State and federal
law mandates that emergency care be provided to any person, regardless of their
ability to pay. Clinics, hospitals, and physicians providing emergency care
are often uncompensated, although the amount of the shortfall is not known.
Proposition 67, the Emergency Medical Services Initiative, seeks to fund uncompensated
emergency care from new and existing revenue sources.
Proposition 67
would generate over $500 million in new revenue for emergency care by expanding
the current tax on in-state telephone calls (presently up to .075% of a customer's
monthly bill) by an additional 3%, with the funds being directed to a new 911
Emergency Trauma Care Fund. The added 3% surcharge on telephone use would be
capped at $0.50 per month for residential service, but the cap would not apply
to business and cell phone lines. The Legislative Analyst's Office estimates
an initial $500 million in new state revenues from the measure.
Proposition 67
would also redistribute some existing revenue and change the way that revenue
is administered. Under present law, each county in California is allowed to
create a Maddy Emergency Medical Services Fund using revenues from criminal
fines and penalties. Monies from Maddy funds must be disbursed according to
a specified formula to physicians, hospitals and emergency medical services
programs. Proposition 67 would require all counties to establish Maddy funds.
Administration of the funds would be shifted to the state although individual
counties could request permission from the state to administer specific Maddy
fund accounts.
Presently, California
allocates about $32 million in revenue from Proposition 99 cigarette taxes to
pay for uncompensated medical care. Proposition 67 would lock in the Proposition
99 allocation at the current $32 million level. Over time, this would have the
effect of reducing Proposition 99 revenue for other state programs, since Proposition
99 revenue is declining.
Proposition 67
proponents contend that California is facing a crisis in emergency care. They
note that dozens of emergency rooms and trauma centers have closed across the
state in the past decade, and that more will close unless new funding is made
available. Inaction, they say, means increasingly longer trips to crowded and
understaffed emergency rooms. They view the added tax on phone service as modest
and note that low income phone customers are protected by the $0.50/month cap
on new surcharges for residential phones and by the total exemption of lifeline
rates from the tax increase.
Proposition 67
opponents contend that a $500+ million tax increase is not modest and point
out that there are no caps or exemptions for cell phones or business lines.
In the Official Voter Information Guide opponents argue that "90%
of the funds [would] go to large health care corporations and other special
interests," with no guarantee that new emergency rooms would be provided
or emergency response times reduced.
Official Voter Information
Via the California Secretary of State. The text, legislative analysis and ballot arguments are
from the Official
Voter Information Guide. Campaign finance data is from the
Cal-Access database of campaign receipts
and expenditures.
Text
Legislative Analysis and Ballot Arguments
Campaign Finance:
Individual Campaign Committees
Total Contributions and Expenditures (select "Nov. 2004 election" and "Prop. 67" in dropdown boxes)
Public
Interest Sites
League of Women
Voters of California Education Fund
Impartial analysis of Proposition 1A: In
Depth and Pros
and Cons
California Journal
Ballot
propositions: Analysis of the November propositions by California Journal editors in their October issue.
HealthVote2004.org
HealthVote2004.org provides voters with facts and non-partisan analysis, as
well as easy access to information on who supports and opposes the measures,
who is paying for the campaigns, how much is being spent, results of statewide
polls, and the latest news. HealthVote2004.org is a collaboration between
two non-partisan, non-profit organizations-the California HealthCare Foundation
and The Center for Governmental Studies.
Advocacy
Sites
Coalition to Preserve Medical Care
Pro Proposition 67. Site has a list of endorsements, including the California
Emergency Nurses Association, the California Medical Association, and the
California Primary Care Association.
Californians
to Stop the Phone Tax
Anti Proposition 67. Site includes a list
of organizations and individuals opposed to Proposition 67.
"Health-Related Propositions: Support for Prop. 71, Stem Cell Research Bond, continues to grow. Voters moving to the No side on Prop. 72, Health Insurance Requirements," Field Poll, Release #2147,
October 31, 2004.
"Los Angeles
Times Poll Excerpts," Los Angeles Times Poll, Oct. 20, 2004.
Responses to questions on Propositions 63, 66, 67, and 71.
Los Angeles
Times Poll
"Health-Related
Propositions: Prop. 72 (health coverage) ahead by 16 points. Prop. 61 and
63 also lead, but Prop. 67 trails," Field Poll, Release #2140,
October 12, 2004.
"Voters sharply
divided on stem cell research bond measure: favor two other health-related
propositions but oppose a fourth," Field Poll, Release #2130,
August 15, 2004.
In this poll, conducted July 30-August 8, 2004, likely voters opposed Proposition
67 47% to 37%.
Halper, Evan.
"Few Heed Call for Phone Bill Tax: Foes of Prop. 67 say hospitals should
look elsewhere for money to fund emergency care," Los Angeles Times,
Oct. 25, 2004.
NewsBank
(UCB)
Saunders, Debra
J.
"Yes on 67," San Francisco Chronicle, Oct. 24, 2004.
San
Francisco Chronicle
Garvey, Megan.
"Voters Favor Scaling Back 3-Strikes Law: A decade after passing strict
sentencing rules, most want changes. They also support a stem cell research
measure, one of 16 on the ballot," Los Angeles Times, Oct. 20,
2004.
NewsBank
(UCB)
Lucas,
Greg.
"Prop. 67 a call for help from medical workers: Higher phone surcharge
would help fund emergency rooms, doctors, firefighters," San Francisco
Chronicle, Oct. 20, 2004.
San
Francisco Chronicle
Benson, Clea.
"Prop. 67 phone tax would fund ERs: Measure is backed by doctors' groups
to shore up urgent care," Sacramento Bee, Oct. 12, 2004.
Sacramento
Bee
Hubbell, John
M.
3 out of 4 health care measures doing well: Prop. 72 still ahead in new poll
despite governor's opposition," San Francisco Chronicle, Oct.
12, 2004.
San
Francisco Chronicle
Snyder, Marc A.
"PROP. 67 An Opposing View: A small price to keep a vital safety net
intact," San Francisco Chronicle, Oct. 12, 2004.
San
Francisco Chronicle
[Opinion]
"Reject the Phone Tax," San Francisco Chronicle, Oct. 3,
2004.
San
Francisco Chronicle
"What Would
Proposition 67, The 911 Emergency and Trauma Care Act, Mean for California?"
California Budget Project Budget Brief, August 2004.
California Budget Project
Colliver, Victoria
"Emergency rooms feel fiscal pain: uninsured patients cost hospitals,
docs millions, study says," San Francisco Chronicle, Sept. 22,
2004.
San
Francisco Chronicle
California Medical Association
A system
in continued crisis: CMA's annual ER losses report. Eureka: California
Medical Association, Sept. 2004.
[Opinion]
"Vote yes on Prop. 61, but no on 67 and 72," San Jose Mercury
News, Sept. 8, 2004.
NewsBank
(UCB)
Nevius, C.W.
"Don't stake life on care coverage," San Francisco Chronicle,
Aug. 17, 2004.
San
Francisco Chronicle
Wells, Annette.
"Prop. 67 call surcharge to target care crisis," The Sun (San
Bernardino), Aug. 16, 2004.
NewsBank
(UCB)
Smith, Dan.
"Static on the line for phone-tax proposal," Sacramento Bee,
Apr. 26, 2004.
NewsBank
(UCB)
