Prop 72: A Base to Build On

Source: Health Access California

Proposition 72, to ensure that employees get basic health coverage on the job and to expand such coverage to a million more workers, was defeated by a vote of 49% to 51%, a razor-thin margin of 160,000 votes out of over 9 million cast on the ballot measure. It was the closest margin of the sixteen initiatives on California's November 2004 ballot.

THE IMPACT: The result of this referendum means that SB 2 (Burton), which was passed by the legislature and signed into law last year, is repealed. Large employers can (and will) continue to scale back health coverage to their workers, or drop it altogether.

Rather than take a significant step in reducing the number of uninsured, California is likely to see the number of uninsured increase, as well as other resulting problems in our healthcare system, such as emergency room and hospital closures. Taxpayers will still be asked to pay for the health care costs of the workers of Wal-Mart, McDonald's and other large corporations that don't provide health coverage to all their workers, rather than having that money instead fund other Californians in need of health coverage.

BUILDING THE BASE FOR THE FUTURE: Despite the final outcome, health advocates should take solace and pride in how well we did in supporting Proposition 72, and making it such a close fight. On Election Day, nearly half of the California electorate voted for health care reform. Health advocates can build on this base of over 5 million people to win the reforms we so clearly need.

The campaign educated millions of voters that many large corporations don't provide health coverage to their workers or their families, and such corporate practices have consequences, not only for these working families, but for the taxpayer, the health care system, and society in general.

The election overall showed that health care reform is a political asset, rather than a liability. Health-related propositions that did not have large funded oppositions won. No incumbent Democratic legislator lost, even though they had all voted for SB 2, the legislative precursor for Proposition 72, and in may cases, ran on the issue. In part using health issues, including Proposition 72 and the cost of prescription drugs, Democrats retained their significant majorities in the Senate and Assembly.

THE COALITION TO WIN: Despite these reasons for caution, a diverse coalition of over 200 organizations came together to support Proposition 72. Having already passed the bill, advocates did not plan for this fight, but once the gauntlet was thrown, health advocates understood we needed to defend this important advance in health policy. The coalition in support of SB 2, with the leadership of the California Medical Association, the California labor Federation, health Access California, and many others, made new alliances with a range of health provider, community, religious, grassroots, labor, senior, ethnic and constituency organizations. This was the first time that health reform was supported by all elements of the health care community: doctors, nurses, consumers, hospitals, and even some health plans.

THE MESSAGE: The opponents spent much of their time scaring those with good coverage (which are the majority of voters) that Proposition 72 would negatively impact them and their health care, when in fact it would make their coverage more secure. Doctors and nurses were credible spokespeople in stating that the proposal was not government-run health care, and in talking about the crisis in health care and the need for reform.

The late focus on how taxpayers often have to pick up the cost of the health care of the workers of Wal-Mart and other large corporations helped cut through the clutter of the election season, and brought home the overall impact of the uninsured, and the fact that the uninsured are largely workers and their families.

FOR THE FUTURE: There is much more to say about this campaign, and what it accomplished, in terms of the message, the money, the media, and the mobilization of the masses. Health Access and other entities will provide analyses and host convening to review the lessons we learned for future fights. Next time, we will be better equipped to win, and we will.

We will win because we have to, because the health care system is unraveling. Employers are entering into a "race to the bottom" in terms of the health benefits they provide: in fact, in the past three years, there are five million more jobs in the country that no longer provide health coverage. With state and federal deficits forcing budget cuts, our public insurance programs like Medicaid and Medicare, which provide coverage for millions of children, seniors and people with disabilities, are under attack, and will be even more so in the newly hostile environments in Washington. More Americans are uninsured, and the health care system of hospitals and clinics that we all rely on are overburdened and some are even closing.

NEXT STEPS: The status quo is not an option. The opponents of Proposition 72 kept saying "right problem, wrong solution," but failed to ever provide their alternative. Health advocates always said that Prop 72 was only a piece of the puzzle. We need to continue with our multi-prolonged efforts - to expand coverage for children, to control drug and other health care costs, to oppose budget cuts, to educate voters about the systemic problems in the health care system, to organize broader and deeper than before - as well as continue to fight to ensure that employers keep their health care responsibility to their workers. California advocates are currently investigating how we might revisit this issues, in the legislature, on the ballot, or otherwise.

A defeat at the ballot box, especially one this close, is often not the end of a fight, but the beginning.