal for primary care and emergency room visits.”[32]
- San Diego Free Press and OB Rag endorsed Proposition 52.[33]
- San Diego Union-Tribune: "The measure would shore up a Medi-Cal system that now takes care of one-third of state residents and encourage more providers to accept Medi-Cal patients for outpatient and specialized treatments. It could be scrapped by a two-thirds vote of the Assembly and Senate — an important safety valve in case of fiscal emergency."[34]
- San Francisco Chronicle: "While it seems unlikely that lawmakers would allow this critical program to expire, voters should seize the opportunity to not only guarantee that it will continue, but to require a two-thirds vote of the Legislature to divert any money from it. We recommend passage of Prop. 52."[35]
- San Francisco Examiner: "This has meant about $2 billion a year in additional federal money to Medi-Cal that have gone to hospitals. The measure would not only continue the program but make it reversible only by voters or by a two-thirds vote of lawmakers. It is a worthy and appropriate measure."[36]
- San Mateo Daily Journal recommended a "Yes" vote on Proposition 52.[37]
- Santa Cruz Sentinel: "It preserves an important revenue source for an underfunded, but vital safety-net program used by millions of Californians with Medi-Cal coverage and ensures the health-care providers who treat them are paid adequately. It would be irresponsible not to claim the federal matching funds."[38]
- Ventura County Star: "This is, like so much related to our system of health-care financing, an overly complicated issue. But it was, and is, a good idea that hospitals in California devised to help us get the maximum financial assistance from the federal government for our Medi-Cal program. The hospitals certainly benefit, but so do all Californians, who either receive this care or are not faced with the alternative of higher taxes to pay for it."[39]
Opposition
If you know of any editorial board endorsements that should be posted here, please email the Ballot Measures project director.
Polls
- See also: 2016 ballot measure polls
- In mid October 2016, CALSPEAKS surveyed 622 likely voters on Proposition 52. Support among respondents was 50 percent.[40]
- The Field Poll/IGS Poll surveyed 1,498 likely voters between October 25 and October 31, 2016, and found support for the measure at 66 percent.[41]
Polls with margins of error
| California Proposition 52 (2016) | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Poll | Support | Oppose | Undecided | Margin of error | Sample size | ||||||||||||||
| CALSPEAKS 10/7/2016 - 10/13/2016 | 50.0% | 18.0% | 32.0% | +/-7.0 | 622 | ||||||||||||||
| Note: The polls above may not reflect all polls that have been conducted in this race. Those displayed are a random sampling chosen by Ballotpedia staff. If you would like to nominate another poll for inclusion in the table, send an email to editor@ballotpedia.org. | |||||||||||||||||||
Polls without margins of error
- Note: The Field Poll/IGS Poll does not report a margin of error because "[polls] conducted online using an opt-in panel do not easily lend themselves to the calculation of sampling error estimates as are traditionally reported for random sample telephone surveys."[41]
| California Proposition 66 (2016) | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Poll | Support | Oppose | Undecided | Sample size | |||||||||||||||
| The Field Poll/IGS Poll 10/25/2016 - 10/31/2016 | 66.0% | 29.0% | 5.0% | 1,498 | |||||||||||||||
| Note: The polls above may not reflect all polls that have been conducted in this race. Those displayed are a random sampling chosen by Ballotpedia staff. If you would like to nominate another poll for inclusion in the table, send an email to editor@ballotpedia.org. | |||||||||||||||||||
Path to the ballot
The California Medi-Cal Hospital Reimbursement Initiative was introduced as the "the Medi-Cal Funding and Accountability Act of 2014" in July 2013 by the California Hospital Association. The measure was approved for circulation on December 3, 2013, as a combined initiated constitutional amendment and state statute, but it did not qualify in time for the 2014 ballot. Instead, it was placed on the 2016 ballot.[42][7]
- Thomas W. Hiltachk submitted a letter requesting a title and summary on October 9, 2013.
- A title and summary were issued by California's attorney general's office on December 2, 2013.
- 807,615 valid signatures were required for qualification purposes.
- The 150-day circulation deadline for #13-0016 was May 1, 2014.
- The Secretary of State’s suggested signature filing deadline for the November 4, 2014, ballot was April 18, 2014.
- 1,223,888 signatures were filed with election officials on April 21, 2014.[2] This was three days after the suggested deadline.
