California Politics: They think voters got it wrong. Twice

A woman wearing a mask is hooked up to a machine in a hospital bed
(Irfan Khan / Los Angeles Times)

We’re used to seeing losing political candidates come back and try again. Even after they offer a concession by saying that “the voters have spoken” and insist that they’ve run their final race, it’s hardly surprising when a vanquished challenger decides somewhere down the road that it’s worth another shot.

But ballot measures are different.

Deep-pocketed groups that carefully consider the prevailing political winds and, in some cases, spend years gearing up for a statewide battle don’t generally do it all over if they lose — to say nothing of trying a third time. After all, why would voters suddenly change their minds and embrace what they’ve already rejected?

It’s a question Dave Regan has heard before.

Asking voters to redo the do-over on kidney dialysis

“We’re stubborn enough that we’re going to hang in there,” said Regan, the leader of SEIU United Healthcare Workers West, the backer of all three efforts to change the rules under which private, for-profit kidney dialysis clinics operate in California.

The healthcare workers union has until next week to gather at least 623,212 verified voter signatures needed to qualify its third proposal in the last four years. A half-dozen or more other ballot measure efforts — including sweeping efforts to legalize sports betting and rewrite state tax policy — also will soon wrap up what have been expensive petition drives.


Local elections officials need a couple of months to inspect and verify signatures, and Secretary of State Shirley Weber will certify the Nov. 8 ballot measures in late June.

For Regan’s union, there’s hope that the third time will be the charm. The first two efforts were ballot box flops.

In 2018, almost 60% of voters rejected the first effort, Proposition 8. The measure would have capped the profits earned by the operators of dialysis clinics when they exceeded a fixed threshold. The resulting campaign was a $130-million slugfest, with most of the money spent by the two companies that operate most of California’s dialysis centers.

Two years later, the healthcare workers union took a different approach. Rather than focus on profits, 2020’s Proposition 23 sought to impose new rules requiring on-site doctors, more transparency about clinic infection rates and requirements that some insurance providers’ clients wouldn’t be refused treatment.

The proposal was different but the outcome was the same. Fewer than 4 in 10 ballots were in favor of Proposition 23, and the cost of the campaign topped $113.6 million.

Now, four years and almost a quarter of a billion dollars in campaign spending later, the healthcare union is trying again.

The third effort closely mirrors Proposition 23 but loosens the previous effort to require in-person doctors. The proposal now states that instead of a physician, each clinic can have a nurse practitioner or physician assistant on duty during treatment hours — hours that can extend from early in the morning until late at night.


“We’re committed to reforming this industry,” Regan said in an interview Thursday. “We’re not going to be bullied just because the industry has unlimited resources” for its political campaigns.

The criticism of the union that’s persisted, and most vocally lodged by the companies that run the California dialysis clinics, is that the recurring ballot measures are mostly designed to push the businesses into allowing the dialysis clinic workers to unionize.

It’s an accusation that led a representative of the campaign that’s backed by the two big dialysis companies, DaVita Inc. and Fresenius Medical Care, to liken the union’s ballot measure campaigns to “extortion.”

“The voters clearly understand this and we’re confident that they’ll again overwhelmingly reject this dangerous abuse of the ballot system,” Kathy Fairbanks, a spokesperson for the campaign, said Thursday.

Regan rejects those accusations and insists the impetus remains a series of needed changes to dialysis clinic operations.

“It’s not about that,” Regan said on the issue of enlisting new union members. “It’s about reforming an indefensible part of the healthcare industry.”

California Republicans gather

Friday marks the kickoff of the California Republican Party’s spring convention, and the event raises an interesting question for political watchers: Who is the state party’s standard-bearer?


Long gone are the days when the GOP faithful could point toward a prominent statewide official. The election of then-Gov. Arnold Schwarzenegger and then-Insurance Commissioner Steve Poizner in 2006 were the party’s last victories in races for any of California’s eight constitutional offices. And the most recent statewide voter registration statistics show there are almost two Democrats for every Republican among the state’s registered electorate.

The answer to the question posed earlier is probably House Minority Leader Kevin McCarthy, who will be the featured speaker at the convention’s Saturday dinner. He is also the only prominent GOP leader on the party’s published itinerary for the weekend, with lesser-known candidates for governor and other offices holding receptions during the event in Anaheim.

But some might also look for leadership from Lanhee Chen, the former GOP presidential advisor and Obama appointee to the Social Security Advisory Board who now teaches at Stanford. Chen is running for state controller and won the endorsement Thursday of The Times’ editorial board. Chen faces a lengthy list of Democrats on the June ballot and is likely to advance easily to November.

The last Republican to be elected state controller was Houston Flournoy, who served from 1967 to 1975.

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