The survey of 986 likely voters, conducted earlier this month, found Becerra leading with 23% support, followed by Hilton at 20%. Democrat Tom Steyer was at 15%, Riverside County Sheriff Chad Bianco at 13% and former Rep. Katie Porter at 12%.

The numbers are especially significant in California’s top-two primary system, where the two candidates with the most votes advance to the November election regardless of party. For months, the crowded Democratic field raised the possibility that two Republicans — Hilton and Bianco — could finish first and second, shutting Democrats out of the general election.

Becerra, a former California attorney general who later served as health secretary under President Joe Biden, has gained ground since U.S. Rep. Eric Swalwell left the race amid allegations of sexual misconduct.

Jonathan Underland, a spokesperson for Becerra’s campaign, said the poll reflects growing support for the former Biden administration official.

“Becerra has built real momentum — strong poll numbers backed by working Californians who are energized and ready,” Underland said.

Steyer’s campaign disputed the PPIC survey’s findings in a written statement, arguing that the poll failed to capture recent gains for the liberal billionaire. The campaign pointed to its own internal tracking and to another poll conducted for Hilton.

The PPIC poll also offered a broader look at California voters’ mood ahead of the midterm elections, which will determine control of Congress during the final two years of President Donald Trump’s second term.

Three-quarters of likely voters said the country is moving in the wrong direction, the highest share recorded by PPIC in more than 20 years. While 92% of Democrats expressed that view, so did 50% of Republicans. The share of Republicans who said the country is headed in the right direction dropped from 64% in a February PPIC poll to 49% in the latest survey.

The poll also showed a strong advantage for Democrats in congressional races. If the midterm election were held today, 64% of likely voters said they would support the Democratic candidate in their local U.S. House race, compared with 35% who said they would vote for the Republican candidate. Those findings could signal trouble for Republicans as they try to keep control of the House of Representatives.

Younger voters are another group drawing attention in the election. Californians under 29 make up nearly one-fifth of the state’s eligible voters, and many cite concerns about inflation, health care and housing as they weigh their choices.

In a separate election-related development, Gov. Gavin Newsom signed a new law Wednesday barring local police from seizing ballots from election officials.

The law was rushed through the Legislature after Riverside County Sheriff Chad Bianco, who is running for governor, seized more than 600,000 ballots from the county registrar of voters earlier this year. Bianco said the action was part of a “fact-finding mission” into election accuracy, though he did not present evidence that the ballots had been improperly cast.

The new law took effect immediately, ahead of the June 2 primary. It prevents county registrars from turning over ballots or voting equipment to law enforcement and reaffirms that the attorney general, secretary of state or county election officials can sue any person, business or entity that takes ballots from an election official’s custody.

“We have to step up, and we have to draw the line,” Newsom told reporters. “We have to clarify the rules of engagement. It’s a warning to the folks out there that think they can do the bidding of the Trump administration.”

California lawmakers also are considering a proposal aimed at helping young people affected by gun violence, including in San Bernardino County.

The bill would create a pilot program offering free mental health and counseling services to young people who were shot, witnessed a shooting or lost a family member to gun violence. The program would serve youth in Alameda, Los Angeles, San Bernardino and Solano counties.

Nicole Kravitz-Wirtz, an associate professor with the Centers for Violence Prevention at UC Davis, said young shooting survivors often receive treatment for physical injuries but are left without a clear path to continuing mental health care.

The Assembly advanced the bill to the Senate on Tuesday. However, the proposal does not yet include a funding source. A legislative analysis estimated the grants would cost about $7,800 per survivor each year.

Original source: CalMatters

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The Public Policy Institute of California survey found Becerra, a former congressman, California attorney general and Biden administration cabinet secretary, leading among likely voters with 23%. Hilton, a former Fox News commentator, follows at 20%.

Under California’s top-two primary system, the two candidates who receive the most votes in June advance to the general election regardless of party. If the poll reflects the final outcome, Becerra and Hilton would face each other in November.

The numbers also point to a difficult fall campaign for any Republican who makes the runoff. PPIC has repeatedly found Democrats with nearly twice the voter support of Republicans statewide, a trend that appears to favor Becerra if he secures a November spot.

The survey marks a dramatic turn in a race that for months lacked a clear front-runner. Becerra had not been a dominant presence early in the campaign, but his standing improved sharply after former U.S. Rep. Eric Swalwell ended his campaign amid sexual misconduct allegations that later led to his resignation from Congress.

