When lawmakers feel they have no boundaries, as is the case in California, ideas that would have little to no chance elsewhere not only get a hearing, but become law. This explains how the mere thought of hiking the minimum wage for health care workers and support staff to $25 an hour was ultimately, and almost inevitably, converted into a bill.
Some would no doubt benefit from the higher pay. But their windfall would also be a loss for their coworkers and patients.
Democratic Sen. Maria Elena Durazo, author of Senate Bill 525, passed 21-11 by that chamber at the end of May, called the legislation “critical.”
“Higher wages,” she said, “will help restore health care jobs to the status of a job in which a person can support a family.”
So if boosting the minimum wage for health care workers nearly $10 higher than the current minimum wage is a fine idea, why wasn’t it done long ago?
Maybe because someone pointed out how it would impact jobs.
If SB 525 becomes law and health care employers are required to pay workers $21 an hour starting June 1, 2024, then $25 an hour beginning on June 1, 2025, we should expect that there will be fewer workers in the field as each worker becomes more unaffordable. The winnowing will begin as soon as the bill is signed into law.
When not finding ways to trim staff, employers will let open positions go unfilled. It’s the same with every minimum wage increase, even small ones. They’re job killers, and the bigger the wage boost, the bigger the death toll.
The official line from the Service Employees International Union, which represents nurses and other health care employees, is that lawmakers “listened to health care workers” and “heard the truth about” how they “are exhausted and burned out,” and how short staffing has caused the “double and triple work” that has left patients “waiting to get the care they need.” This fully ignores the reality that forcing employers to pay workers more has never resulted in a hiring frenzy.
In some cases, employers will have no choice but to increase their payrolls. They can lay off only so many workers or let so many positions go unfilled. Don’t expect them to fully absorb the higher costs, though. They will pass them on to patients, or third-party payers. In other cases, suddenly unprofitable facilities will be closed, leaving patients with fewer choices; longer drives; a shortage of emergency care options, specialty services and diagnostic testing; and providers they’re not familiar with and who are not familiar with them.
Rural communities are especially vulnerable to clinic closures for a number of reasons. One, when they lose health care facilities, it becomes more challenging for them to attract employers. Two, the sick, and the healthy who occasionally need to see a doctor to stay that way, run short of alternatives. In many cases, the results are devastating.
“It’s the worst thing that could have happened to us,” small-business owner Tony Camarena said of the recent loss of Madera County’s only hospital.
This potential of a cascade of medical facility closures has occurred to Sen. Dave Min, a Democrat from Orange County. He has “deep concerns that this bill may end up causing health care facilities to exit the state, to go out of business, at a time when we really need them.”
Like so many other bills, SB525 is a gift to organized labor. Unionized nurses already earning more than $25 an hour could use the new law to leverage higher pay, using the “prevailing wage” argument as wages around them rise. An army of others who would benefit include: those involved in “technical and ancillary services; janitorial work; housekeeping; groundskeeping; guard duties; business office clerical work; food services; laundry; medical coding and billing.”
Also on the list are call center and warehouse workers, as well as schedulers. Even gift shop workers, “where such services directly or indirectly support patient care,” would get a raise.
If “there is no reason, no inherent greater value, in justifying treating a janitor working in the health care industry differently from other janitors,” as Pepperdine University economist Gary Galles points out, then why are these custodial jobs, and so many other peripheral occupations, covered by the bill?
Most likely, says Galles, to extend “the political power of nurse unions to others working in health care, in order to unionize those jobs.”
Politics are just that simple in California.
Kerry Jackson is a fellow with the Center for California Reform at the Pacific Research Institute.
