California hospital and physician associations are working to defeat two initiatives on the November ballot that would radically alter state healthcare delivery.
The state's providers are especially worried about Proposition 187, the "Save Our State" initiative. Endorsed by Gov. Pete Wilson, the measure is doing well in voter polls. It would bar illegal immigrants from receiving non-emergency healthcare and public school educations as well as other state- and county-funded benefits.
"Literally every healthcare organization in the state" opposes the proposition, said David Langness, vice president of the Hospital Council of Southern California.
Because the measure fails to meet federal anti-discrimination standards relating to access to public education and healthcare, California could lose about $15 billion in federal funding to schools and hospitals annually if the measure passes, according to a report by the state Legislative Analyst's office. Of this total, the state stands to lose up to $9.3 billion annually in federal Medicaid and Medicare funds, said Lilly Spitz, assistant general counsel of the California Association of Hospitals and Health Systems.
And health professionals are concerned that if illegal aliens are denied non-emergency care, hospital emergency rooms will be even more swamped.
A study published by the California Medical Association last week indicates that passage of Proposition 187 would hasten the spread of tuberculosis in the state because illegal immigrants would fear that physicians would report them to authorities. The proposed law contains many reporting requirements.
Gov. Wilson has made illegal immigration an issue in his campaign, and polls have shown voters favor Proposition 187, authored by Republican Assemblyman Dick Mountjoy, by a two-to-one margin. Though support for the measure has been eroding, "it looks like it could pass," Mr. Langness said.
CAHHS, along with the state's hospital councils, the California Medical Association and the American Civil Liberties Union, are preparing to file a lawsuit to halt implementation of Proposition 187 if it passes, Mr. Langness said.
Proponents, who include former U.S. Immigration and Naturalization Service officials, argue that illegal aliens cost state taxpayers more than $5 billion a year. The Clinton administration condemned the measure.
Meanwhile, recent polls by the Los Angeles Times and Mervin Field Research Co., an independent, San Francisco-based research organization, show voters overwhelmingly opposed to Proposition 186, the "California Health Security Act," a single-payer initiative. Editorials in the state's major newspapers have also opposed the initiative. But opponents-including the state's hospital organizations, the CMA, insurers and business groups-aren't taking any chances.
They plan to spend $1 million on advertising in the last two weeks before the election. Proponents of the measure will be spending at least as much, said a spokesman for Taxpayers Against the Government Takeover. As of Sept. 30, the opposing group had raised $5.7 million and hopes to get $7.5 million by the end of the campaign, he said.
Proposition 186 would eliminate private health coverage as well as Medi-Cal (the state's Medicaid program) and Medicare, and replace them with a tax-funded, government-run system headed by a healthcare commissioner.
The initiative would provide a benefit package including eyeglasses, hearing aids and long-term care to all residents.
To support the Canadian-style healthcare system, Proposition 186 calls for raising $40 billion through a payroll tax increase of up to 8.9 percentage points, an income tax increase of as much as 5 percentage points and a $1-a-pack tax increase on cigarettes.