California Dialysis Clinics Win Doctor Staffing Ballot Battle


A labor-backed measure to require doctors to always be on duty at dialysis clinics was heading to defeat in California.

The industry spent more than $105 million to try to derail the initiative (Proposition 23), which would have required doctors to be present at all times the dialysis centers were open. Rejection would be a victory for providers including DaVita Inc. and Fresenius Medical Care.

It was one of several health-related ballot questions put before voters around the country, including proposals to increase taxes on tobacco and vaping products in Oregon and Colorado.

After the ballots are counted and results certified, which may take weeks, the fight over dialysis regulation will continue in court. On Nov. 12, state and the industry must update a federal judge on the status of a lawsuit providers filed to block enforcement of a California law affecting dialysis patients.

That union- and insurance industry-backed law prohibits third parties, such as dialysis clinics, from steering or directing dialysis patients to private insurance. Private insurance pays higher reimbursement rates than public programs such as Medi-Cal, California’s Medicaid program, which proponents of the law argued would drive up health care costs, according to a legislative analysis.

Opponents attacked the dialysis proposition’s price tag, which the independent California Legislative Analyst’s office estimated would cost the state and local governments tens of millions of dollars.

California’s voters were narrowly supporting a bond measure dedicated to stem cell research (Proposition 14), even though repaying the bonds with interest could cost the state’s general fund $7.8 billion, according to the state Legislative Analyst’s office.

Proponents including venture capitalists and Gov. Gavin Newsom (D) urged support, saying therapies for cancer, spinal cord injuries and other diseases may take years to develop. Opponents included the Howard Jarvis Taxpayers Association and the California Catholic Conference.

Elsewhere, Colorado voters approved an initiative (Proposition EE) for a new levy on vaping products and a tax increase tax on tobacco products.

Oregon voters approved a proposal (Measure 108) that would increase tobacco taxes and impose a new levy on vaping products. The additional revenue would be used to fund health-care coverage expansion and programs to keep people off tobacco and nicotine products.

©2020 Bloomberg L.P.

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