SACRAMENTO – During the California Democratic Party convention in Sacramento last weekend, the spiciest news was outgoing chairman John Burton dropping an f-bomb on a group of activists demanding that the party embrace a single-payer health system. It’s not really news when the notoriously foul-mouthed Burton says such things, but the fracas highlighted the pressure party leadership faces to embrace government-run medical care.

Yet the foulest rebuke to advocates for single payer this week did not take place at the convention. It took place nearby at the state Capitol, in the form of an appropriations committee report that found that a single-payer bill working its way through the state Senate would cost more than double the state’s total budget.

Senate Bill 562, which had previously passed the Senate health committee, was placed in the “suspense file” by the appropriations committee on Monday as legislators analyze the huge price tag. They have until the end of the week to move it out of the file, or it will die this year.

The committee made clear the size of the undertaking: “The fiscal estimates below are subject to enormous uncertainty,” it explained. “Completely rebuilding the California health care system from a multi-payer system into a single payer, fee-for-service system would be an unprecedented change in a large health care market.”

The appropriations analysts estimate an annual cost of $400 billion a year, which soars above the projected $180 billion state budget. Of that cost, the committee explained, about half of it would be covered by existing federal, state and local health care funding. That leaves a $200-billion hole, which the committee says could be covered by a 15 percent payroll tax. Even if the calculation includes reduced health care spending by employers and employees, the committee still estimates a $50-billion to $100-billion shortfall.

And, quite significantly, these costs could be understated given the kind of demand that would be created by this system. Its main advocates, Sens. Ricardo Lara, D-Bell Gardens, and Toni Atkins, D-San Diego, view health care as a “human right,” so the system the bill would create would provide nearly unlimited access to medical care. In fact, the Senate health committee report opined that “SB562 will change health care in California from commodity to a right.”

“Under the bill, enrollee access to services would be largely unconstrained by utilization management tools commonly used by health care payers, including Medi-Cal,” according to the committee report. “The ability for enrollees to see any willing provider, to receive any service deemed medically appropriate by a licensed provider, and the lack of cost sharing, in combination, would make it difficult for the program to make use of utilization management tools … . Therefore, it is very likely that there would be increased utilization of health care services under this bill.”

And the committee only is talking about predicted costs. It’s not its job to engage other policy debates, such as those touching on subjects including rationing, waiting lists for services if the demand overwhelms supply and the quality of care. The bill would apply to illegal immigrants, which raise critics’ concerns about the state becoming a worldwide magnet for “free” health care.

The bill is fairly short given the complexity of the subject. But the Mercury News captured the gist of the single-payer approach in a March news article: “Instead of buying health insurance and paying for premiums, residents pay higher taxes. And those taxes are then used to fund the insurance plan — in the same way Medicare taxes are used to provide insurance for Americans 65 and over.”

This bill would put control of health care in the state under the authority of a nine-member panel and essentially eliminate the role of insurance companies – thus replacing them with a government bureaucracy. But the size of the tax bill and state costs even have Democratic Gov. Jerry Brown expressing what the newspaper calls “deep skepticism.”

The analysis makes some other important points. For instance, it’s not clear that the federal government would go along with this, and it is totally discretionary whether the feds would grant the necessary waivers involving Medicare and Medicaid services. The bill’s funding is based heavily on the ability to divert federal funds from those programs.

The analysis also notes, “There are several provisions of the state constitution that would prevent the Legislature from creating the single-payer system envisioned in the bill without voter approval.” In Colorado this past November, voters defeated a single-payer initiative, Amendment 69, with an overwhelming 79 percent to 21 percent “no” vote.

Supporters of the measure claim that it will reduce “waste” by putting all health plans under a single umbrella, thus ending the duplication of multi-plan systems. But critics note that competition is the best way to keep costs low – not putting a system under one giant governmental entity. Advocates see it as a way to ensure proper health care for everyone, but the appropriations report confirms critics’ concerns that such a system could obliterate the state budget and kill job-creating private enterprise because of the high tax bite.

As the Democratic Party protests illustrated, we can expect the debate to become even more acrimonious and obscenity laden as the days go on.

Steven Greenhut is Western region director for the R Street Institute. Write to him at sgreenhut@rstreet.org.

Some Californians have long complained of their state’s status as a so-called “donor state” — one that sends more money to Washington than it receives. But as political tensions with the White House have heated up, and some federal funding put in play, at least rhetorically, analysts have crunched the numbers, shedding fresh light on the relationship between Sacramento and the nation’s capital. 

