Endorsement: No on Proposition 35. Let the Legislature figure out how to fund Medi-Cal.

When Californians are investigating how they should vote on the often complex statewide ballot measures with which we are presented every other November, it can help to take a look at who is supporting and who is opposing an issue.

Which is often a case study in the old legal, and political, adage: Follow the money.

This is especially the case when the measures involve some genuine complexities out of the realm of issues voters may already know where they stand on — rent control, say, or cleaning up pollution.

When it comes to the intricacies of the way funding is provided for the state’s Medi-Cal health care services, many of us could be forgiven for being at sea about the ways that happens, and so confused about a proposal that would change where that funding comes from.

When looking at this upcoming ballot’s Proposition 35, entitled “Provides Permanent Funding for Medi-Cal Health Care Services — Initiative Statue,” we can easily find that supporters include  private ambulance companies, and Planned Parenthood, and easily deduce that this support comes because of guaranteed funding for those entities contained in the bill.

There are also doctors’ groups, especially specialized ones, including the American College of Obstetricians & Gynecologists, and the American Academy of Pediatrics, listed as in support.

But sometimes the most telling endorsements, or announced opposition, can come from groups who confound expectations in their stances.

The California League of Women Voters, for instance, is generally considered to be a liberal group, which ordinarily would be expected to support initiatives that expand access to health care for Californians.

But the League has come out strongly against Proposition 35, which it describes as “a well-meaning but misguided effort to try to provide more and steady funding for Medi-Cal and potentially improve reimbursement rates for medical providers.”

The group also provides a helpful synopsis of what the initiative would do, which, in a reading of the proposal and even in conversation with its proponents, as the editorial board had, can be hard to understand: “Prop. 35 would change the temporary tax that helps fund Medi-Cal to a permanent tax on Managed Care Organizations (MCOs) and require the tax proceeds to be used to support only Medi-Cal and other health programs.”

That sounds reasonable enough, on its face. But the League quickly comes to the chase, noting that such a police change would involve “making that money unavailable for other priorities and making it difficult to respond to future changes to Medi-Cal that might be mandated by the federal government.”

The League also notes that it is generally opposed, as are we, to “ballot-box budgeting, which limits the Legislature’s flexibility to make budgetary decisions and adjust priorities based on emerging and essential needs. Budgetary decisions should be made by the Legislature, not by earmarking funds through ballot initiatives.”

There are other reasons to vote no on 35. For one thing, the federal government has to approve it, and may not if there’s a change in administration. Then there’s the “Health Care Workers Account,” with the requirement that 25% of the money in the account “shall be deposited in the Medi-Cal Workforce Subaccount” where it can be used for “recruiting and retaining workforce.” That’s pay raises for union members that would be locked in by the ballot measure.

Then there’s a worrisome clause in a sentence in the initiative’s language: “By expanding California’s capacity to produce its own generic prescription drugs …” Forgive us for our skepticism about the state of California’s ability to successfully produce something as complicated as an effective prescription drug.

And then there’s the “Stakeholder Advisory Committee.” No government agency or department can implement any part of this law without first “consulting” with and obtaining “witten input from” the Stakeholder Advisory Committee.

This thing sounds like the wrong way to fix the Medi-Cal funding problem. Vote no on Prop. 35.