- On August 1, 2014, the initiative qualified for the 2016 ballot. 807,984 or 66.42 percent of the signatures were deemed valid. That's only 369 more signatures than were required to get the issue on the ballot.[43]
Cost of signature collection:
Sponsors of the measure hired Arno Political Consultants and The Monaco Group to collect signatures for the petition to qualify this measure for the ballot. A total of $2,192,811.85 was spent to collect the 807,615 valid signatures required to put this measure before voters, resulting in a total cost per required signature (CPRS) of $2.72.
State profile
| Demographic data for California | ||
|---|---|---|
| California | U.S. | |
| Total population: | 38,993,940 | 316,515,021 |
| Land area (sq mi): | 155,779 | 3,531,905 |
| Race and ethnicity** | ||
| White: | 61.8% | 73.6% |
| Black/African American: | 5.9% | 12.6% |
| Asian: | 13.7% | 5.1% |
| Native American: | 0.7% | 0.8% |
| Pacific Islander: | 0.4% | 0.2% |
| Two or more: | 4.5% | 3% |
| Hispanic/Latino: | 38.4% | 17.1% |
| Education | ||
| High school graduation rate: | 81.8% | 86.7% |
| College graduation rate: | 31.4% | 29.8% |
| Income | ||
| Median household income: | $61,818 | $53,889 |
| Persons below poverty level: | 18.2% | 11.3% |
| Source: U.S. Census Bureau, "American Community Survey" (5-year estimates 2010-2015) Click here for more information on the 2020 census and here for more on its impact on the redistricting process in California. **Note: Percentages for race and ethnicity may add up to more than 100 percent because respondents may report more than one race and the Hispanic/Latino ethnicity may be selected in conjunction with any race. Read more about race and ethnicity in the census here. | ||
Presidential voting pattern
- See also: Presidential voting trends in California
California voted for the Democratic candidate in all seven presidential elections between 2000 and 2024.
More California coverage on Ballotpedia
- Elections in California
- United States congressional delegations from California
- Public policy in California
- Endorsers in California
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- More...
Related measures
This type of measure is called a "lockbox" measure, which is 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. The overall concept of a "lockbox" is to prevent fees and other revenue that is generated through one use from ending up in the state's general operations budget, instead ensuring that those funds are spent in a way related to how they were generated.
The following statewide "lockbox" measures qualified for the November 2016 ballot:
- Alabama Rules Governing Allocation of State Park Funds, Amendment 2
- Arizona Allowed Uses of Revenue from Sale of State Trust Lands Amendment, Proposition 123
- Illinois Transportation Taxes and Fees Lockbox Amendment
- New Jersey Dedication of All Gas Tax Revenue to Transportation Amendment, Public Question 2
- California Proposition 52, Voter Approval to Divert Hospital Fee Revenue Dedicated to Medi-Cal (2016)
Recent news
The link below is to the most recent stories in a Google news search for the terms California Proposition 52 Hospital. These results are automatically generated from Google. Ballotpedia does not curate or endorse these articles.
See also
- California 2016 ballot propositions
- 2016 ballot measures
- Laws governing the initiative process in California
External links
Basic information
Support
- Yes on Proposition 52
- Yes on Proposition 52 Facebook
- Yes on Proposition 52 Twitter
- Yes on Proposition 52 Youtube
Opposition
Other resources
Additional reading
Footnotes
- ↑ 1.0 1.1 1.2 California Attorney General, "Letter requesting a ballot title for Initiative 13-0022," accessed November 12, 2014
- ↑ 2.0 2.1 Sacramento Business Journal, "Ballot measure seeks stable source of Medi-Cal funding through fee," April 22, 2014
- ↑ 3.0 3.1 3.2 3.3 3.4 3.5 Note: This text is quoted verbatim from the original source. Any inconsistencies are attributable to the original source. Cite error: Invalid
