On Your November Ballot: Prop 34 Aims to Expand Medi-Cal Prescription Drug Funding — With Restrictions

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Pharmacist, hands and box for drugs with document at shelf for medicine, check and inventory for health. Person, employee and container for prescription, search and pharma paperwork for pills at shop. PHOTO: California Black Media // Shutterstock

By Edward Henderson, California Black Media

In less than two months, Californians will vote on Proposition (Prop) 32. This voter guide is one in a series of articles that will help you understand what supporters and opponents of each of California’s 10 ballot initiatives are saying about each one.

Prop 34 would permanently allow Medi-Cal, California’s version of the federal Medicaid program, to pay pharmacies directly for prescription drugs.

California started doing this in 2019 after Gov. Newsom signed an executive order allowing the payments. This initiative would codify the executive order into state law. The measure would also require healthcare providers to spend almost all the money (98%) they get from a federal prescription drug program directly on patient care — instead of having the leverage to use it on other things.

Prop 34 would increase the money that comes to California for Medi-Cal prescription drugs with a matching federal subsidy. However, it will restrict healthcare organizations and non-profits from spending that money on other health care-related social services.

Supporters of the proposition argue that, if approved, providers would be held accountable for their spending and provide more affordable care to individuals who need it. California Black Media (CBM) spoke to Elizabeth Helms, President and CEO of the California Chronic Care Coalition (CCCC), who has endorsed a YES vote for Prop 34.

The CCCC is an alliance of multiple patient organizations and provider groups with a focus on access to quality, affordable health care, wellness and prevention, and coordinated care.

“We are patient-centric,” said Helms. “We care that people are able to access the care that they need, including their medications, seeing physicians. And when we see that not happening, or we start hearing it from the field that (people are) having problems, (people) can’t do this, (people) can’t afford this, (people) can’t get timely care; you know, (people are) having to choose food over medicine or all these other things. Proposition 34 is important. Especially to people who need care, who can’t get it.”

Some of those opposed to the proposition argue that the only reason it is on the ballot is to personally target The AIDS Healthcare Foundation (AHF) and their CEO Michael Weinstein, who supports rent control legislation. The California Apartment Association Issues Committee has provided $21.3 million in campaign support for the measure.

CBM spoke to David Kline, Vice President of Communications & Research at California Taxpayers Association who supports a NO vote for Prop 34.

“This is 100% financed by billionaire landlords and the California Apartment Association, and they don’t have an interest in health care,” said Kline. “This is a revenge initiative, a revenge against AIDS Healthcare Foundation for supporting rent control. And they’ve been very explicit on their website and videos they’ve put out about that have had at. But they don’t mention the AIDS Healthcare Foundation in their argument because they know how popular the organization is. This is a wolf in sheep’s clothing.”

The proposition only applies to providers who spend at least $100 million on expenses other than direct care, that also own and operate buildings and that least 500 severe health and safety violations in the last 10 years. These stipulations have led many to believe it is aimed at The AIDS Healthcare Foundation because they are one of few organizations who meet these criteria

“(Passing Prop. 34) would have a terrifying chilling effect,” said Kline. “What organization, you know, nonprofit would be safe who was speaking truth to power? I mean, taking on these billionaires, if they knew that all that they had to do was to put something on the ballot to take away their nonprofit status and remove their licenses?”

When asked about their thoughts on the involvement of Prop 34 and a focus on Weinstein, the CCCC did not have a comment, reiterating that their focus is “100% on patients” and directing as much funding as possible to their wellbeing.

“The proposition does several things,” said Helms. It protects up to $2 billion in prescription drug rebates for the state of California annually. And these rebates will help offset the cost of the Medi-Cal program, protect access to critical services for millions of low-income patients. It prevents the worst abusers of the 340B program from misusing money that is supposed to be used to help patients.”

A YES vote on this proposition would require Organizations like the AHF to spend nearly all of their money only on healthcare and no other endeavors.

A NO vote would repeal the proposition and keep things the way they already are.