Billionaire Democrat Tom Steyer remains in third place in the PPIC poll with 15%, despite spending nearly $200 million on advertising, including sharp attacks aimed at Becerra. Riverside County Sheriff Chad Bianco, a Republican, is at 13%, followed by former Rep. Katie Porter at 12%.

Bianco’s standing is of particular interest in Inland Empire politics. Earlier in the campaign, some Democratic strategists worried that Hilton and Bianco could both finish ahead of the Democratic field, potentially shutting Democrats out of the November contest. Becerra’s rise has largely eased those concerns, though the possibility helped revive debate over California’s primary rules.

Some Democrats are now supporting an effort to repeal the top-two system and return to party primaries. Voters approved the current system in 2010 after then-Gov. Arnold Schwarzenegger and Democratic legislative leaders placed the measure on the ballot as part of a budget agreement. Supporters argued it would encourage candidates to appeal to a broader electorate and produce more moderate elected officials.

Party leaders have long been uneasy with the system, but PPIC’s latest findings show voters remain generally supportive. The institute reported that about six in 10 voters are satisfied with the choices in the governor’s race and believe the top-two primary has mostly benefited California since its adoption.

The primary began with an unusually crowded field, with 61 names on the ballot and roughly a dozen candidates considered serious contenders. Several prominent Democrats who might have entered the race — including former Vice President Kamala Harris, U.S. Sen. Alex Padilla, Attorney General Rob Bonta and Lt. Gov. Eleni Kounalakis — did not run. Kounalakis initially filed for governor but later shifted to a campaign for state treasurer.

Swalwell had been viewed as an early leader before suspending his campaign in April after the San Francisco Chronicle reported allegations of sexual assault from women. Additional reports followed, and he later resigned from Congress.

Porter and San Jose Mayor Matt Mahan were also expected to be competitive, but neither has gained enough traction in the latest polling to break into the top tier. Steyer has stayed within striking distance through an aggressive advertising campaign, but the PPIC results suggest his spending has not pushed him into one of the top two spots. His campaign rejected the poll’s findings, describing the survey as an outdated snapshot of the race.

Original source: CalMatters

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In accordance with President Biden’s Competition Executive Order, CMS is further strengthening its efforts to increase price transparency, holding hospitals accountable and ensuring consumers have the information they need to make fully informed decisions regarding their health care.

“As President Biden made clear in his executive order promoting competition, a key to price fairness is price transparency,” said HHS Secretary Xavier Becerra. “No medical entity should be able to throttle competition at the expense of patients. I have fought anti-competitive practices before, and strongly believe health care must be in reach for everyone. With today’s proposed rule, we are simply showing hospitals through stiffer penalties: concealing the costs of services and procedures will not be tolerated by this Administration.”

“CMS is committed to addressing significant and persistent inequities in health outcomes in the United States and today’s proposed rule helps us achieve that by improving data collection to better measure and analyze disparities across programs and policies,” said CMS Administrator Chiquita Brooks-LaSure. “We are committed to finding opportunities to meet the health needs of patients and consumers where they are, whether it’s by expanding access to onsite care in their communities, ensuring they have access to clear information about health care costs, or enhancing patient safety.”

The proposed rule includes the following actions:

Price Transparency

Hospital price transparency helps Americans know what a hospital charges for the items and services they provide. CMS takes seriously concerns it has heard from consumers that hospitals are not making clear, accessible pricing information available online, as they have been required to do since January 1, 2021.

CMS proposes to increase the penalty for some hospitals that do not comply with Hospital Price Transparency final rule. Specifically, CMS is proposing to set a minimum civil monetary penalty of $300/day that would apply to smaller hospitals with a bed count of 30 or fewer and apply a penalty of $10/bed/day for hospitals with a bed count greater than 30, not to exceed a maximum daily dollar amount of $5,500. Under this proposed approach, for a full calendar year of noncompliance, the minimum total penalty amount would be $109,500 per hospital, and the maximum total penalty amount would be $2,007,500 per hospital.

Based on information that hospitals have made public this year, there is wide variation in prices – even within the same hospital or the same system, depending on what each insurance plan has negotiated with that hospital. CMS is committed to ensuring consumers have the information they need to make fully informed decisions regarding their health care, since health care prices can cause significant financial burdens for consumers.

Health Equity

CMS is seeking input on ways to make reporting of health disparities based on social risk factors and race and ethnicity more comprehensive and actionable. This includes soliciting comments on potential collection of data, and analysis and reporting of quality measure results by a variety of demographic data points including, but not limited to, race, Medicare/Medicaid dual eligible status, disability status, LGBTQ+, and socioeconomic status.

