Proposition 29: California voters say no to controversial new dialysis requirements

California attempted for the third time to pass a controversial dialysis measure that would have required that a physician, nurse practitioner, or physician assistant be present on site while a patient is undergoing dialysis treatment, and should have at least 6 months of experience providing care to patients with end-stage renal disease.

Proposition 29 would have mandated that physicians report dialysis-related infections and specify whether or not the physician has a financial stake in the clinic. If passed, clinics that fail to provide reports would have been slapped with $100,000 fines.

It also would have added a provision that dialysis providers cannot discriminate against a patient’s ability to pay for services.

Supporters argued that extra precautions are needed to ensure that if something goes wrong during dialysis, an hours-long treatment, a provider will be nearby to help them. They also argued that for-profit dialysis clinics are opposed to these rules because it would cut into their billion-dollar profits.

No Prop 29, which was against the amendment, included Fresenius and DaVita, two of the largest dialysis providers in the state. The California Medical Association, the California Republican Party, and the California Chamber of Commerce were also against this measure.

Opponents said dialysis clinics will be forced to charge patients more or close because of the expanded costs of care. The state’s Legislative Analyst’s Office estimated that Proposition 29 will increase costs for dialysis clinics.

They also argued that if clinics shut down, patients will not receive the care they need, which could negatively affect their health.

As of November 6, about $7.9 million was raised in support of the measure by Service Employees International Union-United Healthcare Workers West, while $86.4 million — mostly from Fresenius and DaVita — was raised against the measure, according to the Los Angeles Times.