November 10, 2014
Area(s) of Interest: MICRA Payor Issues and Reimbursement 

CMA Capitol Insight is a biweekly column by veteran journalist Anthony York, reporting on the inner workings of the state Legislature.

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A Good Night for Doctors

Election 2014 will be remembered nationally as a good night for the Republican Party. In California, one undeniable narrative is how good the night was for California doctors.

The California Medical Association (CMA) led the charge to beat back Proposition 46, which would have boosted health care costs by raising the cap on medical malpractice awards. Voters resoundingly rejected the measure, likely putting an exclamation point on the issue for the next several years. Trial lawyers have now failed in the Legislature and the ballot box to boost their fees in malpractice cases. Additionally, CMA continues to defend the Medical Injury Compensation Reform Act (MICRA) in the courts.

CMA was also part of a coalition that helped defeat Proposition 45, which would have given the insurance commissioner unprecedented power to regulate health insurance rates. The measure was opposed by a broad coalition including health plans, hospitals, doctors and even Nancy Pelosi. Despite the official endorsement from the state party, many Democrats (including the House Minority Leader) came out against the measure, saying it could imperil the further implementation of the Affordable Care Act.

In Sacramento, Dr. Richard Pan won a hard-fought race against fellow Democratic Assemblyman Roger Dickinson. And CMA’s own Chief Strategic Officer, Jay Hansen, even won his election to the board of the Sacramento Unified School District.

Elsewhere, Republicans took advantage of a traditional dip in midterm turnout and some big spending in targeted races to pick up enough legislative seats to end Democrats’ supermajorities in both houses.

The GOP picked off two Democratic Assembly incumbents – Steve Fox, D-Palmdale, and Sharon Quirk-Silva, D-Fullerton — and appear headed to unseat a third – freshman Assemblyman Al Marutsuchi, D-Torrance.

It’s a sign of how much has changed in this state over the last two decades when Democrats can win 52 Assembly seats and 26 Senate seats, not to mention sweeping all statewide offices yet again, and still be seen as having a bad Election Night.

Twenty years ago, Californians passed mandatory sentencing laws and the “three strikes law.”. This year, they passed Proposition 47, which will reduce prison terms for thousands of inmates. So it goes.

For the California Teachers Association (CTA), one of the most powerful political players in the state and a crucial piece of the Democrats’ base, Election night brought a mixed bag. The CTA’s contender for state school superintendent, Tom Torlakson, won his race, but in the East Bay, the story was different.

There, Republicans scored big wins in Contra Costa County, where Catherine Baker upended Democrat Tim Sbranti, a board member of the CTA’s own political action committee and a top priority for labor this cycle. And Republicans seemed poised to knock off Muratsuchi, giving the party its only legislative seat whose boundaries are entirely within Los Angeles County.

For Republicans, amid their nascent rebuilding and with Chairman Jim Brulte at the helm of the party in his first election cycle, there is fodder to string together a positive narrative. Whether this is the beginning of a sustained GOP comeback is less clear.

Election 2014 also adds another batch of data for us to consider the impacts that the top-two primary and independent redistricting are having on California politics.

When Republicans retook the seats held by Quirk-Silva and Fox, they reclaimed turf that Democrats briefly captured during the 2012 Obama landslide.

In the Senate, Republicans defended their vulnerable incumbents, while picking up an open seat in Orange County, keeping Democrats below the vaunted two-thirds supermajority in that house.

While the supermajority may be a symbolic victory for the GOP, it’s unclear what real world consequences the new margins may have. The budget is still a majority-vote endeavor, and many of Gov. Jerry Brown’s initiatives that required two-thirds vote – the water bond and rainy-day fund come to mind – wound up with wide bipartisan support.

The real importance of the supermajorities is that while the budget can be approved with a simple majority, it takes two-thirds votes to raise taxes.

That means that any kind of tax package, whether it’s an extension of Proposition 30 or some tweak of Proposition 13, will need to be put on the ballot by voters’ signatures instead of by the Legislature, and it may accelerate the timeline and price tag of getting those measures on the ballot.

But Brown has proven incredibly stingy with his political capital and had already signaled that he was unlikely to support those reforms publicly next year.

The tax fight is coming, and Democrats and their allies know that 2016 is the time to have it. Last week’s results simply means one unlikely route to the ballot has been officially closed off.

Meanwhile, electoral reforms passed by voters in the early part of the decade continue to change the political formulas and landscape in California. We now have competitive races in November.

Seats that changed hands last week will likely be multi-million dollar battlegrounds in 2016, as will some other seats where demographics are trending away from the GOP.

We also see the new term limits rules shifting the experience mix in the Legislature. Five of the 20 Senators who were elected this week have no previous legislative experience. For decades, the Senate had been a sort of graduate school to the Assembly’s undergrad. Moving houses was viewed as a type of promotion.

No longer. While we had a large freshman class in the Assembly this year, it was one of the last ones we’ll have for a while, as many Assemblymembers forego Senate runs in favor of staying in their Assembly districts for their entire 12 years of eligibility. The introduction of the Senate learning curve creates a new dynamic in the “upper house” and a new set of challenges for new Senate leader Kevin DeLeon.

The changes have also given us a couple of wildcards.

The biggest surprise of the night was Democrat Raul Bocanegra’s struggles against a political unknown, Patty Lopez. Bocanegra, a prolific party fundraiser who was in line to become the next chairman of the Assembly Utilities Committee, was trailing as of Wednesday morning against Lopez, a community activist who spent literally no money on her campaign according to the Secretary of State’s Web site, and whose only campaign videos online are in Spanish.

But Lopez is a Democrat, and under the new primary rules, she advanced to the fall runoff against Bocanegra by finishing second in the June primary. Under the old rules, Bocanegra would have been running against a Republican and sailed to reelection in his solidly Democratic San Fernando Valley district. Now, his fate will be determined by provisional ballots, lawyers, recounts and the like.