Doctors, nurses and insurers are spending big to determine how you'll get your health care

Insurers, doctors and nurses are spending millions on lobbying and donations to lawmakers' campaigns in the current legislative session, battling over costly large-scale changes as they await Gov. Jerry Brown's successor.

Major health industry groups have spent more than $18 million on lobbying, according to an analysis by The Sacramento Bee, in an effort to kill or water down bills proposed to rein in rising health care costs and impose new regulatory requirements for insurers and health plans.

The spending, similar to levels in the prior legislative session, foreshadows a costly and thorny political debate in the years ahead. Democrats are seeking to protect coverage gains made under Obamacare, expand access to care for the low-income and undocumented, lower premium costs and blunt broader changes to the health care landscape pushed by the Trump administration that they see as a threat to their long-term goal of universal coverage.

Brown has resisted spending the money it would take to implement the changes. Assembly Democrats proposed 16 major health care bills after the leader of the Assembly shelved a bill out of the Senate that sought to create the nation's first single-payer health care system, leading to a bruising political fight among lawmakers and health care groups. The budget Brown signed this month doesn't include funding for the most far-reaching, high-dollar ideas.

But their agenda sets the stage for another push under a new governor, one aimed at undertaking major reductions in the overall cost of health care, imposing industry price controls, creating new government subsidies, improving the affordability of coverage and expanding access to those currently uninsured.

Lt. Gov. Gavin Newsom, the frontrunner in the governor's race, has teed up his own prescription for what he sees as today's most pressing problem in health care: rising costs. He has called for a new system that covers everyone regardless of immigration status or ability to pay, and for the state to begin analyzing whether a single-payer system would work to lower costs in the nation's largest state.

"These are the makings of a big health care debate in Sacramento next year, with groups lined up on all sides of these issues, and a likely new governor who has taken a very public position," said Larry Levitt, senior vice president of the Kaiser Family Foundation, a nonprofit health research organization not affiliated with Kaiser Permanente.

Should Newsom win, as polling suggests is likely in the heavily Democratic state, he will also contend with these forces. He has endorsements from the California Nurses Association and the California Medical Association, often on warring sides of the health care debate.

"In the last couple years, there's been a lot of talk about dramatically remaking the health care system in California, so it certainly won't be a surprise to see industry groups ramping up their advocacy and lobbying efforts," Levitt said. "These are very big and powerful industries, including hospitals and providers and drug manufacturers and insurance companies."

The six Democrats who this year put forward major proposals out of the Assembly have accepted sizable, and in some cases maxed-out, campaign contributions from health care industry groups opposed to major changes, according to a campaign finance analysis by The Bee and MapLight, a nonprofit research organization that tracks money in politics.

Assemblyman Joaquin Arambula, D-Fresno, and Assemblyman Jim Wood, D-Healdsburg, who led efforts in the Assembly to craft an alternative to the single-payer bill, accepted the largest amount in campaign contributions from health insurers, doctor and hospital groups and the pharmaceutical industry.

Arambula has taken more than $48,000 into his 2018 campaign account through the end of June, and Wood has accepted $45,000, according to the analysis.

The four other lawmakers — Assemblywoman Autumn Burke, D-Marina Del Rey, Assemblyman Ash Kalra, D-San Jose, Assemblyman David Chiu, D-San Francisco, and Assemblywoman Laura Friedman, D-Glendale — accepted $32,900, $18,800, $18,500 and $9,600, respectively.

The practice is common, and is one measure of the industry's effort to influence California politicians. Health care activists complained that their proposals were too conservative and piecemeal. The lawmakers said they weren't swayed by the money.

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https://www.sacbee.com/news/politics-government/capitol-alert/article214099429.html