Hospital fees

Health systems are asking California voters to approve Proposition 52,

which would permanently extend Medi-Cal’s hospital fee program. The fees paid by hospitals generate billions in federal matching funds that subsidize healthcare services for children, seniors and lowincome citizens.

The proposition would also make it harder for lawmakers to use MediCal funds for anything other than their intended purpose by requiring voter approval to divert the money. Current law requires the Legislature to renew the program—it has been renewed four times since being established in 2009—while Proposition 52 would require a supermajority vote to end it. Lawmakers have diverted funds from the program only once— $400 million to shore up the budget in 2012—but the California Hospital Association argues it could happen again during an economic downturn, when people need Medi-Cal services most.

Despite a lack of opponents, Proposition 52 faces an uphill battle because it’s complex and has to fight for voters’ attention on a ballot crowded with 18 statewide propositions.