<ref>tag; name "quotedisclaimer" defined multiple times with different content - ↑ 4.0 4.1 4.2 4.3 4.4 4.5 4.6 California Secretary of State, "California General Election November 8, 2016, Official Voter Information Guide," accessed August 18, 2016
- ↑ 5.0 5.1 California Secretary of State, "Medi-Cal Reimbursement Initiative Enters Circulation," accessed January 7, 2016
- ↑ Yes on Proposition 52, "Home," accessed August 3, 2016
- ↑ 7.0 7.1 California Secretary of State, "Medi-Cal Reimbursement Initiative Enters Circulation," December 3, 2013
- ↑ 8.0 8.1 8.2 8.3 8.4 8.5 Yes on 52, "Our Coalition," accessed September 14, 2016
- ↑ Daily Republic, "Supervisors endorse Medi-Cal funding initiative," April 6, 2016
- ↑ Times of San Diego, "California Democratic Party Supports Legalizing Marijuana," June 20, 2016
- ↑ California Republican Party, “CAGOP Endorsements of Propositions on the California 2016 Ballot,” accessed September 12, 2016
- ↑ Green Party of California, “Green Party positions on Statewide Propositions - November 2016 General Election,” October 3, 2016
- ↑ Peace and Freedom Party, "Peace and Freedom Party recommends," accessed September 17, 2016
- ↑ Harvey Milk Democratic Club, “Official Endorsements for the November 8, 2016 Election,” August 17, 2016
- ↑ Santa Monica Daily Press, “Endorsements surge as campaigns heat up,” September 17, 2016
- ↑ California Environmental Justice Alliance Action, “2016 Environmental Justice Voter Guide,” accessed October 5, 2016
- ↑ Yes on 52 Youtube, "Yes on 52 Channel," accessed September 14, 2016
- ↑ No on 52, "Homepage," accessed September 14, 2016
- ↑ San Francisco Chronicle, "Prop. 52, a measure to fund Medi-Cal, is its own worst enemy," September 9, 2016
- ↑ Sierra Sun Times, “Congressman Tom McClintock Comments on California Ballot Propositions,” October 14, 2016
- ↑ Libertarian Party of California, "Measures," August 21, 2016
- ↑ Mother Jones, “California Voters Were Hit With a Blizzard of Ballot Propositions. Here’s Your Cheat Sheet,” October 18, 2016
- ↑ Cite error: Invalid
<ref>tag; no text was provided for refs namedPolitiFact - ↑ 24.0 24.1 24.2 24.3 24.4 Cal-Access, "Proposition 52," accessed February 18, 2025
- ↑ The Bakersfield Californian, "Our View: Vote yes on Prop. 52, hospital fees for Medi-Cal," August 30, 2016
- ↑ East Bay Express, "Vote With Us! The East Bay Express' Endorsements for Election Day 2016," October 11, 2016
- ↑ East Bay Times, "Editorial: Prop. 52 complicated, but worth support," September 18, 2016
- ↑ Los Angeles Times, "Editorial: Yes on Proposition 52 to keep Medi-Cal funded," September 13, 2016
- ↑ The Mercury News, "Editorial: Proposition 52 will ensure Medi-Cal funding," September 14, 2016
- ↑ The Record, “Record endorsements: Voters faced with 17 state ballot measures,” October 15, 2016
- ↑ The Sacramento Bee, "In support of children's health care, yes on Proposition 52," September 7, 2016
- ↑ San Diego City Beat, “2016 Voter Guide: State measures,” October 12, 2016
- ↑ San Diego Free Press, "San Diego 2016 Progressive Voter Guide," October 13, 2016
- ↑ San Diego Union-Tribune, "Yes on Proposition 52: California should prop up Medi-Cal," October 12, 2016
- ↑ San Francisco Chronicle, "Chronicle recommends: Yes on Prop. 52," September 13, 2016
- ↑ San Francisco Examiner, "Examiner Endorsements: Statewide ballot measures," October 23, 2016
- ↑ San Mateo Daily Journal, "Editorial: Daily Journal proposition endorsements," October 28, 2016
- ↑ Santa Cruz Sentinel, "Editorial, Oct. 28, 2016: Vote yes on Prop. 52, tax for Medi-Cal," October 27, 2016
- ↑ Ventura County Star, "Editorial: Vote yes on Prop. 52 to keep Medi-Cal funds," September 27, 2016
- ↑ CALSPEAKS, "General Election October 2016 Survey of Californians," October 20, 2016
- ↑ 41.0 41.1 The Field Poll, "Voters Inclined to Support Many of this Year's Statewide Ballot Propositions," November 4, 2016
- ↑ Standard Examiner, "Hospital Funding Measure Won't Qualify in Time for November 2014 Ballot," June 4, 2014
- ↑ California Secretary of State, "Final Full Check Update - 08/01/14," accessed August 3, 2014
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