Hard to untangle

California’s Legislative Analyst’s Office, an independent body, “has pored over the data to calculate a number that is the monetary essence of California’s relationship with the United States,” the Los Angeles Times noted. “And what a number it is: The federal government spends some $367.8 billion a year on California. That’s an average of about $9,500 for every woman, man and child in the state.”

“In truth, the money isn’t spread out evenly. About 56 cents of every federal dollar spent in California, according to the analysis, goes to health or retirement benefits — Social Security, Medicare and money for low-income residents’ health care through the Medi-Cal program. Defense contracts are the next biggest slice of the pie, followed by paychecks to military and civilian government employees. From there, federal spending gets sprinkled among a number of programs run by the state government.”

The question of what Californians put in, however, has grown complicated over time. “Part of the difficulty stems from the tangled web of money that flows between individuals, the state and the federal government,” as the New York Times observed. “Perhaps the most cited figure comes from the Tax Foundation, a conservative group that found Californians got back about 78 cents in services per federal tax dollar paid in 2005. Other tallies have been higher: between 91 cents and $1.06 on the dollar, according to the Times. 

Limited authority

Although the widening political gulf between the White House and leading California Democrats spurred the interest in recalculating what taxpayers receive, experts have cautioned that even a battle of wills with Washington won’t likely result in a freeze on federal cash. “Key court decisions restrain the federal government’s ability to put coercive strings on funding,” the Sacramento Bee recalled. “Some Republican as well as all Democratic lawmakers would object on behalf of their California constituents. And with upward of $67 billion in federal grants being funneled to the state annually, picking and choosing would quickly get complicated.”

“The Supreme Court, for one, has at times been skeptical about the federal government attaching conditions to funding. In a much-discussed 2012 decision on the Affordable Care Act, Chief Justice John Roberts Jr. wrote that the law had gone too far when it effectively threatened states with losing federal Medicaid funding if they didn’t expand their Medicaid programs to low-income adults.”

Sizing up cutbacks

At the same time, however, the prospect of additional federal grants in at least one controversial area have come under attack from within the state itself. “In a letter to Transportation Secretary Elaine Chao, California’s 14 Republican members of Congress asked that the administration block $650 million in federal grants the state wants to use to electrify a portion of commuter rail that runs between San Francisco and San Jose,” The Hill reported. “Republicans said the money, which would come on top of more than $3.5 billion in federal funding already granted for construction costs, would be wasted.” 

“The Obama administration provided billions in grant funding through the 2009 stimulus package and an omnibus appropriations measure in 2010,” the site noted. “California voters approved a nearly $10 billion bond to fund the project in 2008. But since the high-speed rail system was first proposed, costs have ballooned, from about $33 billion to more than $60 billion.”

Republicans have also eyed another place to pare back politicized funds. “Rep. Duncan Hunter, R-Alpine, won’t request federal funds in the coming fiscal year for states, cities and universities that have a policy to not comply with enforcement of federal immigration laws,” according to a statement cited by the Los Angeles Times.

The popular Democratic governor echoed other Democratic leaders in the state by taking shots at Republican President Donald Trump and congressional Republicans and their proposed, yet sometimes vague, agenda.

On the day Trump pushed through two controversial oil projects opposed by environmentalists, with a repeal of the Affordable Care Act slowly working through Congress and with federal action on immigration looming on the horizon, Brown pointed to the battle lines drawn between the state and the federal government.

“While no one knows what the new leaders will actually do, there are signs that are disturbing,” Brown said. “We have seen the bald assertion of ‘alternative facts.’ We have heard the blatant attacks on science. Familiar signposts of our democracy – truth, civility, working together – have been obscured or swept aside.”

Yet the tone wasn’t entirely combative, compared to legislative leaders. Brown lauded Trump’s plans for massive investment in infrastructure (“Amen to that, brother”) and highlighted bipartisan accomplishments in the state, like the creation of the rainy-day fund and the water bond.

Brown also drew a stark contrast with Hillary Clinton, who, during the campaign season, referred to half of Trump’s supporters as a “basket of deplorables.” 

“Democrats are in the majority, but Republicans represent real Californians too,” Brown said. “We went beyond party when we reformed workers’ compensation, when we created a rainy-day fund and when we passed the water bond.”

Brown lauded accomplishments during his governorship, which included increasing education funding, passing climate-change legislation, removing a substantial budget deficit and adding millions of people to insurance plans through both Medi-Cal and private policies.

