Opinion: Proposition 35 harms the very communities it promises to help

Despite Proposition 35’s promises to help fix the health care crisis in California, this measure would undo the investments vulnerable people need.

We, a health care advocate for underserved communities and a legislator who chairs the state’s health care budget subcommittee, urge a no vote.

Medi-Cal is the state’s health insurance program for people with low incomes. Among those who count on Medi-Cal are one in three California children, millions of seniors, people with disabilities and working families who don’t get health care coverage at work. What’s more, a strong Medi-Cal program benefits all of us, regardless of where we receive our health care. When patients can’t access the care they need to stay healthy, they are more likely to come to work sick or have the emergency room be their only — and costly — form of care.

Community health care advocates and state officials have worked closely with doctors, patients, hospitals and more to improve health care for vulnerable Californians and address gaps in care that lead to poorer health outcomes in communities of color. To provide funding, California for years has used revenues from a tax on health insurers to qualify for additional federal dollars.

Both sides of Proposition 35 support that tax. The dispute is in part over how to spend it and who should benefit. The ballot measure rolls back recent progress in community investments, prioritizing funding for a select group of health care providers over the holistic care our communities need.

Worse, Proposition 35 jeopardizes billions of dollars in additional health care funding each year. Architects of the ballot initiative, including commercial insurance plans, crafted the measure to cap the tax rate these corporations pay to support Medi-Cal. As a result, the measure would not only reduce the amount of money available to provide care for children, seniors and families, it would also directly conflict with federal direction on the future of the program. California could lose billions in federal funding each year, forcing cutbacks not only to health care but also other support, from food to housing, that vulnerable people need to be healthy.

Proposition 35 would hurt children, seniors and people of color.

Under the measure, health care providers including doctors, ambulance companies and hospitals would keep pay raises, squeezing out funding to keep children covered, support at-risk seniors and boost community health workers. In this way, the initiative puts the interests of a small group of providers over the patients served by the Medi-Cal program.

It prioritizes powerful interests over equitable resources for community care. If Proposition 35 passes, it would lock in funding for deep-pocketed interests year after year while leaving communities diminished opportunity to make their voices heard about their health care needs. And there is no accountability in the measure to ensure that increased provider payments actually generate better health outcomes for patients.

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Proponents argue Proposition 35 is needed to ensure that Medi-Cal dollars aren’t redirected to other state programs. But the likely result of their initiative would be that in an economic downturn, doctors and specialists would continue to receive bigger paychecks while vulnerable Californians are cut off from their insurance coverage or have other support reduced.

We support raising funding through the health insurance tax to improve Medi-Cal. But we oppose taking away flexibility legislators need to ensure the needs of families, children, seniors and people with disabilities are a priority. Vote no on Proposition 35.

State Sen. Caroline Menjivar, D-Panorama City, is chair of the Senate Budget Subcommittee on Health and Human Services. Kiran Savage-Sangwan is executive director of the California Pan-Ethnic Health Network, a statewide multicultural health advocacy organization.

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