CAMPAIGN ’96: SUPPORT LAGGING FOR CA HMO PROPOSITIONS

      "If there is a groundswell of consumer discontent about
 managed care," Californians are "out of the action" as most of
 them "seem barely aware" of two ballot initiatives designed to
 regulate managed care and ensure quality care.  WALL STREET
 JOURNAL reports that polls suggest Propositions 214 and 216 are
 "headed for easy defeat."  A statewide Field Poll conducted this
 week found that 46% of Californians would vote against both
 propositions, and individually each measure had less than 30%
 support.  While there are differences, both measures would end
 "gag" clauses, ban financial incentives for doctors to limit
 health care and only allow health care professionals to deny care
 (see AHL 9/13).  JOURNAL reports that the lack of support for the
 measures "reflects confusion about which measure is which and
 what each would do."  More importantly, according to the JOURNAL,
 "there doesn't appear to be a sense of outrage against managed
 care in California, where 58% of the population is enrolled" in
 HMOs.
      CONCERNS:  Voters may not be inclined to support the
 measures because proponents of the two initiatives "seem to
 devote as much energy attacking each other as they do their
 mutual opponents."  Another "blow" to the initiatives' public
 support came when the state's nonpartisan legislative analyst
 said that both propositions would "raise the cost of state and
 local governments' health programs 'in the range of tens of
 millions to hundreds of millions of dollars annually.'"  Drew
 Altman, president of the Kaiser Family Foundation, said, "That
 kind of language is guaranteed to produce a 'no' vote these
 days." 
      WHAT'S HAPPENING:  A "lesson of the California election, may
 be that the whole issue has limited voter appeal," according to
 the JOURNAL.  Voters are "more worried about the security of
 their medical coverage than about quality," at least in states
 where most residents are in managed care plans, JOURNAL reports. 
 Altman said, "People are worried about rising medical costs and
 losing their insurance."  Robert Laszewski, a health care
 consultant, said that because quality regulations play well with
 voters while appearing to not increase spending, they are "the
 cheap political date in health care" (Rundle/McGinley, 10/31).