Californians on Election Day voted down two statewide ballot measures that would have made significant changes to health care in the state. Voters rejected a measure that would have given the state insurance commissioner the power to approve or deny health insurance premium increases, and they voted down changes to the state’s medical malpractice system.
Proposition 45 would have given California’s elected insurance commissioner the authority to review proposed health insurance rates for the individual and small-employer markets. If the commissioner determined a premium increase was excessive after an actuarial analysis, he or she would have the power to deny its implementation.
Proponents said the measure was necessary to keep health insurance costs under control, but critics argued it would give one politician too much power while creating an unnecessary and costly new state bureaucracy. The opponents also argued the measure allowed for political interference in medical treatment decisions.
The measure was opposed not only by insurance companies but also by leading proponents of the Affordable Care Act, such as House Minority Leader Nancy Pelosi (D–CA). Also joining the opposition was the current head of California’s Obamacare exchange, Peter Lee, and several unions and medical organizations.
Explaining her opposition to the measure, Pelosi said, “This proposition—written several years before Covered California was up and running—would have injected confusion and uncertainty into the health coverage options of millions of California families,” according to the November 5 Los Angeles Times.
Voters overwhelmingly rejected Prop 45, with 60 percent voters disapproving of the measure.
Malpractice Proposal Defeated
The second proposal, Proposition 46, would have undone past reforms to California’s medical malpractice law by increasing the limit on lawsuit awards for pain and suffering from $250,000 to about $1.1 million and would have required hospitals to conduct random alcohol and drug tests on their physicians after any medical mistakes that caused patient injury.
The measure would also have required doctors to check a state database to determine a patient’s prescription drug use when prescribing certain medications, with the goal of preventing drug abuse.
The measure’s sponsors argued raising the cap on noneconomic damages was necessary to account for inflation; it has changed little since the cap was first implemented in 1975. If the proposition had passed, California’s $1.1 million cap would have been the highest in the country.
Opponents of Proposition 46 argued the measures would benefit trial lawyers while harming doctors and consumers. No on 46, a coalition opposing Prop 46, estimated the measure would cost a family of four an additional $1,000 in health care costs a year.
Making malpractice insurance more costly would also likely result in California losing many doctors and specialists to states with more affordable medical-liability insurance, opponents argued.
More than two-thirds of voters voted against Proposition 46.
Sally Pipes, president of the Pacific Research Institute, called the vote encouraging and noted it was one of the few recent instances of California voters rejecting greater government regulation in health care. “Perhaps there is a silver lining ahead for limited government policies in the Golden State,” she told Health Care News.
Matthew Glans ([email protected]) is a senior policy analyst at The Heartland Institute.