California voters have approved a ballot measure that makes permanent a fee on hospitals that helps fund Medi-Cal, the state's health insurance plan for people with low incomes.
Proposition 52 is winning with 70 percent of more than 4 million votes cast. The measure was proposed by hospitals, which spent more than $60 million to promote it.
The fee currently draws $3.5 billion a year in federal matching funds and forms a major source of funding for Medi-Cal.
It is routinely renewed by the Legislature but requires support from a two-thirds supermajority of lawmakers. Hospitals say permanently extending it ensures the funding source is protected from politics.
A union representing health care workers opposed the measure, saying it benefits wealthy hospital executives.