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California Gov. Jerry Brown. Photo: Stephen Lam/Getty Images

Even in California, one of the nation's most liberal states, industry pressure and moderate lawmakers have stymied ambitious efforts to control health care costs.

Why it matters: As the national Democratic Party swings left on health care, California shows that even with strong liberal majorities, it's still an uphill battle to successfully chip away at the health care industry's bottom line.

Details: Even aside from California's failed single payer bill, more substantively realistic proposals have hit roadblocks, too.

  • The biggest of these was a controversial bill that would have regulated prices for health care services within the private insurance system.
  • That bill passed through committee in the state assembly, but then was shelved. It faced fierce opposition from doctors and hospitals, but the bill's sponsor said that he'd draft a new version of the bill next year, per the LA Times.
  • Carmela Coyle, president and CEO of the California Hospital Association, told reporters last week that it's unlikely that lawmakers will come up with a bill that's palatable to hospitals.
  • "Any attempt to control prices will bring the health care industry out in force," the Kaiser Family Foundation's Larry Levitt said. "Politically speaking, there likely needs to be some counterweight to hospitals and doctors for that effort to succeed."

An ambitious bill to cap dialysis payments also died, after Gov. Jerry Brown vetoed it late last month. The dialysis industry is now working to defeat a related ballot initiative that would cap dialysis clinics' profits.

There are exceptions. California has passed laws regulating pharmacy benefit managers, requiring a justification for prescription drug price hikes above a certain amount, and creating more oversight of health plan mergers.

Yes, but: California has so far had a lot more success expanding coverage and defending the Affordable Care Act than in controlling costs — widely seen as the next big health care debate.

  • The state has banned short-term health plans, and limited the use of association health plans.

What's next: California lawmakers will likely continue to duke it out over high-profile efforts like the all-payer bill, but they will also continue to focus on coverage-related issues, like increasing the Affordable Care Act's subsidies.

  • “The big question, I think, is going to be, how do discussions happen in the next two years to lay the groundwork for...the next administration federally?" said Covered California's Peter Lee. "Whether or not California pulls out its wallet...we’ll see. Will that information help thinking for 2020 and beyond? We think so.”
  • Some advocates are also hoping for a big change from Gavin Newsom, who's expected to win the governor's race this year. Newsom is seen as more liberal than Brown.

"There are now high expectations for what a new governor might do beginning next year," Levitt said.

Go deeper

Scoop: Former OMB director to set up Pro-Trump think tanks

OMB Director Russ Vought parfticipates in a photo-op for the printing of President Donald Trumps budget for Fiscal Year 2020 at the Government Publishing Office in Washington on Thursday, March 7, 2019. (Photo By Bill Clark/CQ Roll Call)

Russ Vought, who led Donald Trump's Office of Management and Budget, plans to announce two pro-Trump organizations Tuesday, aiming to provide the ideological ammunition to sustain Trump's political movement after his departure from the White House.

Why it matters: The Center for American Restoration and an advocacy arm, America Restoration Action, will try to keep cultural issues that animated Trump’s presidency on the public agenda, according to people familiar with the matter.

Janet Yellen confirmed as Treasury secretary

Janet Yellen. Photo: Alex Wong/Getty Images

The Senate voted 84-15 to confirm Janet Yellen as Treasury secretary on Monday.

Why it matters: Yellen is the first woman to serve as Treasury secretary, a Cabinet position that will be crucial in helping steer the country out of the pandemic-induced economic crisis.

Dan Primack, author of Pro Rata
4 hours ago - Economy & Business

Scoop: Red Sox strike out on deal to go public

Illustration: Sarah Grillo/Axios

The parent company of the Boston Red Sox and Liverpool F.C. has ended talks to sell a minority ownership stake to RedBall Acquisition, a SPAC formed by longtime baseball executive Billy Beane and investor Gerry Cardinale, Axios has learned from multiple sources. An alternative investment, structured more like private equity, remains possible.

Why it matters: Red Sox fans won't be able to buy stock in the team any time soon.

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