A significant portion of the speech was devoted to immigration, noting immigrants are “an integral part of who we are and what we’ve become.” Brown called attention to some of the state’s immigration initiatives, like the Trust Act and a measure issuing driver licenses to undocumented immigrants, saying “we may be called to defend those laws and defend we will.”

“Whether it’s the threat to our budget, or to undocumented Californians, or to our efforts to combat climate change – or even more global threats such as a financial meltdown or a nuclear incident or terrorist attack – this is a time which calls out for courage and for perseverance,” Brown said. “I promise you both.”

The bad news: Providing certain health care services just became way more expensive for the counties. 

The Brown administration is ending a program that coordinated care for seniors and low-income families because it was no longer cost effective. As a result, the state will save $626 million this year, forcing counties to pick up the check. 

The Coordinated Care Initiative allows Californians who are eligible for both Medi-Cal and Medicare to “receive medical, behavioral health, long‑term services and supports, and home and community‑based services coordinated through a single health plan,” according to the budget document released Tuesday. 

But the law allows the Department of Finance to end CCI if it is deemed no longer cost effective. Federal regulations requiring in-home caregivers to receive overtime after 40 hours per week drove the cost of the program up with the minimum wage hike.

Last year, state analysts estimated the plan to gradually increase the minimum wage to $15 per hour would cost the state $4 billion by 2021. Cutting the CCI program will lower the state’s burden to $2.6 billion, according to a Department of Finance official. 

Cutting the program will shift the labor costs onto the counties, which is estimated to cost more than $4.4 billion over the next six years, according to the California State Association of Counties. 

 “This would be devastating to counties all over the state,” CSAC President and Alameda County Supervisor Keith Carson said in a statement. “We undoubtedly would have to make cuts in other vital social services to cover these costs.”

Republicans in Washington appear poised to repeal the ACA, better known as Obamacare, some time after Donald Trump is sworn in as president. With premiums on the rise and consistently poor polling, repeal is music to the ears of many, as evidenced by every federal election since the measure was passed in 2010.

However, a partial repeal would cause Californians to lose hundreds of thousands of jobs, billions of dollars in annual federal funding and kick millions of people out of coverage. Some of the losses would be offset by gains elsewhere, but it’s impossible to give a complete analysis of the offsetting effects without Republicans’ replacement plan.

What we know

Even with Republican majorities in Congress and a Republican president, a full repeal of the ACA is unlikely, due to a 60-vote threshold in the Senate that would require at least a handful of Democratic votes.

UC Berkeley Labor Center analysts used a 2015 partial-repeal bill that was ultimately vetoed by President Barack Obama to estimate the effects. Under that bill, California would lose $20.5 billion annually in federal funding for low-income subsidies and expanded Medi-Cal coverage.

As a result of that lost funding, 3.7 million Californians would lose Medi-Cal coverage, while another 1.2 million would lose subsidies, which may or may not make coverage unaffordable. 

Offsets

The billions in lost federal funds would be offset by smaller gains elsewhere, like $6.3 billion in tax cuts to California insurers and high-income earners. A repeal could also remove the requirement to have coverage, saving $1.3 billion in penalties for the uninsured. 

The study estimates approximately 250,000 jobs would be lost from repeal. However, approximately 41,000 jobs would be created through tax cuts, as well as through eliminating fees on insurers, penalties to companies for not providing coverage and penalties for the uninsured.

Popularity

Polling and electoral results have repeatedly shown the law to be unpopular with the public nationally, and Californians are facing an expected average increase in premiums by 13.2 percent next year. 

Nationally, the public is divided on the law. In November, 45 percent of adults had an unfavorable impression of the law, compared to the 43 percent who had a favorable impression, according to a Kaiser Family Foundation tracking poll.

Republicans have incrementally seized power in Washington on a repeal platform ever since Democrats passed the ACA in 2010 with their own congressional majorities and president, Barack Obama. In 2010, Democrats lost the House. In 2014, they lost the Senate. And in 2016, they failed to regain the Senate and lost the White House.

Supermajority eludes Democrats

Good morning. As you know, Donald Trump will be the next president of the United States in what felt like another mini Republican wave election.

In fact, Republicans seemed to have fought off a Democratic supermajority in the state Legislature Tuesday night, according to early returns.

With a supermajority, Democrats would be able to increase taxes, override gubernatorial vetoes and send measures to the ballot without Republican support. Democrats need two seats in the Assembly and one in the Senate in order to hold a supermajority — both chambers are a must.

