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About a month ago, Orange County officials declared a health emergency due to the record numbers of pediatric hospitalizations and emergency room visits, driven by growing numbers of cases of respiratory syncytial virus. Similar levels of concern are being raised by public health officials in San Diego, Santa Clara, Los Angeles and other counties.
Local Ballot Initiatives
In Duarte and Inglewood, voters rendered a split decision on ballot measures to institute a $25-an-hour minimum wage for certain health care workers (the measures included operational restrictions such as preventing the ability to lay off workers to manage additional expenses). Voters in Duarte rejected the initiative 63% to 37% and voters in Inglewood approved the measure 53.5% to 46.5%. CHA, the Hospital Association of Southern California (HASC), local hospitals and community partners, and our campaign team aggressively fought both measures, as they unfairly apply only to some health care workers at some facilities, while excluding a majority of others doing the exact same job.
It’s important to note that Inglewood is one of the most progressive cities in the state, with a voter registration that is 76% Democrat and just 5% Republican. The fact that Measure HC squeaked by, even with a heavy push by supporters, indicates that many voters recognized the serious flaws in this initiative.
Inglewood and Duarte were not the only cities in which SEIU-UHW attempted to advance minimum wage ballot initiatives. In several others, including Los Angeles, thanks to the work of CHA, HASC, and the ballot initiative team, the measures have been postponed to 2024; in other cities, no ordinance or measure was advanced.
Despite the loss in Duarte and the narrow victory in Inglewood, it is expected that labor unions will continue proposing similar measures in cities across the state, as well as a potential statewide effort, in 2023.
State Outlook
In Sacramento, Democrats will retain their supermajority in both legislative chambers; in the Assembly they will hold 62 of 80 seats and will hold 31 of 40 seats in the Senate.
Perhaps of greater importance is that nearly one-third of lawmakers — at least 37 of 120 — will be new to the Legislature, meaning that they will need to be brought up to speed on many of the issues vital to hospitals. This includes matters like Medi-Cal underfunding, behavioral health care challenges, and physician choice for employment, among others.
On one of the field’s top priorities, reform of the 2030 seismic building standards, CHA will be conducting an extensive, community-based educational effort in 2023 to acclimate legislators to this issue and help them understand the magnitude of the challenge facing hospitals, as well as the gravity of the impact on patients and communities if relief is not provided.
Federal Landscape
In Washington, D.C., Republicans claimed a narrow majority (222-213) in the House of Representatives, and Rep. Kevin McCarthy of Bakersfield is poised to become speaker of the House. Democrats retained control of the U.S. Senate and gained a seat after a Tuesday runoff victory in Georgia, creating a 51-49 split.
Ultimately, this likely means further gridlock for federal policymaking, despite the fact that many priorities remain unchanged, including protecting Medicare, insurer accountability, and rebuilding the nation’s health care workforce. Other issues, such as price transparency, affordability, and billing practices, are likely to be raised and will demand engagement alongside our federal partners at the American Hospital Association.
Building relationships with legislators and advocating within changing dynamics of power are core to the work CHA does on your behalf every year. The notable differences for 2023 are that at the state level, the sheer number of first-time legislators means a need for enhanced education and engagement. At the federal level, the slim Republican majority will bring unique challenges for leadership to accommodate all factions of the party, creating an environment where politics could well play a far larger role than policy compared to previous years.
What has not and will not change is the need for you to continue to elevate your voices with policymakers, as advocacy on hospitals’ behalf is most effective when it is coordinated, sincere, and personal. Stay tuned throughout the coming year for opportunities and requests to engage in this new political environment.