Access to Emergency Care in Rural Areas

Since 2010, 138 rural hospitals have closed – disproportionately within communities with a higher proportion of people of color and communities with higher poverty rates. Rural communities experience shorter life expectancy, higher mortality, and have fewer local providers, leading to worse health outcomes than in other communities.

Rural hospital closures deprive people living in rural areas of crucial services, including access to emergency care. To address these concerns, Congress enacted Section 125 of the Consolidated Appropriations Act of 2021 (CAA), which establishes a new provider type for Rural Emergency Hospitals (REHs). REHs will be required to furnish emergency department services and observation care and may provide other outpatient medical and health services as specified by the Secretary through rulemaking. In this proposed rule, CMS is requesting information to inform the development of requirements that would apply to Rural Emergency Hospitals (REHs). This new provider designation will apply to items and services furnished on or after January 1, 2023.

CMS is seeking feedback on a wide-range of issues to help inform policy proposals for the CY 2023 rulemaking cycle, including feedback on the potential services to be provided by REHs; health and safety standards and quality measures to be established for REHs; and payment provisions for this provider type.

COVID-19 Lessons

To incorporate lessons learned from the COVID-19 pandemic, CMS is seeking comment on the extent to which hospitals are using flexibilities offered during the COVID-19 public health emergency (PHE) to provide mental health services remotely and whether CMS should consider changes to account for shifting practice patterns. In addition, CMS is proposing changes to measure how many of our nation’s front-line healthcare workers in hospital outpatient departments and ASCs are vaccinated against COVID-19, and to make this information available to the public so consumers know how many workers are vaccinated in different health care settings.

Improving Patient Experience and Outcomes

The Radiation Oncology (RO) Model aims to improve the quality of care for cancer patients receiving radiotherapy and move toward a simplified and predictable payment system. The RO Model tests whether prospective, site neutral, modality agnostic, episode-based payments to physician group practices, hospital outpatient departments, and freestanding radiation therapy centers for radiotherapy episodes of care reduces Medicare expenditures while preserving or enhancing the quality of care for Medicare beneficiaries.

CMS is proposing changes to the RO Model, which aim to improve the experience of patients receiving radiation treatment, while incorporating evidence-based best practices to help providers improve patient outcomes.

Patient Safety

CMS is increasing Medicare beneficiary safety by reversing changes made for 2021 regarding the care setting for which Medicare will pay for surgical procedures that may pose risk to patients.

Specifically, the agency is proposing to halt the phased elimination of the Inpatient-Only (IPO) list—procedures that Medicare will only make payment for when provided in the inpatient setting. There are some services designated as inpatient only that, given their clinical intensity, would not be expected to be performed in the outpatient setting. CMS adopted a policy for 2021 to eliminate this list over a phased period and removed musculoskeletal procedures from the list in 2021.

This change happened without individually evaluating whether the procedures met the long-standing criteria previously used to determine if a procedure could be safely removed. Some of the musculoskeletal services removed includes services like limb amputations and invasive spinal procedures.

CMS reviewed each procedure code of services that were removed and found none met criteria for removal, with insufficient supporting evidence that the service can be safely performed on the Medicare population in the outpatient setting.

CMS is proposing to add them back on to the list in 2022, and is seeking comment on whether to maintain the longer-term objective of eliminating the IPO list, maintaining the IPO list, or maintaining the list but continue to streamline the list of services. The latter would continue systematic scaling of the list back to ensure inpatient-only designations are consistent with current standards of practice.

CMS is also proposing to reinstate the patient safety criteria it uses to evaluate whether a procedure should be payable in the Ambulatory Surgery Center setting that were removed in 2021. CMS is proposing to adopt a nomination process whereby the publicly can formally nominate procedures it believes are safe to perform for the Medicare population in the ASC setting.

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For a fact sheet on the Calendar Year (CY) 2022 OPPS/ASC Payment System proposed rule (CMS-1753-P), please visit: https://www.cms.gov/newsroom/fact-sheets/cy-2022-medicare-hospital-outpatient-prospective-payment-system-and-ambulatory-surgical-center

The OPPS/ASC Payment System proposed rule is displayed at the Federal Register, with a 60-day comment period. The proposed rule can be downloaded from the Federal Register at: https://www.federalregister.gov/public-inspection/current

cms.gov • Contributed

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