But as of just before 2 a.m., Republicans looked like they would hold their seats in the Senate.

CalWatchdog has more.

In other news, here’s how the ballot measures did, according to the Los Angeles Times:

• The $9 billion in school bonds passed.
• Medi-Cal funding measure passed.
• Statewide vote on bonds of $2 billion or more was too close to call.
• Legislative transparency measure passed.
• Extension of Prop. 30 passed.
• Tobacco tax passed.
• Parole measure passed.
• Repeal of ban on bilingual education passed.
• The Citizens United advisory measure was too close to call.
• Condoms in porn was too close to call.
• The pharmaceutical pricing measure was too close to call.
• Death Penalty repeal was too close to call.
• Ammo regulation passed.
• Recreational pot was legalized.
• The measure redirecting the plastic bag fee did not pass.
• The measure to speed up Death Penalty appeals was too close to call.
• The plastic bag referendum was too close to call.

And in Congress:

• Attorney General Kamala Harris was elected to U.S. Senate.
• Democrat Ro Khanna knocked off Rep. Mike Honda, a fellow Dem. This was the only California Congressional incumbent to have been declared defeated last night.

Scheduling in Legislature:

• Gone till December.

Gov. Brown:

• No public events announced.

Tips: matt@calwatchdog.com

Follow us: @calwatchdog @mfleming

New follower: @DonZoltan

And then last week, when a video with similar claims was released by the “No” campaign, The Bee doubled down on its assessment that the commercial contains “inaccurate claims about school funding and omits information to mislead voters.”

Making no value judgement about the pending measure, while happily admitting that the fact-checker sites generally perform good work and a valuable public service, CalWatchdog decided to fact-check the fact-checkers.

Full disclosure: I grew up in Virginia and smoked from age 12 to 28. While I loved smoking, Newports especially, in the end I preferred playing soccer, walking up the stairs at a normal pace, falling asleep without violent coughing fits, waking up without puffy eyes, and yes, having money in my pocket. 

Ad transcript

Davina Keiser, a Long Beach Math Teacher says to the camera: “Good schools are important to my students, and California. That’s why voters passed a law to ensure that schools get 43 percent of any new tax revenue. I was astounded to learn that Prop. 56 was written intentionally to undermine that guarantee. Prop. 56 raises $1.4 billion a year in new taxes and gives most of that money to wealthy special interests, like insurance companies. But not one penny goes to improve our kids’ schools. That’s just bad math.”

As The Bee points out, “The words ‘cheats schools of $600 million a year’ appear on the screen.”

Since the three fact check stories are largely the same, we’ll analyze the most recent Bee story.

The Bee writes: “Similar to an earlier ad funded by the tobacco companies, the new commercial contains inaccurate claims about school funding and omits information to mislead voters. It is a stretch to say Proposition 56 ‘cheats schools of $600 million a year.’ Nothing in the measure reduces school funding from current levels. If the measure passes, the education budget doesn’t decrease.”

We agree that “cheat” is a stretch. Cheat implies there is intent on the part of the Yes campaign to either deceive voters or go outside the normal framework to achieve its objective. Since the proponents are going through the legal, democratic process and are not hiding the fact that the measure is exempt from education-funding requirements, “cheat” seems like normal political hyperbole. 

But that doesn’t mean there isn’t a diversion of funds, or at least a diversion of potential funds. In 1988, voters passed Prop. 98, which Prop. 111 then amended the following election. These policies earmarked a certain amount of new revenue for education funding. While the number changes depending on many factors, it could be between 40 and 50 percent (we found conflicting numbers in our research, but this range should suffice).

Voters have the power to amend the Constitution to waive this requirement, as would be done in this case. But that doesn’t change the fact that we currently live in a world where a certain amount of all new funding is earmarked for education.

Even if everyone says it’s fine to do this, the money still won’t be going to education. If this wasn’t true, proponents wouldn’t have had to write the Prop 98 exemption into the Prop 56 language. 

For The Bee to write Prop. 56 would not cut funding is a red herring. The ad says “cheat,” not cut. And while “cheat” itself is misleading, there is an unquestionable loss of potential revenue. 

The Bee writes: “While Keiser says she was ‘astounded’ to learn that the measure works around Proposition 98, she shouldn’t be. It isn’t unusual. The last two increases in tobacco taxes approved by voters shielded the money from the Proposition 98 education funding guarantee.”

