How is money shaping California health policy?

I’ve begun looking into how campaign contributions are shaping health policy in California.  And yes, I know the appropriate response to that sentence is:  Good luck with that!

Yet given the enormous changes that are underway in health policy, and with California taking arguably the lead position nationally, this ambitious question is worth an answer or two. 

The approaching convulsions of the Affordable Care Act will fundamentally change the way many Californians are insured and how they obtain medical care.  So what role do the millions of dollars going annually to California state Senate and Assembly members play in these big changes?

I had begun to look at some numbers when I recently heard a former state health official talk about how lobbyists increasingly are gaining clout in determining health policy in Sacramento.

So I’m even more intrigued about what’s happening, and I’m writing this now to seek reader thoughts on how money is shaping health policy in California.

Here are three trends that show up in very early research:

-- Over the last 10 years the amount of money being spent on state legislative campaigns from health interests has gone up significantly.  That’s probably not much of a surprise.  But two other things are more intriguing.

-- There’s been a big shift of money in favor of Democratic candidates.  This is a bit of a puzzle, at this point in my reporting, because Democrats have only slightly increased their majorities in the state Senate and Assembly.  Why then such a big shift in favor of Democrats?

-- Another big change is that much more money now flows to Assembly candidates than to Senate candidates.  On the one hand, this makes sense, since there are twice as many Assembly members.  But why, then, 10 years ago, were campaign contributions pretty equally distributed between Senate and Assembly members?  What caused the shift?

Those are some early findings.  Ultimately, I want to see how campaign contributions are shaping health policy, and how this has changed over time.  And are there cases where money is causing bad health policy to happen?

Comments welcome here, or email me at

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