Proposition 29: Dialysis industry defeats challenge at ballot box, for the third time

Proposition 29 has been defeated. As election results roll in Tuesday evening the “Yes” vote was trailing by 40 points. If the results hold, the dialysis industry will have successfully defeated new regulations at the ballot box for the third election in a row.

Dialysis clinics are where about 80,000 Californians with kidney disease go to get treatments two to three times a week, an expensive and life-saving procedure.

Proposition 29 was the latest attempt by the Service Employees International Union-United Healthcare Workers West union (SEIU-UHW) to impose new regulations, even after voters rejected the union’s attempts twice before, in 2020 and in 2018.

The spending trends by each side were telling: The dialysis companies spent over $100 million in 2018 and again in 2020. This time, as of late October 2022, they had poured $86 million into opposing Proposition 29, but the union hardly campaigned for the measure this year, since getting it on the ballot.

The two companies that dominate the industry in California, DaVita and Fresenius, operate three-quarters of the 600 clinics in the state. The industry brings in an estimated $3.5 billion in revenue from operations in California annually.

The California Legislative Analyst’s Office predicted the measure “would increase each clinic’s costs by several hundred thousand dollars annually on average,” and the dialysis companies said the added regulations and associated costs would force them to close clinics.

The “No on 29” campaign, backed by the dialysis companies, said the union was abusing California’s direct democracy system, trying to push the companies to the negotiating table and gain leverage. But the union said the dialysis industry is making huge profits off vulnerable patients, and cutting corners that endanger patient safety.

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