To be clear, you can’t fact check whether or not someone should or shouldn’t be astounded. But since The Bee speculated on Keiser’s level of astoundedness, we’ll speculate it’s possible she wasn’t aware of the prior measure’s exemptions. It’s even more possible that she’s just reading from a script.

To continue our speculation, we believe there is a significant percentage of voters who are unaware that prior tobacco taxes were exempt from Prop. 98. Again, we’re just speculating, but doesn’t it seem more logical than assuming every voter is fully-versed in budgetary minutiae and constitutional law?

In fact, Judge Michael Kinney agreed when he said in August that “Voters don’t know the numbers.” According to the Los Angeles Times, that was Kinney’s justification when he ruled the attorney general needed to be more specific in Prop. 56’s summary, to make clear to voters the connection between Prop. 98 and school funding.

The Bee is correct that the last two tobacco-tax ballot measures were exempt from Prop. 98. But the original tobacco excise tax, passed in 1959, has been contributing a certain amount to education funding since Prop. 98 was approved in 1988. So it’s not unprecedented. We can sympathize with Keiser or any other voter who doesn’t know all of this. 

The Bee writes: “It’s also wrong to say ‘not one penny’ of the funding goes to improve schools. The Legislative Analyst’s Office estimates that up to $20 million of the new tax revenue would to go the Department of Education for school programs to prevent the use of tobacco among young people.”

Anti-tobacco programs in school will do little to give teachers raises, reduce classroom sizes, improve academic performance, improve graduation rates, increase the number of kids going to college, or implement any other meaningful suggestion policy makers and advocates have for improving California’s schools.

While steadily increasing, only 23 percent of voters think California schools have improved over the last few years, while 30 percent say schools gotten worse (35 percent say it’s stayed the same, which could either be negative or positive), according to a recent poll from Policy Analysis and California Education/University of Southern California Rossier School of Education.

These programs may deter some kids from smoking and encourage others to quit (although it never worked on me), and maybe a tobacco opponent would make an argument that lowered-tobacco/nicotine usage actually improved a school, but it would be stretch. To claim it’s “wrong to say ‘not one penny’ of the funding goes to improve schools” is absurd, unless The Bee is being both narrow and creative in its understanding of improvement.

It’s possible that proponents aren’t as concerned with the loss of potential education funding because of another measure on the November ballot, Prop. 55, which would extend a temporary tax on personal incomes of $250,000 or more to education and health care funding. The Legislative Analyst’s Office estimates this will generate between $4 billion and $9 billion per year until fiscal year 2030-31, with a little more than half going to education.

Tom Torlakson, the state superintendent of public instruction, co-wrote the ballot measure argument in favor of Prop. 55, arguing it would fund the hiring of more teachers, help with college affordability, help restore arts and music programs and help stave off cuts, among other things. “We can’t go back to the days of devastating cuts and teacher layoffs,” Torlakson and others wrote.

But despite the sky-is-falling argument on Prop. 55 (there would be a substantial loss of revenue if Prop. 55 fails), Torlakson wrote a letter in favor of Prop. 56, which, as the PolitiFact California fact-check noted, said: “Make no mistake, Proposition 56 will not divert a dime away from schools. Rather, it will raise revenues for school based tobacco prevention and intervention programs.”

The state’s top educator pleads with voters to bolster education funding to fight off “devastating cuts,” while he’s cavalier about the loss of a potential $600 million. There’s a chance the prospect of Prop. 55 passing helped him leave $600 million on the table.

The Bee writes: “This time around, Proposition 56 directs most of the tobacco tax revenue increase to Medi-Cal to raise reimbursement rates, which critics have long blamed for the state’s health care conundrum. Doctors say the financial reimbursements they receive for providing care to California’s most impoverished patients are too low to maintain a practice. The ‘wealthy special interests’ the ad refers to are doctors, clinics, hospitals, managed care plans and any other health-related group that get Medi-Cal payments because they provide services to eligible patients.”

There is big money at stake here. The Legislative Analyst’s Office estimates Prop. 56 could generate between $1.27 billion and $1.61 billion in revenue next fiscal year.

The ad says “most of this money goes to wealthy special interest groups, like insurance companies.” Medi-Cal, the state’s health care program for low-income residents, would receive the bulk of the Prop. 56 revenue, after certain requirements and programs are paid for.

Depending on how the money is actually divvied up in the budget process will determine whether “most” of the funding goes to insurance companies, like managed-care plans, although other health care providers, like doctors, clinics and hospitals, will get their share as well. 

In February, the Legislative Analyst’s Office estimated that in 2016-17, 75 percent of Medi-Cal beneficiaries are enrolled in managed care. 

The auditor found “that nearly 12 percent of California’s more than 79,000 foster children were prescribed psychotropic medications during the fiscal year 2014-15, whereas studies suggest that only about 4 to 10 percent of non-foster children are prescribed these medications.”

Even considering that “children in foster care … often have a greater need for mental health treatment,” the auditor points to serious concerns about possible over-medication, given these substances’ potential adverse side effects.

The key concern, raised by a five-part San Jose Mercury News investigative series beginning in 2014: “They are wrenched from abusive homes, uprooted again and again, often with their life’s belongings stuffed into a trash bag. … But instead of providing a stable home and caring family, the state’s foster care system gives them a pill. With alarming frequency, foster and health care providers are turning to a risky but convenient remedy to control the behavior of thousands of troubled kids: numbing them with psychiatric drugs that are untested on and often not approved for children.”

The auditor studied case files for 80 foster children in Los Angeles, Riverside, Madera and Sonoma counties and found that “many foster children had been authorized to receive psychotropic medications in amounts and dosages that exceeded the state’s recommended guidelines.”

Furthermore, the auditor found that “many of these children do not appear to have received follow-up visits or recommended psychosocial services in conjunction with their prescriptions.” And “counties did not always obtain required court or parental approval” before administering the drugs. The scathing report also pointed out that the current decentralized child-welfare system has reduced the state’s ability to oversee the process.

The most controversial legislation, which passed with a unanimous vote in the Assembly and which had only three “no” votes in the Senate, is Senate Bill 1174. The bill gives the Medical Board of California more power to investigate and prosecute “repeated acts of clearly excessive prescribing, furnishing or administering psychotropic medications to a minor without a good faith prior examination of the patient and medical reason.”

As the official Senate bill analysis points out, opponents believe “that initiating investigations as proposed will ultimately target prescribing physicians who specialize with patients with severe mental health difficulties” and would prefer a “review panel” by professionals who “could review outlying prescribing practices.” The California Medical Association, for instance, argues the bill will discourage physicians from working in these environments, according to a news report.

Senate Bill 1291 is mostly a record-keeping measure: “This bill would require annual mental health plan reviews to be conducted by an external quality review organization and, commencing July 1, 2018, would require those reviews to include specific data for Medi-Cal eligible minor and non-minor dependents in foster care, including the number of Medi-Cal eligible minor and non-minor dependents in foster care served each year.”

The final measure is Senate Bill 253, which also passed overwhelmingly. It requires that “an order authorizing the administration of psychotropic medications to a dependent child or a delinquent child in foster care be granted only upon the court’s determination that the administration of the medication is in the best interest of the child.” The main opposition to SB1291 and SB253 involved concerns over resource and budgetary matters.

These measures address, in part, the auditor’s call for a more “effective oversight structure” of drug prescriptions in the foster-care system. For instance, the auditor argues that counties should be better monitoring requests for such drugs; should “ensure court approval or parent consent prior” to their prescription; require that physicians follow up after such prescriptions; and “ensure proper mental health services are received along with psychotropic drugs.”

Three other related bills now are law. They require closer monitoring of psychotropic prescriptions at group homes and provide other expanded reporting and monitoring of such prescriptions. The main goal is to provide more oversight given the large percentage of foster-care children who are prescribed such drugs. As the Chronicle reported: “As many as 20 percent of foster children age 6 and older receive psychotropics, according to data compiled for senators.” And the state auditor found that more than a third of them had such drugs prescribed “without the required court approval.”

California’s reforms reportedly go further than those in other states. The governor’s decision on these three bills is well worth watching.

Steven Greenhut is the Western region director for the R Street Institute. He is based in Sacramento. Write to him at sgreenhut@rstreet.org.

Legislators’ new campaign slush funds

Good morning. Happy Monday. Legislators begin another week of whittling down the seemingly never-ending piles of bills left to consider before the session ends later this month.

But a new report highlights what many of the legislators have been doing outside of the building.

“Hamstrung by strict limits on political contributions, California lawmakers have found a way to continue to extract large sums from some of Sacramento’s most powerful special interests.”

• “A casino operator has hired former Rep. Gary Condit’s firm to lobby the state Legislature at a time when the legislative panel overseeing gambling issues is chaired by Condit’s son-in-law,” writes the Los Angeles Times.
• How two Republican state legislative candidates in tight races are running from GOP presidential nominee Donald Trump, from The Orange County Register.
• “The government spends more than $1 billion annually on California teeth, offering dental coverage to 13 million low-income residents who qualify for Medi-Cal services. But, most California dentists refuse to participate in the Denti-Cal program, leaving patients with impossible wait times that lead to expensive health consequences,” reports Capital Public Radio.
• “A 2014 California voter-approved initiative that reduced penalties for certain drug and property crimes has led to the lowest arrest rate in state history as police frequently ignore those illegal activities, experts say,” reports The San Jose Mercury News/AP. 

Assembly:

• In at 1 p.m.

Senate:

• In at noon. 

Gov. Brown: 

• No public events announced. 

Tips: matt@calwatchdog.com

Follow us: @calwatchdog @mflemingterp

New follower: @DilTown

Seventeen total. And while voters will read and learn more as the campaigns unfold between now and Election Day, here is a quick reference guide to get your bearings. 

Referendum to Overturn Ban on Single-Use Plastic Bags: This is as it sounds. In 2014, the Legislature passed a ban on single-use plastic bags. So a “yes” vote would uphold the ban. A “no” vote would overturn it.

To uphold the law would ban the use of single-use carryout bags, except for perishable items. It would also impose a fee of at least $.10 per paper bag or thicker plastic bag if the customer didn’t provide a reusable one. 

The ban actually died on the Assembly floor in 2014 three days before it passed. What changed? A deal was struck between the United Food and Commercial Workers Union and Safeway creating the $.10 fee, which will be kept by the grocer/retailer.

Plastic Bags, Part II: If the plastic bag ban is upheld by voters, this initiative would divert the $.10 fees for bags to a state fund to pay for environmental programs. This would be in lieu of the money going to the grocers.

Campaign Finance (Poll): This is basically just an elaborate poll. It’s a non-binding measure that allows voters through the ballot process to log their approval or disapproval of campaign finance law in the country.

A similar measure got tied up in court in 2014, as opponents called it a ploy to drive voter turnout. But in January, the state Supreme Court ruled it was allowable, and so here it is. 

Specifically at question is the 2010 Citizens United ruling where the U.S. Supreme Court allowed for corporations and labor unions to spend unlimited sums in support or opposition of a political candidate. 

Guns and Ammo: This is Lt. Gov. Gavin Newsom’s pet project. This would ban magazines of 11 rounds or more, require background checks for ammunition and require the state to share data in the FBI’s background check system, among other things.

However, a bill passed by the Legislature on Thursday but not signed yet by Gov. Jerry Brown would amend this ballot initiative (yes, it amends something that isn’t yet law) to further limit who can purchase ammunition to both persons whose data matches up with the Automated Firearms System and to those who have a ammunition purchase authorization. There are some exceptions. 

Naturally, this sidestep of Newsom to amend his measure ruffled his feathers, dragging him and Senate President Pro Tem Kevin de Leon, the bill’s sponsor, into a public disagreement. 

“This last-minute, anti-democratic, poison pill sneak attack makes you wonder if the Pro Tem cares about himself more than he cares about doing the right thing,” said Newsom spokesman Dan Newman, according to The Sacramento Bee. “Is he someone who truly respects the will of the voters and wants to reduce gun violence or is he merely a self-serving cynic completely consumed with petty personal grudges?”

Death Penalty Repeal: This repeals the death penalty as the maximum punishment for murder and replaces it with life without parole, applying retroactively to those already sentenced to death.

This has a provision mandating those who’ve been sentenced to life without parole to work, with 60 percent of their income possibly going towards restitution to victims. 

The Opposite of a Death Penalty Repeal: And for those who think the death penalty should stay as the ultimate sentence for murder, this measure would speed up the process by implementing a time limit on the lengthy appeals process, by assigning the superior court for the initial review and by limiting the number of successive petitions. 

Like the competing measure, this would impose a work requirement for restitution to victims.

Drug Pricing: This would set pharmaceutical prices for any state agency to be as low as what the U.S. Department of Veterans Affairs pays — the VA benefits from federally mandated cost controls.

According to KPCC, the measure would apply to “any program in which the state is the ultimate payer for a drug,” which includes: Medi-Cal fee-for-service plans, CalPERS (provides health benefits to current and retired state employees), prison inmates and people receiving AIDS drugs from the government.

Condoms in Porn: This may as well be called the Condoms In Porn Act, because it would require porn actors to wear condoms during the filming of sexual intercourse.

It also requires that producers provide testing and vaccinations for STDs. And for what it’s worth, producers would also have to post the condom requirements at the job site.

No Blank Checks Initiative: This would require any bond of $2 billion or more for a state project to go before the voters for approval.

As dull as that sounds, it could have a dramatic impact on Gov. Jerry Brown’s legacy, in that it would likely put funding for the bullet train and the twin tunnels water project up to a vote of the people. 

School Bond: This would authorize $9 billion in bonds for school construction and modernization, supported by a coalition of school districts and school developers. Pretty self-explanatory.

The measure failed to qualify in 2014, however, amid opposition from Gov. Jerry Brown, who said at the time local school construction was best left up to local control.

Earlier this year, Brown reiterated his opposition, calling the initiative a “blunderbuss effort that promotes sprawl and squanders money that would be far better spent in low-income communities,” according to EdSource.

FYI: Blunderbuss is a “blundering person,” according to Merriam-Webster. It’s also an old fashioned, muzzle-loading gun. 

Prop. 30 extension: This is a 12-year extension of Prop. 30, which was a seven-year temporary tax on earnings of more than $250,000 annually to bolster education funding, with the extension coming two years early.

Prop. 30 passed to stave of imminent sharp cuts in education. Now that the economy has recovered, proponents want to keep the money flowing and now hospitals want a cut too.

The extension would allow a quarter-cent sales tax that was part of Prop. 30 to expire, but would add up to $2 billion in funding per year for Medi-Cal, the state’s Medicaid program. 

As part of Prop. 30, the program was supposed to receive several layers of accountability, including a state-run audit of the fund that doles out the money to schools that still hasn’t happened. The controller’s office previously told CalWatchdog the audit would likely happen before voters have to decide.

California Legislature Transparency Act: The CLTA is a constitutional amendment requiring the Legislature to make available online the final version of a bill at least 72 hours prior to a vote on either the Assembly or Senate floor. It would also require all open legislative meetings be recorded with the videos posted online within 24 hours and would give permission to individuals to record and share their own videos of open meetings.

Assembly Speaker Anthony Rendon, D-Lakewood, is currently negotiating with CLTA proponents over changes proposed by the Legislature — but the negotiations are not going well. 

Multilingual Education: This would repeal most of Prop. 227, which in 1998 placed heavy restrictions on bilingual educations for English learners in favor of English-immersion education.

Why would voters overturn their prior decision? Education Week framed the debate well. Proponents argue new data shows the value of bilingual education, native English speakers would be allowed access to a bilingual education (if they choose), and because we live in a different world with rapidly changing demographics. 

Why would voters keep Prop. 227 on the books? Ron Unz, a former candidate for U.S. Senate and governor who pushed for Prop. 227, argued that an overall improvement over a year-period in standardized test scores shows Prop. 227 worked. And others would likely make a nativist argument: This is America, and residents should learn English. 

Medi-Cal Hospital Reimbursement: This one is a little confusing. The federal government contributes to the state’s health care program for low-income patients, called Medi-Cal. In order to get this money, the state has to contribute matching funds.

In 2009, the state passed a law taxing hospitals to help contribute to the state’s portion of the Medi-Cal funding to get the money from the feds. However, the state was diverting some of this money into the general fund.

So, this measure amends the state Constitution requiring these funds go to where they are intended.

It would require a two-thirds vote of the Legislature to amend the fee allocation program only when the changes would “amend or add provisions that further the purposes of the Act.” It would require voter approval to repeal or replace the program with a “similar statute imposing a tax, fee or assessment unless that similar statute is either.”

Sentencing overhaul:  Jerry Brown’s baby. After surviving a legal challenge and rumored sky-high signature collecting fees, this bill made it to the ballot just before the deadline. 

Brown’s measure would allow for some nonviolent felons to be paroled early in certain instances, require judges to hold hearings prior to determining whether to try juveniles as an adult, and develop a good behavior, parole-and-sentence credit system for prisoners. 

Marijuana Legalization: This would allow individuals, 21 and older, to transport and use up to an ounce of recreational pot. It would allow individuals to grow as many as six plants.

If approved, California would join Alaska, Colorado, Washington and Oregon in allowing recreational pot. 

Tobacco Tax: If this passes, smokers would pay a $2-per-pack tax on cigarettes, with a similar increase on other tobacco products and e-cigs containing nicotine. The money will go primarily to healthcare and anti-smoking/tobacco-related health programs.

Editors Note: The American Progressive Bag Alliance sponsored a media dinner hosted by Calwatchdog to discuss and debate the plastic bag ban with journalists in Southern California.